Danielle Jackson Thorn, Ms Email & Phone Number

Pittsburgh, Pa, Us

Pittsburgh, Pa, Us

Passionate about connecting individuals to their next career opportunity and providing clients with stellar candidates in the areas of Human Resources, Supply Chain and Executive Administration for the Northeast US and Remote.

Remote

A stellar temporary employee in a variety of industries, for a variety of agencies in Pittsburgh Onsite and Remote. Provided temporary support in Leadership, Management Consulting, Market Research, Property Management, Human Resources, Call Center Setup, Remote Workforce Transition, Employee Recognition, Team Building, Incentives, and Strategy .

June 2000-December 2005 (early career start and experience in Member services -MA/MC/Commercial, Call QA/Training and Development/Special Project Internal Consultant specializing in Team Building, Incentives and Retention in Call Center and Operations teams)Complaints and Grievances Coordinator II (January 2017-November 2018)Acted in a management capacity during periods of short staffing to ensure that regulatory requirements were met.Created and oversaw development of policies, procedures, training programs, and other resources to ensure staff were adequately supported to maintain compliance with regulatory requirements. Analyzed trends and department data to identify opportunities to improve processes, educate, reduce costs and improve service to members.Investigated and resolved member and provider complaints, benefits appeals, and administrative appeals for Medicaid, CHIP and Community Health Choice. Appeals areas serviced include vision, dental, quality of care and service, pharmacy, and medical benefits appeals.Collaborated with internal areas to perform trend analysis; identified reasons for appeals and determine if a review of corporate policies, procedures, or product design was necessary. Participated in departmental audits in preparation of regulatory site visits. Participated in work groups to improve the process flow between complaints and grievances, as well as intake and member services to ensure the best quality and member and provider satisfaction.

Pittsburgh, Pennsylvania, United States

Master Of Science - Ms, Professional Leadership Specializing In Training And Development

Bachelor Of Arts - Ba, Communications/Theater