• Developed and led a comprehensive data integrity strategy to enhance overall data quality and ensure regulatory compliance.• Guided cross-functional teams in delivering NCQA/HEDIS training, improving departmental compliance and member satisfaction.• Enhanced HEDIS audit processes through meticulous planning, improving audit success rates and operational efficiency.

• Supported efforts to improve member and provider satisfaction initiatives by conducting effective root cause analysis and implementing sustainable change for over two million members.• Led strategic and project initiatives while applying DMAIC and DMADV principles, resulting in improved consumer experiences for stakeholders to support business change and efficiency throughout the organization while considering enterprise goals, tracking KPIs, and adhering to project timelines.• Monitored mid to large-scale complex change initiatives for teams ranging from 5 to 15 individuals while considering organizational strategies, compliance with market laws, consistent application of business processes, updated training plans, and an improved consumer experience for all stakeholders.• Conducted cost and data analysis to recognize potential issues to drive thoughtful, data-driven recommendations for prioritization, solution design, issue management, risk identification, and mitigation.• Leveraged Microsoft Excel, Tableau, and analytical skills to examine data, develop visualizations, identify opportunities, and deliver recommendations for automation opportunities to support process optimization and growing business needs, reducing turnaround times by 10%.• Developed effective communication to provide key insights to the leadership team, concisely and accurately delivering critical messages with supporting data on the project's status.• Analyzed process gaps across the enterprise, and recommended process improvements and governance updates to ensure enhanced quality.

• Led cross-functional teams of 25+, managing multiple complex projects with end-to-end ownership, ensuring timely completion of critical deliverables, and promoting collaboration within diverse virtual teams.• Utilized solid project management skills to advocate for Sales, external clients, internal resources, and vendor partners to prioritize and launch health products in a client-facing role by leading groups of individuals to foster operational excellence and cultivate a thriving work environment with a 100% completion rate.• Received a 'Value in Action' award for success in tracking and prioritizing projects through client coordination by planning implementation milestones, documenting business requirements and project scope, monitoring activities in CRM tools, and communicating a project's status to minimize adverse conditions.• Developed action plans, managed a detailed project schedule by utilizing project plans, identified areas of improvement through business expertise, and mitigated risks while assuming full responsibility as the liaison for external clients.• Partnered with internal and external resources to define and track PGs and SLAs during the product's life cycle.• Assessed risks and escalated issues, while considering process improvements and recognizing opportunities for optimizing end-to-end processes.

• Researched, adjusted, and adjudicated Healthcare claims while maintaining high-qualitystandards.• Demonstrated operational support and examined claims thoroughly.• Conducted policy interpretation while consistently maintaining production goals.• Mentored associates by answering day-to-day questions and accurately teaching benefits and policies.