Deana Rhoades Email & Phone Number

Bangalore, Karnataka, In

Plano, Tx, Us

Plano, Texas, Us

Plano, Texas, Us

Plano, Texas, Us

In my current role, I report directly to the Vice President, and am charged with serving as Thought Leader and driving go-to-market strategies for healthcare solutions including Artificial Intelligence, Robotic Process Automation, Implementation Services, Business Process Optimization Services, Business Process as a Service (BPaaS), Testing as a Service, and Governance as a Service. I also represent service offerings in key client meetings, and conduct sales and educational presentations on industry changes and challenges.Key Contributions:• Spearheaded development of robotics components of an innovative solution for a Blue Cross Blue Shield plan, which generated $365M BPO and Application Services contract to provide BPaaS to health plan. • Translated BCBS’s customer vision into deliverable solution, and designed initial solution architecture diagram that included business process outsourcing delivered globally, application services, consulting services, and analytics.• Served as key presenter at AHIP Medicare, Medicaid, and Duals conference; spoke on “Improving Star Ratings Utilizing Lead Indicators for Operational Metrics.” • Presented to Association for Community Affiliated Plans (ACAP) during the Encounter Data Submissions; presented “Tricks and Treats: Strategies for Getting Accurate Data from Providers.”

Round Rock, Texas, Us

In 2012, I was recruited to lead negotiations with BCBS of Michigan and secure contract to provide Business Process Outsourcing services for Medicare Advantage Premium Billing and Enrollment services. I performed as a solution architect for BPO services, responded to RFIs and RFPs, and developed go-to-market strategies and marketing materials. I also drove turn-around efforts for existing failing BPO accounts; conducted business assessments, identified root cause of issues, and led teams of business analysts in designing new processes to mitigate issues. Key Contributions:• Led successful pursuit of contract with BCBS of Michigan; and served as sole architect of Enrollment, Billing and Membership Reconcilitation operations delivery; hired and trained team, implemented workflow management system, led team in business requirements gathering, established Medicare compliance office function to support account, and delivered solution on-time and within budget. • Executed roll-out of Dell Business Process Management Suite toolset, which was in current use in India, to onshore account teams; trained teams in utilizing workflow system and wrap-around modules to optimize business processes, reduce FTE counts, and enhance productivity and quality. • Designed new global training program for Business Process Outsourcing group; retained technical training advisor and evaluated options for bridging onshore & offshore teams and devising single, unified knowledge management framework.

Menlo Park, California, Us

During this timeframe, I acted as sole system designer and manager of flagship product software tool sold to Medicare Advantage Health Plans, ikaMedicareGateway product, which automates Enrollment, Member Reconciliation, and Payment Reconciliation. I also supervised and mentored an 11-member team of Senior Business Analysts, Business Analysts, Product Specialists, and Compliance Specialists. Key Contributions:• Increased accuracy of membership, enrollment, and payment data with Reconciliation Module, and reduced application processing time up to 80% with Enrollment Pathways tool. • Onboarded 13 new clients, guided implementation team, and wrote functional specifications for enhancements or regulatory changes to software as Product Manager.

Pittsburgh, Pennsylvania, Us

During this timeframe, I served in a series of roles with UPMC Health Plan. Administrator, Medicare Compliance • March-December 2008I was promoted rapidly up through ranks; charged with preparing documentation for CMS audit elements including chapters related to benefits coordination and formulary, P&T, marketing, first-tier, and downstream contracts. Trainer, Enrollment & Premium Billing • 2006-2008In this position, I developed and rolled-out comprehensive training programs for Enrollment & Premium Billing departments on subjects such as accounts receivable, transactional systems, MS Office, and process training. I condensed a 4-week training course into 2 weeks while maintaining staff quality to handle crucial new-hire training during busiest enrollment season.Quality Facilitator, Government Programs Enrollment • 2005-2006At this time, I reported to Government Programs Supervisor and served in this newly created role, charged with designing Quality Program from ground up. I also served as SME on Medicare managed care manual regulations, and led a 12-member team in developing and managing the program.

Served in business operations roles within the Medical Records, Transcription and Medical Billing offices. Performed the role of MIS Help Desk Technician as an intern. Served as an administrator in an outpatient Behavioral Health facility.

Mba, Business Adminstration

Bs, International Business, Marketing

Japanese