Cheryl Pelas Email & Phone Number

Florida, United States

Remote/Client on-site

• Monitored development/configuration work and quality testing to ensure that client deadlines were met.
• Troubleshot any “Bugs” reported by client to promote application functionality.
• Ensured software applications for client/healthcare companies met functionality and compliance needs for Utilization Management, Quality Review/Control, Customer Service, configuration of applications, member.
• Managed multiple projects simultaneously and approximately 100-150 incoming client emails and calls per day, consistently meeting deadlines while maintaining high standard of quality workmanship.
• Developed comprehensive documentation to support end-users and facilitate future enhancements.
• As part of BPaaS and Implementation Teams, represented company for on-site client visits for requirements gathering requirements and Go-Lives for implementation of HealthRules Payor.

Pensacola, Florida, United States

• Directly managed 10-15 Utilization Review and Case Management non-clinical staff members and assisted HS Manager in management of additional 10-15 Utilization Review and Case Management clinical staff members ensuring.
• Enhanced team performance and improved case turn-around time by implementing effective utilization management processes and strategies from 90% to 98% through staff training and optimizing resource assignments.
• Increased compliance with regulatory requirements by monitoring adherence to guidelines and protocols within UM department.
• Built strong relationships with external stakeholders such as hospitals, clinics, provider networks, and insurance carriers to facilitate seamless coordination in service delivery.