Selected Contributions: Strategically leverages a prominent insurance company's assets to engage communities and measurably improve the health, economic, social and/or environmental quality of life.Led a team of Community Health Workers responsible for identifying SDoH barriers and providing corresponding resources to address them, ultimately improving health outcomes for members. Actively involved in initiative planning, ensuring that project objectives are met and align with client needs and expectations.Managed ongoing client relationships, ensuring high levels of satisfaction for assigned initiatives that impact the delivery of healthcare products and services.Collaborated with external vendors, consultants, and internal consulting team members to support initiatives, leveraging their expertise and resources as needed. Accountable for transferring knowledge, best practices, methodology, and tools to client organizations, promoting continuous improvement and excellence. Served as a team leader for concurrent initiatives and projects of varying complexity, effectively managing resources and deliverables.Supported holistic solutions and key strategic plans, aligning project goals with overall organizational objectives.Proactively identified opportunities for improvement within assigned initiatives, making data-driven recommendations to enhance efficiency and effectiveness.Led due diligence for 20+ Blue Cross Blue Shield of Illinois community investment projects, increasing care coordination outcomes by 10%.Organized HEDIS-aligned events, boosting community engagement & participation. Leveraged marking & social impact engagement strategy to improve community investment effectiveness by 12% and implemented three new programs in health equity and SDoH.

Spearheaded claims submissions between healthcare providers and veteran affairs (VA) in order to assist Veterans in obtaining disability for conditions related to active service.Diligently reviewed and finalized veteran disability claims, achieving a 98% accuracy rate and expediting overall benefit disbursement by 12%.

Organized community health events and engagement strategies for a women’s reproductive health technology startup leading to a 32% increase in ROI.Orchestrated digital & in person events and strategy to increase user engagement, brand awareness, and corporate sponsorship.

Serving as the customer’s primary point of contact providing operational and reimbursement support to complex programs within Covance. Conducted insurance research on behalf of patients to determine if they are eligible for prescribed therapy.Documented calls in appropriate tracking system, handle/escalate calls per established guidelines and procedures. Contacted medical insurance companies to help them understand and navigate the complexities of insurance coverage for a prescribed therapy.

Managed day to day activities, intake, and policy for provider support requests and deliverables across multiple communication channels i.e. Phone, Fax, Chat, email, etc. Determining Patient eligibility for copay assistance program, including educating patient on copay criteria, reading verbal copay consent and enrollment. Perform intake of cases and capture all relevant information in the Access 360 Case Management system Serve as a resource for Health Care Providers and patients and use regional reimbursement, distribution and payer policy expertise to provide solutions for complex patient access situations, working closely with the PAA team to appropriately escalate/resolve issues

Leveraged expertise and customer service skills to provide pharmaceutical case management to members in need of additional resources for obtaining medicationIndependently analyzes, reports, and communicates any reimbursement trends/delays (e.g. billing denials, claim denials, pricing errors, payments, etc.).Processes any necessary insurance/patient correspondence, and escalated complaints accordinglyProvides all necessary documentation required to expedite payments. This includes demographic, authorization/referrals, National Provider Identification (NPI) number, and referring physicians.Maintains confidentiality in regards to patient account status and the financial affairs of clinic/corporation.

Successfully managed existing accounts, and collaborated with major health insurance providers to calculate patient out-of-pocket expenses. Researched payers to identify existing contracts, determine if particular specialty products were covered by a contract or coverage policy, & determine the best step is to take if no coverage policy is in place Defined claim submission requirements including method of submission (electronic/paper), format, codes, wording, etc. unless otherwise defined by payer.Verifies patient specific benefits and precisely documents specifics for various payer plans including patient coverage, cost share, and access/provider options according to Program specific SOPs

Successfully completed internal compliance/financial audits in order to assess departmental deficits, profits and identify future goalsInterviewed cashiers to identify gaps in knowledge and training.

Monitored per cap/cost of sales and was responsible for maintaining all aspects of training, salesmanship, displays, stock levels and cleanliness.Ensured that all labor loss were recognized and enforced appropriately.Leveraged interpersonal skills by managing employee workflowManaged inventory to ensure that stock was readily available at any given time, for a diverse range of population.Aided in closing sales and providing customer service to visitors in the games departmentImplemented care plans that support Six Flag’s mission of “friendly, clean, safe, fast service”.