Jade Brantner Email & Phone Number

· Company thought leader. Influences senior leadership to adopt new ideas, products, and/or approaches· Subject matter Expert on Delegation and Value Based Reimbursement· Provide expertise and support to team members in research and analysis of new Delegation projects· Collaborate with Teams to ensure continuity and quality across implementations· Manage projects related to claims process and solutioning for Value-Based Reimbursement· Problem solving and troubleshooting to streamline processes and drive to optimal solutions within system framework· Facilitate development and roll-out of process documentation· Assist in identifying training and/or coaching opportunities for Core Operations· Collaborate with our business partners to better align workstreams and accountability owners to ensure smooth and timely project rollout· Share best practices, identify trends and process improvements with peers· Cultivate partnerships with key business partners to improve and refine the requirements and deliverable process· Align with various Business teams on project management, deliverables, timelines and reporting · Influence and support departmental blue chips & strategy

United States

· Primary point of contact for all Health Plans and business partners for benefit documentation and questions· Review state benefit source documentation and advise HP and business partners on suggested benefit coverage· Build out benefit model in source of truth repository tool to accurately reflect the intent of the plan/product· Detail and capture customer intent by providing proactive solutions to non-standard requests and problems by interpreting the state request and aligning appropriate resources· Work directly with state government officials and the health plans to gain clarity, review, and receive approval of benefits that are to be implemented· Research and remediate implementation issues and UAT defects that need greater benefit intent clarification· Participate in RFP, PRD, SSD and BAR processes for implementations· Assist Configuration Coordination Account Management Health Plan leads in benefit clarification, questions, and documentation requests· Accept, analyze, and respond to source of truth questions and inquiries· Routinely provide Quality Control oversight on the benefit source of truth repository· Participate in the build of benefit summary documentation that supports the call centers and web portals· Drive communication and feedback loop across upstream and downstream partners to ensure interdependencies are known and pipeline of activity is coordinated· Escalate delays and advocate for accuracy and timeliness of account configuration· Coordinate with functional teams to ensure project tasks and activities align with milestone deliverables· Provide recurring progress updates against core deliverables and implementation status to internal and external business partners and key stakeholders

United States

· Sought out as expert· Control point for all configuration changes/updates for benefits in each market· Manage benefit Source of Truth repository using various databases and / or source documents· Proactively identifies non-standard requests and potential problems and assists in documenting requirements and solutioning· Identify potential claim and / or customer service issues during implementations· Align with various Business teams on project management, deliverables, timelines and reporting · Consults with key business partners to ensure benefit intent is understood based on source documents· Mentor, coach, and motivate employees· Coordinate and lead project teams· Present information to senior leaders across the organization· Develop innovative approaches· Serve as a leader / mentor

United States

· Audit claims to ensure adherence to state and federal compliance policies, reimbursement policies, and contract compliance · Use pertinent data and facts to identify and solve a range of problems· Serve as a resource for others with less experience· Conduct 100% audits for newly implemented Lines of Business during Warranty period· Participate in User Acceptance Testing on RPAs implemented to streamline process flow and increase production· Consistently maintain Quality and Production Standards

United States

· Provided expertise claims support by reviewing, researching, investigating, and auditing Medicaid and Medicare claims· Ensured adherence to Health Plan guidelines and reimbursement policies· Analyzed information and utilize to build recommendations to reduce errors and improve process performance· Completed Root Cause analysis and ensure remediation is completed for identified issues· Served as subject matter expert to team members, supervisors, and management staff· Created Standard Operating Procedure Documents· Coordinated with business partners· Provided Focus Audit and internal and external audit support· Consistently maintained Quality and Production Standards

United States

· Provided expertise claims support by reviewing, researching, investigating, and auditing Medicaid and Medicare claims · Analyzed and identified trends and provided feedback to reduce errors and improve claims processes and performance· Served as subject matter expert to team members, supervisors, and management staff· Acted as a facilitator to resolve conflicts within team· Coordinated with business partners to obtain required information for audits· Consistently maintained Quality and Production Standards

United States

· Review and process Medicaid and Medicare claims to ensure timely and accurate payment· Consistently maintained Quality and Production Standards· OJT/Coach/Mentor for New Hire class· Observe and assist trainees to ensure that they comprehend the training administered· Demonstrated processes and procedures one on one and via Webex presentations· Audited trainees’ work for accuracy and provided recommendations for improvement· Tracked trainees’ weekly progress to identify any problem areas