• Provide day-to-day oversight of multiple departments, including Claims, Enrollment, and Underwriting with staff of up to 6.• Perform ongoing audits and monitor Third Party Administrators (TPAs) and Pharmacy Benefit Managers (PBMs) for correct claims processing and reimbursement. Communicate errors and collaborate with TPAs and PBMs to develop solutions. • Review and interpret state documentation related to program benefits and claims submission. Advise staff of policy changes and billing issues.• Develop and maintain financial operations documentation, including policies, procedures, and process workflows.• Work with outside vendors to ensure quality administration of individual and group health plans; including enrollment of members, claims payment, generating premium invoices, and benefit changes.• Reconcile Individual member Advance Premium Tax Credit (APTC), Cost Share Reduction (CSR), and premium payments.• Participated in creation of underwriting and new business functions resulting in acquisition of 27,000+ members.• Develop materials for new member welcome packets; including member ID cards, informational brochures, and new member hand book. • Managed transition to outside print vendor for production of new member welcome packets.• Assist with development of online small group quote tool, individual quote tool, individual online enrollment function, and internal member database.• Hire staff, provide annual evaluations, and encourage opportunities for occupational growth.

• Managed three departments: Membership, Sales Support, and Stock Room. Included all hiring, annual reviews, corrective action, and daily work flow between departments.• Maintained enrollment and eligibility information for over 150,000 members in several different lines of business: Medicaid, Commercial (HMO/POS), and Self-Funded.• Participated in multiple sub committees, especially those geared toward interpreting, communicating, and implementing Health Reform guidelines for members and groups.• Supervised the implementation of at least 50 new processes and procedures to ensure membership and sales support activities were effective, efficient, and capable of handling membership growth.• Administered TPA functions for McLaren Health Plan’s COBRA, Flexible Spending Account, and Dependent Care Account services.• Worked closely with commercial sales team and led all quoting activities in the Sales Support Department to increase commercial membership at the health plan.• Served as Qualified Health Plan (QHP) submission lead in 2014.

Manager of Insurance Operations (1999 - 2010)• Managed the daily operations of the third-party insurance administration department for Automobile Dealers Accessory Corporation, a subsidiary of MADA.• Supervised a team of 6 employees.• Allocated and forwarded monthly over $7M of insurance premium to appropriate carriers. Reconciled member accounts, oversaw processing of all member changes in Blue Cross Blue Shield of MI, Blue Care Network systems, and ADA billing systems.Director of COBRA Services (1998 – 1999)• Administered COBRA services program offered to participating dealer members, which included sending all notifications to potential COBRA subscribers, processing all member changes and reinstatements, customer service, and collecting, posting, and forwarding all premiums to carriers.• Maintained COBRA certification Account Service Specialist (1996 – 1998)• Processed all member changes in BCBSM, BCN, and ADA billing systems.• Reconciled accounts, accurately posted premiums, and maintained customer service and satisfaction.