• Perform User Acceptance Testing (UAT), test, plan, timeline, and peer script reviews• Schedule and prioritize work and activities to meet target schedule, quality, scope, and cost objectives• Work closely with customer to develop requirements for major projects of considerable complexity• Communicate testing progress, issues, results, and other relevant information to project stakeholders/team and management• Attend various type of meetings on a weekly basis with project teams to develop business acceptance criteria and provide testing status• Develop test documentation including, but not limited to, test scripts, cases, plans, timelines, and scenarios for projects• Document test case execution, test results and defects in detail• Diagnose, track, and manage testing issues and defects to resolution• Review and analyze back end SQL data of various healthcare enrollment files specific to member eligibility• Provide final UAT sign off for any new QNXT system deployments

Respond to eligibility inquiries originating from various departments such as case management, claims, member services, provider services, waiver specialist, business analystResponsible for reconciliation of multiple daily and month end eligibility reportsIdentify data issues and analyze member records are loaded correctly into QNXTWork closely with IT to validate system data fixes and code deploymentsCoordinate with transmission and receipt of plan data to and from CMS/DHS for CA, MI, OH, SC,TX, IL

Past participant of the change review board responsible for reviewing and providing feedback on company wide policies and procedures impacting multiple departments

Reviewed provider claim submissions for billing errors or processing issues and provide efficient resolutions.Provided recommendations for the best outcomes of processing a claim or submitting an appeal.

Responded to telephone inquiries from providers and members regarding eligibility, benefits, complaints/grievances, claims/billing issues, appeals submissions and authorization of services in a timely and efficient manner, treating them with respect and courtesy

Research Policy Related to Community Benefit Assisted with development of Annual Community Benefit Strategic Plan Support Implementation of Community Benefit Inventory for Social Accountability System Conduct community benefit outreach and attended various health executives forums & networkingevents

● Raised over $1.1 million dollars in FY 2011-2012● Promoted to supervisor after 3 months of successful fundraising and awarded “Most Valuable Caller” within first month of employment● Managed 60 customer service agents● Evaluated candidates’ strengths versus organizational requirements including monitoring and coaching of effective cold calling techniques● Assessed and investigated caller’s related problems, and conducted performance counseling, coaching, and ● Worked with senior management team to achieve strategic and operational goals● Facilitated trainings and developed scripts used for various call scenarios

• Updated and developed human resources policies and procedures• Recruitment and hiring including background screening, and reference check, posting of job ads,and closing of filled positions• Developed recruiting and networking strategies to recruit qualified candidates across the WestRegion• Represented the organization in job fairs by ensuring promotional information was substantive,concise and well organized to convey a general impression of quality and professionalism