Product documentation, business rules management, maintenance of product designs

Own and maintain the benefit descriptions, benefit interpretation and variations for all product lines for all Administrative and Medical policies and Benefits Display system. Participation in the development and initial configuration of the Benefits Display System as a “home grown” addition to the Amisys system that links data such that accurate member specific benefit information can be accessed by members, providers, employers and internal staff (including Member Services, Provider Relations, Sales and Marketing, Communications, Claims and Utilization Management).

Created, updated, filed, and tracked subscriber documents required for new and existing commercial products, ensured compliance with regulatory requirements, interpreted member benefits, and created and maintained effective relationships with state regulatory agencies and legal counsel.

Designed and evaluated modification of existing product lines, led the operational implementation of new and modified products, and ensured commercial product’s full compliance with New York State Insurance Law. Also analyzed key health care legislation and developed legislative review for customer distribution. Determined requirements and supervised the implementation of operational changes mandated by various health care legislation, including: the Managed Care Reform Act (MCRA), the Health Insurance Portability and Accountability Act (HIPAA), the External Appeal Law.

Responsible for renewals and new business proposals for large group accounts by developing competitive and adequate rates. Developed account-specific strategies to evaluate formulas, benefit and financial arrangements, competitive environment, etc., while achieving corporate goals.

Was employed by ConPharma prior to and during its purchase by American Home Patient. Provided a wide range of accounting services for 15 branch locations of this company handling rentals and sales of home health equipment, specializing in respiratory and IV support.

Provided accounting and Medicare/Medicaid cost accounting support for up to 26 nursing home facilities in the Southwestern United States.