Kim Elston Email and Phone Number
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PMP certified professional with deep expertise in project implementation, process improvement and data analytics.
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Senior Manager Program ManagementAetna, A Cvs Health Company Feb 2023 - PresentUnited States -
Senior Risk Evaluation ProfessionalAuthor By Humana Jul 2020 - Aug 2022RemoteCreate and implement workstreams for Author Special Investigations (SIU) and Subrogation by managing project plans, RAID logs, escalations, and delivery of milestones. Create and maintain procedural documentation for case handling for each workstream. Identify and request system functionality to support workflows and participate in testing solutions. Create reporting capabilities and prepare monthly stakeholder reports. -
Senior Data & Reporting ProfessionalHumana 2014 - 2019Green Bay, Wisconsin, United StatesCreate consistent, repeatable processes for request intake, data analysis, documentation requirements, implementation and results monitoring. Participated in Lean Project for End-to-End process resulting in 10 process improvements to reduce waste. Track and trend audit results to optimize audit performance and increase savings opportunity. Maintain 100+ Prepay rules and Post-pay queries with a combined Hit Rate of 82% and savings of $16.7 million for 2018. Create and maintain 40+ process documents related to query and rule implementation, validation, monitoring and performance. -
Business Consultant-Special Investigations Unit (Siu)Humana 2009 - 2014RemoteImplemented CMS-mandated policy related to Opioid Overutilization review by defining the scope of review, implementing policy and procedures and coordinating required reporting for Opioid review. Participated in the National Council for Prescription Drug Programs (NCPDP) industry sub-team to ensure Opioid policy met objectives and to define industry response to CMS requirements. Mentored a team of seven SIU associates for the development of corporately approved SIU communications. Improved efficiencies by developing methodology for communication submissions to the corporate letter approval process and installed tracking mechanisms by creating a SharePoint site to facilitate SIU review cycle. Created and maintained the SIU Business Continuity Plan achieving a 98% score during disaster simulations.
Frequently Asked Questions about Kim Elston
What company does Kim Elston work for?
Kim Elston works for Aetna, A Cvs Health Company
What is Kim Elston's role at the current company?
Kim Elston's current role is Project Management Professional, PMP.
What is Kim Elston's email address?
Kim Elston's email address is ke****@****ana.com
Who are Kim Elston's colleagues?
Kim Elston's colleagues are Alyssa Gerlack, M.s., Jessica Thorburn, Pharmd, Bcps, Telly Woods, Judy Robles Rodriguez, Susie Venegas, Alan Delarosa, Melissa Friesl.
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