Served as a consultant for departments and units evaluating, planning, and implementing improvements in processes, practices, and organizational effectiveness.• Collaboratively worked on teams of 25+ and stakeholders at all levels in the organization • Possess a solid understanding of process/workflow concepts and standards.• Created and maintain process flows through consultation with subject matter experts. • Strong knowledge of Medicaid state requirements such as Florida, Kentucky, Ohio and Louisiana• Analyzed daily metric reports to ensure ID Cards stay in compliance based on state contracts.• Maintained the P&Ps for the team.

Collaborated with business stakeholders across the organization to understand reporting needs, develop plans to address those needs, and delivered reports to meet those needs.• Composed and update process flows using Microsoft Visio• Coordinated yearly process review/updates for the over 250 Mentor topics for the Government Programs Account Setup team (GPAS)• Managed SharePoint Online sites for Medicare operations • Built and maintain workflows in Power Automate, InfoPath, and Lesson Learned

Worked the End-to-End dials and alerts by collecting & analyzing multi-faceted data using advanced tools. Wrote all the process flows for the team.• Audited letters for approval before release• Assisted with testing of new letters and new processes• End to End daily monitoring of enrollment dials and alerts.• Liaison between enrollment and IT for issues with End to End• Trained new associates on work content specialist and End to End• Drafted, simplified, and updated process flows using Microsoft Visio

Worked directly with Maximus Federal Services to resolve the issues surrounding member’s late enrollment penalties.• Responded to inquiries, calls, and cases in a timely manner, while maintaining at least 99% QA• Screened incoming cases from Maximus, managed and delegated workload to teams of 25.• Followed all guidelines and procedures to retain all relevant documentations pertaining to the appeal to build cases.• Successfully inputted data pertaining to Maximus final decisions• Completed task management projects as requested by department supervisor.

Administrative in Claims and Benefits for the call center specializing in Med Member, Providers and Agents for Medicare Private-Fee-For-Service (PFFS), Health Maintenance Organizations (HMO), Preferred Provider Organization (PPO), and Medicaid.• Responded to inquiries, calls, and cases in a timely manner, while maintaining at least 99% QA• Effectively researched, diagnosed, and organized to resolve customer issues using one call resolution.• Under recommendation of Leadership, performed peer-to-peer training with team associates.• Exceeded department goals for compliance, availability, and quality with 100% pass rate.• Assist with our NEPD (National Education and Policy Development) to initiate a Mentor document to display what information should be on the members ID cards.• Processed claims that denied duplicates in error and added referral numbers when available to process the claim.

Manufactured tooling for plastic injection molds in distribution warehouse.• Managed plastic injection presses up to 720 ton with excellent quality.• Worked with Airline and Star robots, Nova Tec dryers and Rapid granulators.• Keyed Electronic Data Interchanges, release and forecast from the internet in AS400 system.• Preformed on-site visits with our customers to maintain communications.• Maintained all orders greater than 30 Tier one or Tier two customers.• Achieved 100% on time and quality shipments.• Maintained and implemented ISO/9000 (International Organization for Standardization)