Lee C. Email & Phone Number

Fort Mill, Sc, Us

Identify and addressing operational and technological risks within the business.Maintaining, testing, and improving business and systems operationsBuilding and maintaining relationships with key business partners.Lead or participate in multiple projects by completing and updating project documentation;managing project scope; determining daily priorities; ensuring efficient and on-time delivery ofproject tasks and milestones, following proper escalation paths.Assist with identifying and capitalizing on improvement opportunities.Assist with identifying innovative ways to increase member satisfaction and compliancewith MS regulationsEnsure that targets and deadlines are met.Communicating ideas and viewpoints to senior management.Acting as a liaison between business and IT groupsCreating several monthly performance reports.Monitor, analyze and ensure operational compliance Operations include but are notlimited to: Enrollment, Member Communications, Health Risk Assessments, Claims, etcResearch, track and resolve escalated issues regarding these programsHigh proficiency with all Office Apps (Excel, Access, Power Point) and ability to createcomplex formulasAdvanced programming skills and data mining (SAS, Tableau, Aginity Workbench for Hadoop, SQL)Experience on data visualization and data translation with Analytical tools like Tableauand Power Bl.

• Managed projects/campaigns and letters according to turn around time expectations to assure accurate financial reporting.• Ability to problem solve including multiple priorities and research conflicting and/or inaccurate data.• Working knowledge of relational databases, database structure and ability to maintain database of information for each letter campaign (this equates to dollar savings opportunity). • Analyzed, reviewed, forecasted, and trended complex data and report results to team and clients.• Ability to present analysis and interpretation of data for operational and business review and planning.• Dashboard reporting and other external customer reporting as needed.Key Accomplishments:In six months of working I have accomplished 12 completed letter campaigns which normally would have taken a year to complete. The results were positive as it has a large dollar amount in savings for the organization. My dedication in problem solving and understanding to use different applications allowed me to be extremely versatile.- How I was able to meet this accomplishment was understanding the organizations savings model. I also used company provided online lessons to really dive in and understand how these savings benefit. The savings are based of paid claims which is money that can no longer be recouped by my team. What I did was to dive into Data Mining algorithms to look for areas of opportunity. I also was able to work in SAS Enterprise Guide to limit the multiple platform connections and do a one stop shop model for our data pull. By doing this it streamlined a process that would normally take longer in manual processes to cleanup in MS Excel. I let the SAS program do the heavy lifting of the manual cleanup that was normally done.

Charlotte, North Carolina, United States

•​Was responsible for the overall success of IT applicable testing, including results verification before team sign-off.•​Analyzed several types of data and processes, presented findings/recommendations in a professional manner.•​Ability to read, follow, and in many instances, debug Visual Basic for Applications (VBA) macro code, SQL or SAS EGP.s when errors occurred.•​Gathered business requirements for needs from various stakeholders to produce a report, dashboard or workflow process. Worked alongside various departments to accomplish the business needs from inception to completion. Key Accomplishments:Identified defects, improved departmental performances, and operational efficiency by providing metrics. This would maximize staff productivity for department leadership. Worked alongside with our Special Investigative Unit in preventing Fraud, Waste and Abuse by members or providers. I gathered data and analyzed areas of trends for concern.- This particular accomplishment was based off of years of experience in healthcare. By having the knowledge, I was able to make identifications that would not normally pair up in claims to be paid. There are certain services that go hand in hand and when an item is not part of it, I was able to highlight it and prevent fraud or waste. I either did this process for visualization purposes using MS Excel with conditions set to my inputs. I also was able to do this extracting information using SAS Enterprise guide. At times I could also uses SQL Server Management Studio to see certain tables based on CPT Codes.

Charlotte, North Carolina

•​Supervised a team of analysts working with ad-hoc daily, weekly, monthly and quarterly reports.•​Conducted interviews for positions available in the Informatics Department with mentoring highly motivated staff.Key Accomplishments:Successfully reduced failed authorizations for the Claims Dept. by 35% which resulted in profit for the organization.- Failed authorizations are a huge impact in healthcare organizations. When claims are not fully paid or partially paid on an authorization it creates abrasion with the servicing provider. By correcting claims, it ensures a positive outcome in both external relationships as well as financials. How does this profit an organization? It profits with staff doing proactive work instead of time invested in fixing errored claims. Also saving money for the organization by looking at an analysis if it is repeat providers possibly billing incorrectly.

Charlotte, North Carolina Area

•​Served as a Medical liaison with Information Services to ensure all MM/AG technical issues were handled effectively.•​Provided training for new hires on computer functions, telecommunication devices, Outlook, CCMS, Rightfax, and VPN.Key Accomplishments:Implemented a streamlined process to efficiently conduct new hire trainings. Management staff across the organization was pleased with the positive outcomes.- I took all the broken out separated pieces on new hire trainings and simplified it into one process. My concept started from when the new hire powers on the machine till the end of the day when they power it down. Walking them down the days process. Everyone learns at different ways and I needed the new hires to truly grasp what is it I was teaching them. I started my training as if everyone was a beginner. For those that may have been more advanced I would buddy them up with someone who wasn’t. This step helped out the new hires that would not want to ask a question in front of the class. By doing this streamlined approached I received kudos from the new hire and their managers. It also gives them a positive impact in the organization as a first impression.

• Created an Access Database for the Mary Kirkland Lupus Center and various projects to keep track of patient visits, vitals and vaccinations along with the extraction of captured data for needed reports. • Assisted the nurse manager in the logistics of maintaining all exam room equipment to be fully operable.• Maintained the Departments Intranet site by uploading documents and modifying the layout on an ad hoc basis.• Conducted group presentations and one to one teachings on how to use certain Microsoft applications, Word, Excel, PowerPoint, Access and Outlook. I also create for staff training manuals to make using various systems easy and user friendly.• Created time study reports to capture time in a patient’s daily process through the hospital system to evaluate later on where improvements are needed. Showing time stamps of areas on graphs, charts and PowerPoint presentations.• Collected data from various Nursing Departments to generate reports and graphs for senior management. • Monthly statistical and managerial reports• Clinical research reports• Various Nursing Departments custom service reports

• Reorganized staff structure to maximize daily work performances systems and business operations with a resulting $20K reduction in monthly operating costs, while generating staff increase in performance. • Supervised a staff of 20 employees to guarantee a daily work schedule has been completed.• Managed and maintained Sesame software, a billing, receivable and inventory database, by conducting routine backups and reconciled updated software application add-ons. Trained staff as well on new features of system and created user friendly manuals.• Proactive approach for a successful recovery in two months of start date to locate 200k in lost revenue. • Responsible for the day to day management of staff, dealing with all Human Resource related issues and resolved any staff conflicts that arose.• Implemented a simple Access Database to monitor corporate card spending activities and purchases.

• Checked interface reports for failed records on a daily basis and generated interface reports that described failed records in the system to management. • Developed a strong working relationship with MAXSYS system vendor for frequent upgrades and test stages.• Provided troubleshooting support for end users and trained staff on MAXSYS system while maintaining the integrity of the system, The Case Management database. Also created user names and strong user end passwords for MAXSYS as well as user friendly system manuals.• Extracted information from case management database to manipulate and customize service reports into MS Excel and Access. • Conducted payroll services for department using time sheet database.• Created Access form entry sheets to collect data and produce custom reports via MS Excel and Access for senior management. • Maintained the capital budget for the department’s fiscal year.

New York, New York

Honorable Discharge 2005Job Duties- Establish and maintain stock records and other documents such as inventory, material control, accounting and supply reports- Review and verify quantities received against bills of contracts, purchase requests and shipping documents- Unload, unpack, count, segregate, palletize and store incoming supplies and equipment- Construct bins, shelving and other storage aids- Simplify and standardize the collection and use of maintenance data- Raise the quality and accuracy of performance, cost and parts data through improved maintenance management