• Operational tool development to streamline production delivery• Ad hoc reporting support• Simplify complex data into actionable insights• Effectively create data transformations that address business requirements and other constraints• Leverage processes and diagnostics tools to troubleshoot, maintain and optimize solutions and respond to customer and production issues• Assist with building, optimizing, and managing data processing to support data integration for reporting and analytics• Detect data quality issues, identify root causes, implement fixes, and manage data audits to mitigate data challenges• Collaborate with colleagues, internal teams, and various levels of management

Scrum master and report analyst for Payment Integrity – Edit Solutioning andAutomation Team, leading six weekly calls and project deployments on five claimplatforms. Reporting of pipeline project status, Medical Cost Savings, Revenue, FTE, andSG&A actual savings. Ensure reporting accuracy and consistency. Provide project andsavings visibility from initiation through run-rate status. Successes include:• Supported ESAT team to exceed Automation Performance goals through projectmanagement delivering $539M in MCS and SG&A savings for 2023. In that time,overseeing 285 projects and 597 maintenance items and supporting teams todeliver in a Time -To-Value metric of less than 4 weeks.• Developed training and upheld continuous regulation of OSAM (Optum ScalableAgile Methodology) compliance for all ESAT teams and line of business deploymentreleases, leading to a 64% reduction in documentation errors.• Jira Software Migration Lead and Administrator ensuring accurate data migrationfrom server to cloud instance of software, including original interface build(screens, fields, permissions) and seamless transition for 270 in-progress projectsand maintenance items across three lines of business and five claim platforms.• Implementation and maintenance of OneART/EAA Jira Governance for ESAT team.• Shouldered administrative burden for Business Analysts, align with other PaymentIntegrity team data, and provide visibility of project development and financialtarget progress to Senior VP management levels.• SharePoint Administration, creating multiple site pages as needed for growingbusiness need and monitoring security and access of uploaded documentation andlists.• Development of Pended Trans Resubmission reporting recording month over monthperformance (MCS and FTE/Volume) for over 190 Automation Resolution Utilities(ARUs) owned by Payment Integrity.

• Advanced PowerPoint creation for team and upper management, including Smart Audit Master (SAM) Edit Town Halls and the Quarterly Business Review Executive deck.• Multiple daily, weekly, and monthly reports to assist SMEs, Supervisors, and Business Managers with data interpretation, tracking trends, and analyzing outcomes as well as ad-hoc report requests.• Compilation and distribution of departmental Weekly Scorecard.• Designed new reports and restructure existing reports to tailor to the changing needs of business partners.• Conducted biweekly team meetings. • Updated departmental onshore Work In Progress (WIP) status to assist supervisors and workforce in managing inventory levels.• Innovation Intake Ideas team.

• Departmental lead for multiple initiatives including Emptoris, WebStrat, CPAP/PCD, EWS and interest.• Offshore quality liaison responsible for overall data analysis, error trending, rebuttals and remediation.• Daily handling of multiple reports and SharePoint sites including review, analysis, and distribution.• Distributed departmental communication including workforce direction and quality topics.• Identified and reported issues with SAM Edit Rules (directions and programming) and the SAM application.• Time study of Global SME duties to analyze efficiency of workload and justify additional staffing.

• Reviewed, remediated, and rebutted multiple audits for the SAM Edit CCM team.• Team lead for submissions and escalation to internal business partners. • Ongoing team support through meetings, training, and daily interaction and Q&A with team members.• Back up coverage for Supervisor and Quality SME duties as needed.

• Member of the Smart Audit Master edit team, working National, Critical Case, and CCM Edit Rules.• Adjusted claims as directed by SAM edits, and refer for additional review as required .• OJT for New Hire Sam Edit Training class April – July 2013 including 1/1 Coaching, Individual Module Training, Q&A SharePoint, Quality Error Rebuttals, pulling and assigning work through both COMET and UNET, and data analysis for error and skip trends.• Assisted SME with duties including audits, Edit Rule update requests, advocate issues, and questions SharePoint.• Presented weekly 411 information review to teammates in huddle meetings.• Wrote whiteboards to clarify complex or difficult Edit Rules for peer reference.• Member of the Employee Engagement Vital Signs Committee for 2012.• Beta tester for new Macro Express and PCOMM macros.

• Member of the Smart Audit Master edit team, responsible for last-chance claims review before claims are finalized.• Responsibilities included claim investigation, research regarding eligibility, coordination of benefits, and claim history.• Adjusted claims as directed by SAM edits, and referred for additional review as required • Backup support work for the PNO2 adjustments department. • Chosen for independent projects such as Urgent Care TIN spreadsheet, Medicare project, Macro Express project.• Committees included Employee Recognition Vital Signs project and the team captain for Fall Fit Challenge • Wrote several department-wide macros including the FIT macro designed to improve claims quality.• Multiple suggestions for P&P updates and Edit Rule refinements focusing on accuracy and consistency.• 26 months continuous 100% quality scores in DAR and CPA • Employee of the Month for the SAM department June of 2010

• Member of the Rapid Resolution Expert team through which it was necessary to establish customer rapport quickly, and communicate information clearly to ensure full understanding of plan benefits.• Quickly and accurately identified and assessed consumer and provider issues and obtained real-time resolution.• Served as first point of escalation for both internal and external business partners and other customers.• Real-time, accurate resolution of claims and simple adjustments, assisting also as needed with offline claims inventory. • Handled repeat callers, escalated issues and highly complex customer inquiries in a manner that defuses emotion . • 0 Wrong Answers Per Million Opportunities score every month (phone quality score), 100% claims quality score.• Multiple customer commendations.

• Addressed member and provider questions regarding benefits, eligibility, FSA and Health Reimbursement Accounts.• Explained claims payments, identified incorrect claims processing, and routed outstanding issues accordingly.• Team representative to the United Voices/IDEAS committee to identify and rectify internal issues. • Invited to Top 8 Performers Luncheon with business segment Uniprise CEO.• 0 Wrong Answers Per Million Opportunities score every month (quality score), all other metrics met monthly