Strategic Initiative Support

Accountable for process development and maintenance Developed process, policy, and procedure training materialsFacilitated training related to systems functionality and department processesCreator of the maternity referral business rulesDeveloped and implemented changes to referral business rules and sweeper logic to improve efficiency of staffCollaborate with Integrated Clinical Solutions (ICS) department for development of new system functionality and release managementManagement of all special projectsResponsible for development and implementation of 3 separate documentation systems with oversight of 3 associates for testing Co-led expansion into IL and VA ICP/MMAI Led the Humana.com web enrollment upgrade to improve the member experienceDeveloped a HumanaOne Non-Par utilizer process to be used by multiple departmentsDeveloper and designer of department's SharePoint siteFacilitator of large meetings with the department including PowerPoint presentationsQuality audits for large ASO employer group.Accomplishments- Developed and implemented processes and training for the Specialists of a new internal case management program, NICU CM, projected to save the company $1.5M- Developed and implemented process changes and training for a high profile SPARC initiative projected to save the company $300,000

Collaborated with health care providers in coordinating care and services for pregnant members identified as requiring a high intensity of service and/or for those members identified as having complex care needs. Utilized knowledge of benefit plan design and alternatives of care available within the community, as well as national resources available to support the delivery of quality, cost-effective health care. Improved pregnancy outcomes through early identification and education of the member. Participated in a Six Sigma project to identify key causes of a decrease in prenatal program referrals.

Labor & Delivery, Mother/Baby, Newborn Nursery, and Antepartum Units Staff Nurse. Served as Team Lead for all units which required the management of staff and patient assignments, crisis intervention and prevention, and organization of units.