Lisa Uku, Msm, Aie, Cie, Mcm Email & Phone Number

Bordentown, NJ, US

Remote

• Subject Matter Expert (SME) on health insurance regulations at the state and federal level to assist the team in incorporating new requirements into department processes.
• Trains and coaches team members, and develops working aids and guides to ensure continuity across the department.
• Manages a team comprised of full-time salaried employees and independent (1099) contractors.
• Conducts candidate screening, assessment, and on-boarding while expertly balancing the needs of the company, the client, and the team to ensure tasks are prioritized and resources are assigned appropriately.
• Supervises the quality control of assigned examination projects, reviews and approves work papers, and coaches team members as needed to elevate the quality of work performed.
• Develop and oversee the tools, techniques, and technology solutions used to perform the work of market conduct audits.

• Oversee work streams and examiners; maintain exam/project schedule.
• Supervise multiple examiners; provide guidance and assistance as needed.
• Ensure accurate and organized work papers are prepared in accordance with the instructions provided in the NAIC Market Regulation Handbook and procedures of state and federal government, as applicable
• Perform examination project planning activities to include analysis of exam scope, resource requirements, and timeline estimates
• Prepare examination work plans and assign exam tasks to examiners as needed to complete the work of the exam with quality and within anticipated timelines
• Actively participate in peer review as part of the quality program

• Work in small teams to review complaint data (claims and Issuer payment records) to assess compliance
• Analyze Issuer documentation for compliance with federal legislation
• Assist in the analysis of complex health plan and Issuer records to assess compliance with statutes and regulations as directed
• Document and summarize results of analysis to demonstrate evidence of compliance issues and conclusions reached
• Draft requests for information (RFI) and assist in drafting examination findings (Criticisms) to Issuers.

Hanscom Air Force Base, MA

• Subject Matter Expert (SME) for Uniform Business Office (UBO) and associated compliance program; includes Third Party Collections, A/R management, Liability Claims Billing, and Foreign Billing Operations.
• Guided the re-establishment of the UBO program due to the position being vacant for over one year.
• Prepared and executed UBO Compliance training; surpassed third party monetary collections fiscal year goal by 40%; vaulted 66 MDS to #1 in collections for overall goals in Major Command
• SME for 66 MDS Data Quality (DQ) program; continuously makes recommendations for improvement
• Led DQ team and statement completion; ensured timely and accurate completion; 100% monthly DQ statement approval by Air Force Medical Operations Agency for Data Quality
• Analyzed performance metrics and adjusted strategy which led to decreased coding errors by 90%; decreased open encounter rates; clean up of inaccurate bills to reduce risk for fraudulent billing

Quonset, RI

• Rank: Staff Sergeant E-5
• Performed the repair and maintenance of hydraulic and pneumatic systems, as well as all related ground equipment on the C-130J four-engine turboprop military transport Aircraft.
• Conducted troubleshooting, aircraft maintenance, and repairs in accordance with applicable regulations, manufacturer’s instructions, and military policies.
• Lead, trained, and developed junior ranking enlistees in both job training and overall mission readinessDeployments & Service
• Served 4 months in Kuwait During Operation Inherent Resolve (Jun 2016- Nov 2016)
• Served as hurricane mission support in Puerto Rico, St. Thomas, and St. Croix after the devastation ofHurricane Maria (Sept 2017)Medals & Decorations

Southborough, MA

• Designed and implemented individual educational programs for severely disabled students with Autism by utilizing Applied Behavioral Analysis (ABA) principles in both classroom and residential settings.
• Compiled necessary behavioral and educational research data using ACE, ABA software system
• Coordinated and communicated directly with various departments of physical and mental therapy for the successful administration of multi-faceted learning programs.
• Shift Manager - Managed staffing and schedule, monitored safety, as well as ensure checklist and report completion
• Case Manager - Oversaw, implemented, monitored and evaluated actions required to meet the objectives set for residential case student education, as well as health and human services needs

Kingston

• Plan and implement classroom core curriculum and instructive programs for children in collaboration with and in the absence of the supervising teacher.
• Maintained files and records of children’s’ progress in a preschool age setting.

Master Of Science (M.S.), Health/Health Care Administration/Management

Course work in Financial Management and Decision Making, Statistical Analysis, Strategic Planning, Organizational Behavior and Theory.

Bachelor Of Arts (B.A.), Psychology

Double Major: Bachelor of Arts (B.A.), Anthropology Certified in Applied Behavior Analysis