Aligned operations with project priorities/objectives and ensured complete fulfillment of project plans/ requirements by leading functional teams. Instrumental in organizing administrative meetings/ conferences with stakeholders / senior management to convey project status, reduce risks, and demand significant support for project completion. ● Improved data integrity for Veteran Affairs Community Care Network (VACCN) program in 2022 by successfully delivering and managing six projects to… Show more Aligned operations with project priorities/objectives and ensured complete fulfillment of project plans/ requirements by leading functional teams. Instrumental in organizing administrative meetings/ conferences with stakeholders / senior management to convey project status, reduce risks, and demand significant support for project completion. ● Improved data integrity for Veteran Affairs Community Care Network (VACCN) program in 2022 by successfully delivering and managing six projects to support the development of healthcare products/ services.● Fulfilled project timelines defined in Microsoft Project/Smart sheet by leading cross-functional teams and employing strategic plans/tactics. Show less

Oversaw all activities of 20-100 personnel and developed high-performing teams for OPTUM's VACCN contract to streamline services and improve organizational productivity. Nurtured solid communications with workforce management, Human Capital professionals, and other organizations to ensure fulfillment of 30-day compliance standards and align staff operations with project plans.● Optimized data loading and reconciliation tasks with strategic initiatives to support various providers/veterans… Show more Oversaw all activities of 20-100 personnel and developed high-performing teams for OPTUM's VACCN contract to streamline services and improve organizational productivity. Nurtured solid communications with workforce management, Human Capital professionals, and other organizations to ensure fulfillment of 30-day compliance standards and align staff operations with project plans.● Optimized data loading and reconciliation tasks with strategic initiatives to support various providers/veterans in 36 states.● Upgraded Quality levels of health care services and team performance to over 9 % by using innovative Excel and Tableau analytics focusing on development plans and root evaluation methods. Show less

Drove excellent support and services for UHC Nursing Home Medicare Advantage (ISNP) Plan/ Program and more than 100 skilled nursing facilities (SNF) to manage all contract and billing-related projects. Responsible for leading strategic communication and network meetings with staff to secure new business projects and retain existing clients.● Accomplished over $3M in payment resolutions, as well as established business strategy to manage ongoing claims and payments problems.● Improved… Show more Drove excellent support and services for UHC Nursing Home Medicare Advantage (ISNP) Plan/ Program and more than 100 skilled nursing facilities (SNF) to manage all contract and billing-related projects. Responsible for leading strategic communication and network meetings with staff to secure new business projects and retain existing clients.● Accomplished over $3M in payment resolutions, as well as established business strategy to manage ongoing claims and payments problems.● Improved executive and billing staff understanding of key contracts/ agreements and minimized request issues of SNFs to over 60% by launching billing re-education campaign.● Reported ISNP's progress and developments to senior leaders by evaluatingTableau and Salesforce data analytics. Show less

Managed the entire processes of 25 Rx member appeals analysts on regular basis by following company policies and procedures. Supervised instructional training sessions to coach functional team members and attain 98.6% performance.● Reduced extra time to over 40% and increased productivity up to 18% by executing shift bid schedules and systems to facilitate operational employees and improve outputs.● Realized highest employee engagement by 92% in UHC Vital Signs Survey in comparison with… Show more Managed the entire processes of 25 Rx member appeals analysts on regular basis by following company policies and procedures. Supervised instructional training sessions to coach functional team members and attain 98.6% performance.● Reduced extra time to over 40% and increased productivity up to 18% by executing shift bid schedules and systems to facilitate operational employees and improve outputs.● Realized highest employee engagement by 92% in UHC Vital Signs Survey in comparison with other managers/supervisors. Show less

Actively, visited several UHC sites to improve training curriculum and organize instructional training sessions by using innovative coaching methods/techniques. Delivered strategic suggestions and feedback with facts by evaluating 90-180 days; performance of learners. Scheduled tours and refreshments programs for training department with Concur application to track all expenses with mobile devices.● Finished traditional teaching and online training projects to increase learner understanding… Show more Actively, visited several UHC sites to improve training curriculum and organize instructional training sessions by using innovative coaching methods/techniques. Delivered strategic suggestions and feedback with facts by evaluating 90-180 days; performance of learners. Scheduled tours and refreshments programs for training department with Concur application to track all expenses with mobile devices.● Finished traditional teaching and online training projects to increase learner understanding of UHC materials/ products.● Reached average grade of 85% with learner-centric strategy ensuring productive engagement of training classes. Show less

Resolved claim matters; Modified Standard Operating Procedure (SOP) language into simpler languageto increase analyst’s understanding. Directed site-wide and individual training sessions for analysts.● Solved escalated and priority claims issues by reviewing policies, medical records, and other documents according to Texas Employees Retirement System (ERS).