Penny Krawczyk Email & Phone Number

Dudley, Ma, Us

United States

Network Development and Management Analyst

United States

Network Development and Management Analyst

Worcester, Ma

Responsibilities have Included:• Lead analyst in corporate product expansion initiatives• Development of provider networks within all progressive territories, as well as contract maintenance, gathering of credentialing materials and quality control of the directory/website/data warehouse detail • Preparation of DOH/DOI network submission files for the Massachusetts and New York programs, as well as the crosswalk/logic files for encounter reporting• Generation of HSD Provider/Facility tables for submission to CMS (Medicare Advantage-related) and Quarterly internal audit reporting for all MA programs• Principal analyst in regulatory network reporting (utilizing dashboards/metrics) related to Medicare Advantage and other contracted government-sponsored programs, including, but not limited to - network significant changes, provider/member Ratio, and out-of-network claims reporting• Design of membership forecast model/tool for newly developed corporate products• Conception, maintenance and execution of Medicare Advantage AEP (Annual Enrollment Period) membership tool/presentation• Preparation of product territorial maps for the Sales and Marketing divisions of the Company, as well as for use in Management presentations• Data extract and utilization/financial report quality and discrepancy analysis• Update and enhancement of corporate provider/ancillary contract templates, modifying as necessary based upon mandated regulatory changes• Review of corporate policies/updates to determine resultant conflict with network provider contract documents• Annual Essential Community Provider analysis and template preparation for Massachusetts Connector programs• Annual corporate licensure and/or accreditation reporting for submission to the DOI• Claim related analysis for payment/pend status determination

100 Southbridge Street, Worcester, Ma

Responsibilities included:• Design/maintenance and monthly update of corporate profit and loss statement, providing regional (Cost Center/GL) specific reporting• Internal daily/monthly sales reporting and analysis for corporate sales/marketing staff, including forecast, cost, budget and actual spend vs. accrual variance • Regional/channel/product annual forecast planning, including, but not limited to, coordinating the timely accumulation of data from regional sales teams• Analysis of submitted data for potential modification within allocated volume/dollars• Administration of GPS end users, as well as 4 regional sub-administrators• Design and implementation of reporting tools for analysis of time and mileage• Monitoring and analysis of market trends using The Nielsen Company, as well as other research venues• Analysis of market/channel product growth in support of the sales/marketing/ management team and assimilation of gathered data into a presentation format • Preparation and analysis of monthly sales commission reports for the company distributors• Analysis of distributor gross margin sharing information

Worcester, Ma

Five years specializing in the life, group health and annuity focused insurance industry.

Bsba

Completing degree program - transferring from Assumption College toward that end

Bachelor Of Science Business Administration (B.S.B.A.), Accounting And Finance

Transferred to Nichols College