Commercial Group Product Implementation Analyst
Green Bay, Wisconsin Metropolitan Area
● Spearheaded research initiative that showed root-cause analysis and led to decision-making on amended states regulation intakes presented through The Department of Insurance, producing actionable insights with completed plan build.○ Reported results to plan load builders and leadership, resulting in plan build next steps and necessary improvements.● Investigated post-production audits on plan builds which identified if further actions were necessary for quality assurance.● Created a query database to generate ad hoc reports, find coaching insights and troubleshoot discrepancies.● Steered cross-functional teams to identify requirements, define, and prioritize solutions to Claims Administrative Service production referral intakes.● Composed project group identification numbers for fully insured and custom builds, using key metrics and data analytics tools.● Led Zoom meetings with onshore leaderships and offshore India vendor management to ensure compliance, service level agreements and optimize product performance was occurring on medical insurance plans.● Led a team of 10+ to collaborate and develop a new SharePoint web page that houses a self-service library for the operations department.● Assembled policy mandates on each specific state, plans, and options for specialty prescription procedure codes that should be paying 100% insurance coverage versus deductibles and / or coinsurance.○ Improving overall plan build performance by effectively communicating operational decisions.
