•Accountable for communicating complex analytic information to designated stakeholders.•Responsible for writing complex and unique queries to supports sales in client retention and analysis.•Work on cross-functional teams both internally and externally in development, implementation and execution of corporate and group specific initiatives (ICD-10, Care Outcomes, and Finance Initiatives).•Analyze and communicate the effectiveness of benefit programs, clinical programs, and CARE management programs in an effort to communicate Florida Blue integrated value proposition.•Perform analysis using medical, behavioral health, financial, benefit and pharmacy data to identify ideas for clients to improve the health, well-being, and financial situation of their membership and/or group.•Responsible for creating effective analytic processes that enhance BCBSFL ability to message program and benefit efficacy.•Evaluate group performance problems and potential alternatives in support of growth and retention. •Validate, analyze, and interpret information from highly technical areas (e.g. medical informatics, service delivery and finance).•Provide analytical support in the development of enhanced customized evaluations, which include the identification, interpretation and communication of overall account performance against known benchmarks and account specific expectations.•Research and stay abreast of emerging trends in the marketplace including cost and utilization indicators.•Use skills around data and technical information across the enterprise including claims (coding, medical terminology), Finance (General Ledger/Billing), Delivery Systems (Clinical, Network), Service, and other areas.

•Responsible for compiling, analyzing, billing and reconciling approximately ninety five million dollars in ASOII and MPP (self-insured plans) claims each month.•Work closely with IT to identify root causes of claims reporting errors while seeking to eliminate those issues and improve process resolution.•Manages all BCBSFL ASOII/MPP accounts, workflow and information requests; requiring in depth knowledge of corporate products, systems and operational procedures originating from both internal and external customers.•Provide detailed reports and claims analysis, along with ad-hoc projects, and workflow streamlining to include interpreting information from other technical areas, supporting overall performance against known benchmarks, and interacting with leadership, account decision makers, and their consultants.•Assist in design and testing multiple parts of MBI / ASR including ASOII and MPP claims and stop loss graphical user interfaces.•Effectively understands and applies policies, processes, procedures and follows HIPAA guidelines as required by law.•Works closely with Corporate Compliance to ensure PHI is distributed in accordance to Business Associate Agreements and state laws.•Participated in a variety of meetings representing the department regarding new programs, products and groups. •Prepared training guidelines and visual aids for new employees

•Served as the technical expert for large group self-billing.•Created and implemented the self-billing process for National Corporate and provided training of other Geographical Business Units to utilize the same process.•Facilitated individual evaluations, in addition to training sessions for the following: policies and procedures, Excel, PowerPoint and Self-billing reconciliation problem-solving, along with TWC’s, position feedback and coaching for MBO’s.•Provided ongoing support for Excel and Self-billing after being promoted and leaving the department.