Senior Analyst- Quality Assurance
Current·Lead user acceptance test efforts and prioritize business needs for Pet Platform Transformation using knowledge of business functions, processes, and technologies; document and communicate successes, failures, and concerns to build team to ensure results meet business requirements·Developed and launched risk-based quality protocol assuring department transparency, compliance, and extraordinary member care and providing increased detail of feedback and results data to analysts and leadership·Designed and implemented process for reducing missing information denials resulting in an 86% decrease in claims denied for missing diagnosis (about 10,000 claims per month); process to be extended to additional denials in 2025·Compile and analyze quality data; design and implement strategic transformation plans to empower analysts, mitigate risk, and improve results to business and members·Leader in quality work, training, accountability, reporting, and results·Exceptional trainer with change management mindset for successful adoption·SME and Knowledge Advance author for Pet Claims product contract language, reference material, policies, and procedures; reviewed and edited over 100 documents·Lead committee on reference material updates; survey analyst feedback, design/redesign and distribute updated reference information regarding claims evaluation and handling ·Compile and present 8,000+ quality review data points and prepare data stories quarterly to department to ensure calibration and address questions and concerns from analysts, supervisors, and claims leadership team
