Shannon Misener work email
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Shannon Misener personal email
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I am drawn to roles that involve fast-paced environments, cross-functional collaboration regardless of the hierarchy structure, and challenging business and technical landscapes. Collaborating with business architects and product owners is the key to how I transform organizational processes and systems. My teams and I work tirelessly to develop solutions that improve patient experiences, ensuring they receive the products and services they need in a timely manner and with in-network pricing. I lead through influence by positioning myself as a critical thought partner to colleagues and senior leadership. At Prime Therapeutics, I coordinate with numerous interdisciplinary teams to improve our workflows and operational functions. For instance, I coordinated with one of our internal partners to build a platform that reduced one of his tasks from a 15-day process to just a few days. My experience in claims processing, insurance eligibility, and pharmacy benefits management enables me to effectively collaborate with SMEs on reducing operational expenses. I worked with a high-volume pharmacist and conducted a 4-hour deep dive into our systems and platforms to uncover ways to increase her productivity. Since I easily understood the systems she uses for her client, we quickly discovered a lack of integration between our platforms and her clients’. We developed a solution that provided her with a single view, allowing her to turn around cases faster and save thousands of dollars every year. If you would like to connect or know more about my professional story, please send me an InMail message or email me at shannonmisener@yahoo.com. Key Strengths: Business Architecture | Technology Solutions | Employee Relations | Team Collaboration | Information Systems | Process Improvement | Business Solutions
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Business ConsultantAlttraxCape Coral, Fl, Us -
Business Analysis Practice LeadTrue Rx Health Strategists Jun 2024 - PresentWashington, In, Us -
Business ConsultantAlttrax May 2023 - PresentDublin, Ohio, UsCoordinated a team of 22 departments to drive progress on critical path milestones for 1/1 Readiness by planning and adapting to scope changes, overcoming capacity constraints, coaching teams on managing their work queue, documenting mitigation plans for known and unrealized risk, and quickly mobilizing teams to resolve system issues.• Organized 28 actionable recommendations into a roadmap targeting strategic and tactical process improvements.• Led a team of eight professionals to develop and deploy defect free code and remain compliant with Inflation Reduction Act (IRA).• Organized and led project team of five professionals to deploy configurations to production ahead of schedule for Medicare clients. -
Solution Product Owner SrPrime Therapeutics Dec 2021 - May 2023Eagan, Mn, UsChampion for agile transformation in all interactions with multiple cross-functional teams and external business partners. Lead efforts to slice epic concepts into actionable pieces of work, arrange and prioritize backlog, serve as the voice of the customer and key decision maker, and collaborate with senior leadership to stay in alignment with enterprise goals.• Guided team of professionals through platform rationalization processes and developed recommendations.• Partnered with Express Scripts to conceptualize the ‘Transfer Retail to Mail’ capability using existing and new APIs.• Organized and guided Pharmacy Fulfillment team to integrate two new FHIR Standard APIs with Express Scripts. -
Business Architect AssocPrime Therapeutics Aug 2019 - Dec 2021Eagan, Mn, UsPartner with multiple cross-functional teams to gather and document the structure of Prime’s business and technology landscape. Lead, build, manage, and enhance business capability model along maturity and optimization framework to maximize member experience and operational functions.• Exceed yearly savings goals by implementing new systems and tools that streamline SMEs’ workflow • Interface with customer service specialists to develop business architect strategy plan • Leverage seven years of claims processing, insurance eligibility, and Pharmacy Benefits Management (PBM) experience toward optimizing productivity and accuracy • Contribute to aligning investments with member service portfolio through interfacing with internal and external stakeholders -
Business Analyst LeadPrime Therapeutics Jun 2012 - Oct 2019Eagan, Mn, UsSupervised and guided business analysts in conducting efficient process uplifts and serving as a champion for the final product. Defined Minimal Viable Product (MVP) by segmenting multifaceted project concepts into smaller, easily understood features for business and IT partners.• Directed upper management completing a critical project that stalled over 3x • Led a cross-departmental team in developing a long-term plan that resolved supply chain disruptions• Monitored projects in several pipelines and initiated team discussions with impacted departments to ensure scope boundaries were defined and the team was prepared to resolve project challenges -
Business AnalystHealth Care Cost Institute Hcci Jan 2011 - Jun 2012Developed and maintained complex data specifications used to create technical specifications for internal development team.• Assisted with data analysis and problem solving resulting from data to specification mapping.• Played a supportive role to the project with regards to data sample QA and scheduling.• Developed reports, served as a liaison to the HCCI department to identify missing data and errors.• Actively engaged with internal and external business partners to find solutions to issues that arise from day-to-day operations.
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Healthcare Claims Process AnalystMetropolitan Health Plan Jan 2005 - Jan 2011Developed User Acceptance Test cases to analyze system programming relating to MN Unallotment reductions.• Create detailed user manuals for new and existing business processes for example, most recently created a Medicare Risk Adjustment (data pull, record submission, duplicate check, reconciliation, etc.) user manual.• Created Business Process Flow diagrams utilizing Visio which detailed how information flows through complex channels in the organization created contracts for providers, assisted in negotiations.• Developed internal auditing tool utilizing MS Access to identify discrepancies between MHP systems and State regulations/mandates.• Developed reports, served as a liaison to the Information Technology department to identify missing data and errors.• Performed analysis that identified inappropriate patterns in vendor billing, which aided in the auditing, identification and subsequent recovery of over $2,000,000 in overpayments.• Extracted data from IDX upon request by using structured query language via the Database Management System (DBMS).• Added procedure codes and loaded new rates into the system.• Initiated and led the implementation of Medicare's Prospective Payment System (PPS) software (Home Health, ESRD, IP Psych, IP Rehab, and SNF).• Developed MS Access and MS Excel tools to automate and expedite calculations for Anesthesia, Ambulance, Chemical Dependency and Nursing Home claims.• Created tools to aid colleagues in automating tasks to ensure a more efficient work environment increasing productivity.• Actively engaged with internal and external business partners to find solutions to issues that arise from day-to-day operations.
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Special Transaction AssociateUnitedhealth Group Jan 2003 - Jan 2005UsCompleted projects well within 5 data TAT, organized action plans to complete large volume projects of up to 40,000 claims, resolved complex claim issues resulting from Department of Insurance (DOI) inquiries and worked closely with Consumer Affairs on escalated member, Executive, and VIP claim issues.• Represented Uniprise National Operations Center at weekly Transactions and Research Team (TRT) meetings to discuss and offer solutions to known system wide issues.• Through utilization of United Healthcare claims processing platforms, maintained payment accuracy of 99.49% while exceeding production standard by 130.19%.• Resolved Department of Insurance (DOI), Consumer Affairs, Executive, and VIP claim issues to the satisfaction of the customer.• Claims Research Team (CRT). -
Claims AssociateUnited Healthcare Jan 1998 - Jan 2003Lead implementation of database of provider-based project submissions.• Identified and reported abhorrent billing patterns to appropriate personnel.• Developed Excel based macros to increase flagged file productivity from 175 CPH to 800 CPH.• Assisted with cross-training colleagues to increase departmental efficiency.• Lead the standardization of policies & procedures for commercial claim adjustments.• Analyzed claim reports and communicated results to upper management as needed.• Assisted management staff with presentations of Teaming Philosophy to four production sites.• Represented company as a training ambassador for new business; exceeded all production, quality and ramp up expectations.
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Assistant ManagerSpencer Gifts Jan 1993 - Jan 1998Managed store front during peak seasonal periods (Halloween, Christmas). Maintained employee schedules.• Contributed to fraud detection and managing theft incidents.• Assisted with hiring seasonal staff and managing disciplinary incidents.• Maintained financial books containing daily financial transactions.• Monitored and identified issues with record keeping.• Responsible for bank deposits, both mobile and within walking distance.
Shannon Misener Skills
Shannon Misener Education Details
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University Of MinnesotaBusiness Analysis
Frequently Asked Questions about Shannon Misener
What company does Shannon Misener work for?
Shannon Misener works for Alttrax
What is Shannon Misener's role at the current company?
Shannon Misener's current role is Business Consultant.
What is Shannon Misener's email address?
Shannon Misener's email address is sh****@****hoo.com
What schools did Shannon Misener attend?
Shannon Misener attended University Of Minnesota.
What are some of Shannon Misener's interests?
Shannon Misener has interest in Civil Rights And Social Action, Politics, Disaster And Humanitarian Relief, Human Rights, Animal Welfare, Health.
What skills is Shannon Misener known for?
Shannon Misener has skills like Team Building, Customer Service, Business Analysis, Leadership, Marketing, Training, Team Leadership, Employee Benefits, Social Media, Sdlc, Social Media Marketing, Strategic Planning.
Who are Shannon Misener's colleagues?
Shannon Misener's colleagues are Ford Undefined, Brad Carver, Danny Ward, Mark Simpson, Heather Latterell, Nicole Heller.
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