Susan Daniels Email and Phone Number

 Pricing and underwriting the Federal Employee Health Benefit Program (FEHBP) line of business for the health plan with accountabilities ranging from Kaiser pricing strategy to project management responsibilities surrounding the record keeping for the plan.  Analyzed and renewed regional and national clients maximizing profit and growth objectives within the organization.  Collaborated with cross functional departments monitoring liabilities and reserves for the Large Group Accounts.… Show more  Pricing and underwriting the Federal Employee Health Benefit Program (FEHBP) line of business for the health plan with accountabilities ranging from Kaiser pricing strategy to project management responsibilities surrounding the record keeping for the plan.  Analyzed and renewed regional and national clients maximizing profit and growth objectives within the organization.  Collaborated with cross functional departments monitoring liabilities and reserves for the Large Group Accounts.  Analyzed trends in the marketplace developing the most competitive rates and achieving revenue, membership and margin goals.  Managed a book of business including several key complex accounts, delivering over $50 million annually.  Strategically partnered with Actuarial Services and Account Management optimizing business opportunities.  Oversaw multiple internal and external audits, including and primarily the FEHBP line of business, meeting time-sensitive deadlines 100% of the time. Show less

 Reconciled and renewed the FEHBP account generating over $30 million in premium annually.  Audited Ohio Department of Insurance rate filings for accuracy, making certain that all of the benefits and factors were filed for the FEHBP and top ten groups. This was to ensure that there would be no audit findings when the FEHBP rates were audited by the Office of the Inspector General.  Entered the rates and factors supplied by actuary to the pricing system on an annual basis… Show more  Reconciled and renewed the FEHBP account generating over $30 million in premium annually.  Audited Ohio Department of Insurance rate filings for accuracy, making certain that all of the benefits and factors were filed for the FEHBP and top ten groups. This was to ensure that there would be no audit findings when the FEHBP rates were audited by the Office of the Inspector General.  Entered the rates and factors supplied by actuary to the pricing system on an annual basis.  Created, analyzed and summarized quarterly reporting for GM, Ford and Chrysler. Participated in quarterly phone calls with the groups to discuss the trends on several report metrics.  Served as liaison with multiple departments maintaining membership data, benefits and pricing systems. Show less

 Managed process to identify membership coding errors that resulted in Claims overpayments.  Recovered Medicare claims overpayments in the amount of $5 million over a one year period.  Served as IT liaison during new claims system implementation. Tested system upgrades requiring evening and weekend availability.