Susan Eccles Email & Phone Number

Colorado, United States

• Responsible for a team that remediates and or validates provider data from a third-party vendor via outbound calls.• Team is responsible for ensuring the accuracy of data updated or already validated in source systems.• Daily reports and monitoring of each state compliance is adhered to.• Responsible to testing new automation tools to ensure accuracy.• Team went from manual spreadsheets barely making a 6 day turn around time to same day turn around time with automation.• Work with external business partners to ensure data accuracy is entered correctly into Cigna systems.• Partner with external vendors to ensure a smooth transition when changing operating systems.• Improved communication channels between departments by establishing regular meetings and reporting structures related to compliance matters.• Collaborated with cross-functional teams to establish clear compliance guidelines and expectations for all departments.

United States

• Responsibilities included being responsible for all quality and training aspects of the Directory Compliance team.• Team was responsible for end-to-end audits from the third-party vendor through the correct updates to online provider directories.• Collaborated with legal partners to ensure the intent of the law was being adhered to• Managed a team onshore and offshore to ensure quality was being adhered to• Quality metrics improved from 71% to 95%.• Trended data and identified root causes.• Streamlined production processes by identifying areas for improvement and implementing corrective actions.• Provided training to employees on best practices in quality management, fostering a culture of excellence within the organization.• Led continuous improvement initiatives by actively seeking opportunities for process optimization and cost reduction.

United States

• Develop Corrective Actions Plans and coordinate with compliance department to ensure activities are monitored and adhered to• Responsible for intake items and for securing funding of projects• Track and monitor various LMI activity and analyze risk for compliance activities.• Work on responses for Department of Insurance Complaints or inquiries.• Respond for Request for Inquiries from various legislative areas.• Managed all US states for risk and compliance.• Reduced compliance risk in certain states by 98% by implementing system changes.

United States

• Worked on various/ potential DSA's which include product development, Network Adequacy requirements, Medical Management, Delegation, Sales, U/W, Pricing, Customer Service, Billing, and Reporting• Created implementation plan for Qani platform for Hospital Verticals• Assisted in developing several SOPs for cross platform work and reporting.• Managed six different DSA with various needs and agreements.• Decreased turn around time from 36 days to nineteen.

Greenwood Village, Co

• Business Readiness Lead for Facets platform• Created templates and tracking tool to ensure BR activities were identified and completed on time.• Led cross functional work groups to determine best practices and made decisions on those items.• Partnered with external business units to ensure deliverables were completed and evaluated prior to go live.• Worked on warranty items after projects went live.• Developed interim manual process until IT enhancements could be put into place.• Worked on large scale, multi -year projects (CDHP, AIMS, IFP, Implementation Re-structuring.• Reduced case installation from 64 days to 7 days end to end

Master Of Business Administration - Mba, Summa Cum Laude

Activities and Societies: Deans List

Bachelor Of Science - Bs, Athletic Training/Trainer

Bachelor Of Science - Bs, Biology, General