Description
Seasoned professional leader with 25+ years of experience in multiple areas of management to include but not limited to: * Regulatory Compliance (NCQA, HEDIS, CMS) * Customer Service * HMO, PPO, POS, Medicare, Medicare, Commercial products * Member/Provider Services/Member Surveys * Claims Processing (Professional/Institutional) * Credentialing/Provider Enrollment (Physician/Facility) * Provider Data Management * Quality Improvement/Auditing/Training * Human Resources (Hiring/Training/Payroll) * Appeals & Grievances/Compliance/Complaints
Work Experience
| COMPANY | POSITION HELD | DATES WORKED |
|---|---|---|
| (Confidential) | Business Analyst | 9/2018 - Present |
| Centene Corporation/Peach State Health Plan | Director, Quality Improvement Director, Provider Data & Credentialing Manager, Provider Data And Credentialing Credentialing Manager | 6/2017 - 5/2018 |
| Affiliated Computer Services | Provider Enrollment Supervisor | 9/2002 - 2/2004 |
Accomplishments
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