Description
Highly experienced, cross-functional leader in business intelligence analysis, financial analysis, and business consultancy. Over 10 years of supporting organization success through leverage of business intelligence to drive alignment with industry, state and federal regulatory compliance. Proven results in driving profitability and building operational efficiency through business data analysis to create meaningful reports to inform decision making among shareholders and department managers. Adept in development of business strategy, planning and problem solving. Proficient in translating business data into digestible information that improves corporate processes. Demonstrated ability to lead project management from design through implementation. Passionate about leading, coaching and motivating employees to achieve maximum performance and consistently exceed organizational goals.
Work Experience
| COMPANY | POSITION HELD | DATES WORKED |
|---|---|---|
| Aging Parents | Caregiver | 1/2017 - 1/2019 |
| Kaiser Permanente | Consultant/Project Manager Lead Financial Consultant Sr. Financial Analyst (Kaiser Permanente Contract Position) | 1/2006 - 1/2016 |
| KForce (KP Contract Position) | Senior Financial Analyst | 3/2005 - 12/2005 |
Education
| SCHOOL | MAJOR | YEAR | DEGREE |
|---|---|---|---|
| Keller Graduate School of Management of DeVry University | MBA (Accounting) | 2005 | Master Degree |
| San Francisco State University | Business Administration (Computer Information Systems) | 1995 | Bachelor Degree |
Social Media
| TYPE | TITLE | URL | DESCRIPTION |
|---|---|---|---|
| Website | Nexxt hiring solutions | media url | Nexxt was born out of nearly 20 years of experience in the hiring space and a crystal-clear vision for where recruitment is headed. With a strong background as a fast-paced company that consistently strives to foster growth and innovation, Nexxt uses toda |
| Website | media url | The mission of LinkedIn is simple: connect the world’s professionals to make them more productive and successful. | |
Accomplishments
Highlights:
• Recognized for performance excellence for work as program technical lead that supported the annual filing software to troubleshoot and resolve software issues that led to not missing federal Medicare filing deadlines. Led team to successfully file on time 100% of the time, thus avoiding regulatory sanctions and fines, threat of contract non-renewal and loss of revenue. • Generated $175,000 in funding to create a SQL database solution in response to senior leadership health plan-wide process improvement initiative to vastly reduce or eliminate coverage errors in the Evidence of Coverage contract; served as the lead business consultant to write and defend the business case for funding. • Decreased manual data input by 75% and input errors by 80%; improved report turnaround by 2 days, and improved duplication of strategic decisions used in downstream marketing material by 50% by aligning regional reporting metrics across the program, creating, implementing and automating a national reporting tool that standardized and aligned strategic health plan decision making with federal reporting mandates across 7 regions. • Reduced manual input by 30%, decreased errors by 10%, and reduced data processing by 2 days via design and implementation of automated processes, thus resulting in an increase in 2 days for quality review, improved data accuracy and increased regulatory compliance. • Recognized via receipt of a Medicare Strategy Award in 2006 for contributions during staff meetings for improving accounting processes used to report financial data to the CMS. • Received the Medicare Strategy Award in 2006 for excellence in cross departmental collaboration and implementing new processes to improve how financial data is captured and reported in CMS issued financial templates. • Increased efficiency by 30% by developing and automating complex excel spreadsheet using pivot tables, macros, VGA, complex calculations and links.Companies I like:
Health Net, Dignity, Centene, Kaiser Permanente, and other health plans
Job Skills
Keywords
- Quality Assurance
- Structured Query Language
- Documentation
- Project Management
- Leadership
- Consulting
- Financial Analyst
- Financial Modeling
- Mediare Benefits
- Center for Medicare & Medicaid Services
- Regulatory Compliance
- Healthcare
- CMS
- Advanced Excel/Access and VBA Programming
- SharePoint Administration
- InfoPath Forms
- Microsoft Office 2016
- Accounting Financial Reporting
- Process Improvements
- General Ledger
- Business Case
- Communication
- Training Material
- Database
- Government Regulations
- Guideline Interpretation
- Journal Entries
- Business Objects
- Macros
- Audit
Responsibilities
Direct oversight for the California annual Medicare submission process, interpreted new federal guidelines, and ensured benefits were compliant and filed on-time. Defended the methodology used during the federal regulatory review process, provided leadership and subject matter expertise to resolve benefit coverage issues, developed and implemented tools to support day-to-day operations and identified opportunities to increase business efficiency. Created, implemented and automated a reporting quality assurance tool which facilitated filing accuracy, senior leadership and stakeholder reporting and metric accuracy, and downstream marketing material accuracy. Developed comprehensive training materials including a comprehensive Medicare filing process manual. Created training material and trained staff on Original Medicare and health plan benefits, setting up plans on HPMS, how to download plan specific information into federal issued tool and the upload submission process. Streamlined the annual Medicare filing process on a continuing basis through improved process tools and standards, which resulted in achieving a higher degree of accuracy. Facilitated improved benefit descriptions and assured benefits were compliant with Center for Medicare & Medicaid (CMS) Services, the federal regulatory agency responsible for oversight of the Medicare & Medicaid Programs.
In addition to the responsibilities noted for the Senior Financial Analyst role, developed financial models for reports in California annual Medicare bids. Project managed day-to-day operations and facilitated an interdisciplinary team of subject matter experts as part of the annual federal regulatory reporting process to provide Medicare benefits. Ensured reports were accurate and compliant with federal mandates and met senior management strategic initiatives. Completed risk adjustment and utilization analysis, expense forecasting and financial modeling, defended reasonableness of assumptions, appropriateness and accuracy of data and ensured reports met the CMS Office of Actuary (OACT) financial reporting guidelines. Created financial models, tools and reports for key metrics and measures of performance by incorporating multiple data sources into various reports. Managed, maintained and created financial reports that supported the Medicare Business Line. Collaborated with cross functional teams to improve data quality and collection processes, enhanced reporting templates and design, and identified process improvement initiatives to meet diverse and changing federal regulatory reporting needs. Prepared and delivered formal presentation of results to clients, and defended methodology used to calculate the per member per month cost. Acquired data from multiple sources to perform analysis to develop the estimated revenue and cost on a per member per month basis, including interpretation of Medicare guidelines to conduct accurate calculations, reports and estimates. Developed comprehensive work plan, maintain detailed documentation and project managed the annual Medicare financial reporting process, including timeline for major deliverables, key milestones and process agreements impacting the filing.
Direct oversight for general ledger, journal entries, and reconciliation of balance sheets and income statements. Prepared month-end, fixed asset, and re-class journal entries. Created and maintained Business Objects reports for fixed asset accounting and capital reporting. Investigated, resolved and reported regional variance issues, prepared annual fixed asset documentation for property tax reporting. Researched audit requests for year-end.
