Lead Operations Analyst - Evernorth / Cigna - Jacksonville, FL
(2021-09)
- Lead multi-client implementation and execution of CMS-regulated programs across national healthcare organizations (Centene, HCSC, CareSource, Cigna, Medical Mutual).
- Serve as primary liaison between clients, compliance, and internal teams to ensure successful program deployment and adherence to contractual and CMS requirements.
- Oversee implementation and ongoing execution of Medicare Vaccine and Excluded Provider Programs, ensuring compliance and audit readiness.
- Manage enterprise complaint analysis, identifying trends, risks, and corrective actions to improve performance.
- Coordinate cross-functional teams (operations, compliance, QA) to deliver consistent, scalable program execution.
- Develop and present executive-level reports on compliance, risks, and operational performance.
- Standardize processes and quality controls across client implementations to ensure consistency and efficiency.
Supervisor (FEMA Contract) - Maximus Inc - Jacksonville, FL
(2021-09 - 2023-03)
- Managed high-volume federal program operations, ensuring SLA adherence and compliance with FEMA guidelines.
- Led team performance, training, and quality assurance to support national disaster response initiatives.
- Resolved escalated issues and ensured accurate, compliant case processing.
- Drove process improvements to maintain productivity and operational continuity in surge environments.
- Managed federal program operations supporting disaster response.
Supervisor, Unemployment Assistance Operations - Titan Technologies - Jacksonville, FL
(2020-05 - 2021-09)
- Oversaw daily operations, ensuring team adherence to safety protocols and quality standards.
- Trained and mentored new employees, fostering a collaborative work environment.
- Implemented process improvements that enhanced workflow efficiency and reduced downtime.
- Conducted regular performance evaluations, providing constructive feedback to team members.
- Oversaw statewide implementation and execution of unemployment assistance operations during COVID-19 response.
- Managed workloads and staff performance to ensure timely and compliant claims processing.
- Partnered with QA and leadership to maintain accuracy, compliance, and service delivery standards.
- Led process improvement initiatives to reduce bottlenecks and improve turnaround times.
- Managed high-volume claims operations and compliance.
- Improved workflow efficiency and service delivery.
Claims Business Process Analyst - UnitedHealthcare - Jacksonville, FL
(2017-01 - 2020-04)
- Analyzed business processes to identify inefficiencies and recommend improvements.
- Collaborated with cross-functional teams to streamline workflow and enhance operational performance.
- Developed comprehensive documentation for process mapping and analysis, ensuring clarity for stakeholders.
- Led initiatives to implement process automation tools, increasing productivity across departments.
- Supported implementation, testing, and optimization of claims systems and operational processes.
- Acted as business liaison between IT and operations during system implementations and major incidents.
- Managed CMS system access compliance across Medicare and Part D environments.
- Delivered training, documentation, and workflow improvements to support enterprise system adoption.
- Coordinated cross-functional teams to resolve system issues and enhance operational efficiency.
- Managed project timelines and deliverables, ensuring adherence to strategic goals and stakeholder expectations.
- Established strong relationships with internal clients to better understand their needs and expectations related to process improvements.
- Identified opportunities for cost savings through streamlined processes while maintaining quality standards.
Provider Enrollment Analyst - Blue Cross Blue Shield / First Coast Service Options - Jacksonville, FL
(2010-08 - 2012-03)
- Analyzed provider enrollment applications for adherence to regulatory standards, facilitating smooth onboarding processes.
- Engaged with cross-functional teams to ensure accuracy and consistency in provider data and documentation.
- Created comprehensive onboarding training materials for new analysts, fostering knowledge sharing and improving team performance.
- Conducted analysis of enrollment trends to identify opportunities for optimizing processes and enhancing accuracy.
- Oversaw CMS-compliant provider enrollment processes, ensuring precision and adherence to regulations.
- Ensured accuracy of provider credentials while addressing intricate enrollment challenges to streamline processes.
- Spearheaded client onboarding operations to enhance customer experience and satisfaction.
Telecom & Project Management - BellSouth, GTE, Alltel - Atlanta, GA
(1987-08 - 2004-06)
- Led large-scale service implementations and infrastructure projects.
- Managed cross-functional teams, client relationships, and operational transitions.
- Delivered enterprise-level project coordination, system conversions, and service deployments.
