Centene Corp / Health Net Federal Services

Title: Operations Team Lead

Timeline: (March 2017) - (September 2018)
Health Net Federal Services / Centene
5701 E Hillsborough Ave
Tampa, Florida 33610

Link: Health Net Federal Services
Facebook: Health Net Federal Services Facebook

·      I resolved provider, Veteran and VA government claim inquiries, escalation, and investigations. Outperformed in timely and efficient conflict claims resolution with 100% success rate.

·      I collaborated and managed an Excel automated training report, which reduced reporting times. Reducing time from three hours to thirty minutes, with reports and percentages on learning patterns, areas of opportunity, attendance, capability, systems access, critical successes, correlative trending, and summarizations.

·      I successfully grew and developed three agile, cross-functional teams and exceeded performance expectations under the established metrics.

Title: Authorization and Appointing

Timeline: (May 2016) - (March 2017)
Health Net Federal Services / Centene
5701 E Hillsborough Ave
Tampa, Florida 33610

Link: Health Net Federal Services
Facebook: Health Net Federal Services Facebook

Primary:

·      I facilitated Veteran’s with arranging care with non-VA providers.

·      I was the liaison between the ordering physician and facilitating company to ensure any and all requirements to secure approval are identified and communicated prior to service being rendered.

·      I achieved high production rates initiated by management by pursuing prospect leads to ensure pipeline sufficiency.