Results-driven Management Professional eager to contribute extensive compliance,

project coordination, and program administration expertise toward supporting a progressive organization in optimizing bottom-line performance.

 

 

        Proven strengths in monitoring and enforcing regulatory compliance in the health care insurance arena.

        Proactively establish cohesive working relationships with all levels of an organization, critical to expediting daily activities and achieving desired outcomes.

        Deploy sound business instinct to rapidly identify and implement solutions for measurable process improvements.

        Excel in driving sales and marketing efforts with proficiency in new business development, strategic planning, and customer relations and retention.

        Considerable ability to quickly adapt to new roles, responsibilities, industries, and environments.

 

 

Passport Health Plan, Louisville, KY, 2009 to Present

Manager, Statutory Compliance

         Spearhead daily operations related to compliance with state Medicaid contract, reporting, and regulatory requirements.

         Reliably prepare and submit updates on regulatory changes for senior management.

         Efficiently and thoroughly coordinate comprehensive external quality reviews.

• Drive continuous improvement initiatives to fortify compliance and ensure DMS satisfaction.
• Exercise strong organizational skills to create, implement and continually assess processes and procedures vital to achieving and maintaining compliance with HIPAA criteria.
• As Privacy Officer, formulate, implement and monitor privacy policies and procedures and respond appropriately to privacy and security complaints.

 

Commonwealth of Kentucky, Cabinet for Economic Development, Frankfort, KY, 2006 to 2009

Economic Development Representative

• Diligently enforced regulatory compliance for companies participating in financial incentive programs.

 

Continued

 

 

 

 

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Professional Experience continued

 

• Applied exemplary interpersonal skills toward conducting facility visits and meeting with company representatives to evaluate project records, address identified issues, and inspect project premises.
• Provided Kentucky Department of Revenue with information vital to tracking incentives.
• Closely monitored changes to current projects and partnered with legal counsel to amend existing contracts and administer new contracts.
• Teamed with personnel from Financial Incentives Programs Division to uncover problem areas and implement immediate corrective action.

 

Loan Processing Center, Louisville, KY, 2002 to 2004

Sales and Marketing Manager / Branch Manager

• Promoted to navigate complete sales and marketing operations inclusive of research, networking clients, and delivering informative and persuasive presentations.
• Successfully grew sales in primary market to meet company revenue goals.

• In initial role as Branch Manager, effectively performed office management encompassing scheduling, staffing/hiring, training, sales, marketing and policy and procedure development.

 

Passport Health Plan, Louisville, KY, 1997 to 2002

Manager, Statutory Compliance (1999 to 2002)

         Contributed strong prioritization skills toward devising project plans for government filings, auditing reports used for government submissions, and precisely tracking program statistics.

• Collaborated with service providers such as physicians, dentists, ancillary service providers and pharmacies to ensure adherence to contractual obligations.
• Reviewed, assessed and prepared wide range of documentation, reports and correspondence.

 

Member Education / Advocacy Specialist (1997 to 1999)

         Cooperated with Public Affairs Department to create and distribute literature to plan members, community agencies and providers clearly explaining plan benefits and programs.

         Held member education meetings and workshops, community forums, and special events to disseminate helpful information regarding plan services and benefits.

         Conducted program evaluations to gauge effectiveness of member education initiatives, outreach programs, and literature.

 

 

University of Louisville, Louisville, Kentucky:

Master of Arts, Higher Education Administration (in progress), Sports Administration

Bachelor of Arts, Psychology, Social Sciences

 

National Development Council:

Economic Development Finance Professional Certification (EDFP)

 

 

 

 

 

 

 

Date

 

 

Hiring Agent Name

Title

Company Name

Address

City/State/Zip Code

 

Dear__________________:

 

I am currently seeking a challenging career opportunity in a <insert job title/position> capacity and am submitting my resume for your review. In advance, thank you for your time and consideration.

As indicated in the accompanying resume, I bring to you significant experience in steering regulatory compliance related to healthcare insurance, proficiency in project and program management, considerable talents in policy and procedure development, and the flexibility to skillfully handle competing demands and challenges. To complement these qualifications, I offer well-developed planning, critical thinking, analytical and communication skills.

As a proactive contributor to your organization, you will find me to be a self-motivated professional committed to supporting you in achieving your objectives through keen planning, prioritization, and problem solving skills. I am confident that I could be a valuable asset to your organization, and look forward to interviewing with you in the near future.

 

Sincerely,

 

 

 

Yyyyyy x. yyyyyy