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yyyyyy x. yyyyyy

0000 xxxxxx xxxx , xxxx , xxxxx 00000

xxx-xxx-xxxx •



versatile manager eager to contribute broad-scope experience toward supporting a dynamic organization in maximizing bottom-line performance.


leadership profile

quality-driven, strategic leader noted for championing significant process and performance improvements.


skilled at blending strong decision-making abilities with outstanding organizational skills, solid leadership attributes, and successful interpersonal relationship-building techniques.


demonstrate strong abilities in handling multiple projects simultaneously, meeting tight deadlines and working in a fast-paced professional environment.


proven track record of expertise in client-focused industries focused on delivering world class customer service.


consistently generated groundbreaking efficiencies and continuous process improvements to boost bottom-line profitability.


leadership career progression

amerigroup community care                                                                                                               2007-present

quality management-member advocate

  • spearhead all aspects of corporate quality audits, on a quarterly basis, of each company employee to ensure compliance with hipaa member privacy.
  • successfully conduct in-home member visits, providing detailed and engaging education on company plans and programs.
  • actively serve as liaison with state hot line/crisis staff, while also participating in health promotion activities at community centers, provider offices and health fairs.
  • proficiently investigate, resolve and document all member complaints and issues in accordance with state requirements.


cigna                                                                                                                                            1999-2006

medicare appeals senior associate, 2004-2006

  • consistently solved intricate medical eligibility and update issues to ensure member satisfaction.
  • tasked with the evaluation of medical records for first level appeals and drafting of written notification of final claim determination.
  • accurately determined the correct codes and coverage applied to medicare claims, while also recording claim adjustments and online payments in the database.

quality reviewer/auditor senior associate, 1999-2004

  • utilized extensive training in cigna healthcare applications and procedures in the development of process improvement training material.
  • successfully audited and reviewed accuracy of case processing, identifying areas of potential improvement.
  • actively monitored customer service phone calls for informational quality and accuracy.


professional education


masters of business administration in marketing walden university minneapolis, mn 2008-present


bachelors of arts in business management tennessee state university nashville, tn                         1993


yyyyyy x. yyyyyy

0000 xxxxxx xxxx , xxxx , xxxxx 00000

xxx-xxx-xxxx •











hiring agent name


company name


city/state/zip code




i am currently seeking a challenging career opportunity in a [insert job title] capacity and am submitting my resume for your review.  in advance, thank you for your time and consideration.


as demonstrated in the accompanying resume, my professional qualifications include experience in quality operations, conducting corporate audits and recommending improvements. an examination of my credentials will confirm that i am a skilled professional who thrives in a challenging work environment. i am driven, independently motivated, and results-oriented. i enjoy a challenge and work hard to achieve success. it is my practice to operate within a strict conduct of professionalism and integrity with my clientele. to complement this background, i offer dynamic communication, organization, administration, and relationship management skills.


as an employee, you will find me to be a driven team player committed to supporting you in achieving your objectives through superior performance.  i am confident that i could be a valuable asset to your company, and look forward to interviewing with you in the near future.









yyyyyy x. yyyyyy


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