Experience

The Dirty Buffalo
• United States
• Restaurants
• 1 - 100 Employee
• Business Owner General Manager

  • Dec 2020 - Present


Anthem, Inc.

• United States
• Hospitals and Health Care
• 700 & Above Employee

• Manager Business Information

  • Nov 2017 - Jan 2021

  Encounters Manager overseeing daily operations for 24 Medicaid market submissions. Manage the ongoing transition of all markets to a new processing platform (Edifecs).• Manage day to day operations of 24 markets submissions for annual encounters submissions of ~$18B • Successfully transitioned the first 5 markets from legacy platform to a new Edifecs platform with improved accuracy of ~2% and doubled the submission frequency.• Improved submission process efficiencies by 30% within first ten months on the legacy system.• Collaborate with Encounters Operations, and Encounters IT to establish continual process improvements working within the Agile framework• Designed and implemented a Kanban board and process to allow quick response to market issues.• Implemented new standard procedural and control documents. Show less

• Business Consultant

  • Feb 2017 - Nov 2017

  Cost of Care (COC) vendor data exchange business owner for the Enrollment & Billing (E&B) department. Collaborate with senior leaders in cross departmental business requirement meetings.• Manage all current E&B COC data exchanges to and from our vendors• Create detailed requirement documents for project charters• Perform UAT testing on all implementations• Manage the coordination of implementations between IT and E&B business team for new data exchanges

• Business Information Analyst Sr

  • Oct 2015 - Feb 2017

  Team Lead for Encounters Management, assisting with the management and operations for the Florida, Georgia, Kansas, Kentucky, and Tennessee Medicaid markets..• Worked cohesively with the Health Plan senior management teams to drive acceptance rates up and reduce financial penalties• Managed risk adjustment for KY Medicaid encounters• Managed day to day operations of KY Medicaid Encounter submissions, monitoring acceptance rates, and collaborating with healthplan senior management to correct pends/adjustments.• Assisted the with on-boarding, training, and mentoring for the department• Collaborated with multiple department heads, legal representatives, and privacy coordinators to ensure timely and accurate communications for all data breach communications• Liaised ESI projects, drew up requirements, milestone tracking, and ensured deadlines where met for state compliance mandates.• Secured multiple database server locations to support daily operations• Collaborate with IT counterparts to ensure technical changes are tested and implemented into production Show less

• Business Information Analyst II

  • Jan 2014 - Oct 2015

  Team Lead for the Florida, Georgia, Kansas, Kentucky, and Kansas Medicaid markets. Market analyst for the Kentucky, Maryland, Nevada, and New Mexico markets for Encounters Operations .Review, analyze, and edit weekly batches to conform to HIPPA file validation standards. Ensure market submissions stay above a 98% acceptance rating. Collaborate with IT counterparts to ensure technical changes are tested and set into production. • Triaged, and collaborated with multiple department heads, legal representatives, and privacy coordinators to ensure timely and accurate communications with all data breach communications• Liaison between Encounters Management and Express Scripts for all outstanding issues, and implementations.• Assisted senior developer in creation and testing of a client reporting extract database tool• Secure multiple database server locations to support daily operations Show less

• Health Care Economics Analyst

  • May 2012 - Jan 2014

  Assist in efforts to mature data governance department, through regular data governance council meetings, trainings, planning sessions and implementation of supporting software. Perform various user based audits to verify usability to be able to forecast yearly budget requirements. • Learned new technology (Talend), Performed a proof of concept of a new technology, with minimal guidance from management and provider. Implemented Talend into multiple projects for data loading, profiling, and management needs.• Manage all users for the active directory. Start and monitor all workflows for all users requesting access. Perform monthly update audits, as well as bi annual audits to verify business needs, and compare to IT’s list of users.• Designed and maintain monthly Interim Data project SQL Database. Perform monthly database backups, and utilize SSIS for monthly data loads.• Code release coordinator. Liaison between Health Care Economics and IT for all Change Requests utilizing the JIRA system. Facilitate Code release review meetings. Schedule release review meetings, set agenda for each meeting, record meeting notes. Maintain a hard copy log of all approvals.• Assist in creating Data governance policies, Maintain policies and implement new policies as needs arise. Ensure that all new projects follow the standards set by the data governance policies. Ensure that all data profiling is complete and accurate for new data sources. Data Governance meeting scribe. Set agenda for all data governance meetings (reoccurring weekly meeting), record meeting notes, maintain hard and soft copy log of all approved items. Put together the current data stewardship training material. Show less


Tactical Arms Outfitters
• President

  • Oct 2016 - Jan 2019


L-3 Communications

• Aircraft Mechanic 4B

  • Jun 2010 - Feb 2012

  Senior structural mechanic in charge of teams to complete all structural repairs. Assist team lead with all program functions on multiple aircraft platforms. Assemble, motivate, and train small multi-disciplined teams to complete numerous modifications to complete project on time and within budget. • Collaborate with project lead to determine project scheduling, and resource allocations. • Analyze hours used to hours budgeted to provide earned value reporting and budget forecasting. • Streamlined travel reimbursement by removing redundant oversight, resulting in a reduction from 21 days to less than 10 days. • Analyze repair processes, to ensure proper compliance, and ensure quality. • Researching and generating orders monthly to replenish essential resources. Show less



Northrop Grumman

• Airlines and Aviation
• 1 - 100 Employee

• Structures Technician

  • Jul 2009 - May 2010

  Team coordinator responsible for assisting aircraft manager with delegating task responsibilities to employees and monitoring project status. Prioritize work orders and analyzed repair processes to ensure efficiencies, quality, and safety. Identify opportunities for cost savings while maintaining quality and productivity. • Analyzed team performance to safety, and quality control standards. • Reviewed and implemented changes to task list and policies to lean conform to lean processes. • Identified key contributors to form rapid repair teams (3-8 people) to quickly complete mission critical tasks. • Creating decision tracking log extracting items from meeting minutes for aircraft progress meetings. • Perform highly complex repair tasks. Show less



Agusta Westland Bell

• Supply Chain Clerk

  • Oct 2008 - May 2009

  Lead shipping and receiving manager for VH-71 Presidential helicopter program. Responsible for maintaining a continuous accurate inventory and kitting procedures for helicopter parts valued at $2.7M. • Designed and coordinated setup of parts/ kitting department for the VH-71 Presidential helicopter program. • Developed and maintained tracking spreadsheets in Excel to identify and log item shortages. • Perform weekly 10% inventory spot checks comparing inventory system to physical inventory to ensure accuracy, for audit control. • Collaborated with a team of 4 professionals to establish and maintain standard operating procedures for the program’s day-to-day operations. • Created daily, weekly, and monthly status reports for vendor meetings. • Maintain Inventory, Orders, and hours utilizing SAP. Show less



US Marine Corps

• Military
• 300 - 400 Employee

• Sergeant Airframes Technician

  • Jan 2001 - May 2009

  Supervisor of airframes, and hydraulic shop consisting of 12 marines. Lead mentor and train all junior marines. Core player in maintenance division dedicated to maintain mission readiness. • Assign daily work load to complete maintenance and keep mission ready status of at least 85% • Continuous analysis of all programs and processes to include; Maintenance Publications, Tool Control, FOD, and Health and Safety, to ensure full compliance, and maintain proper documentation. • Initiate relationships with local and federal law agencies to receive and compare intelligence information. Designed and implemented a read board and indoctrination class for the Anti-Terrorism Force Protection Unit. (Received Certificate of Commendation). • Awarded Marine of the quarter 3rd quarter 2003 • Responsible for ordering all parts and tools utilizing military ordering system. Show less