Experience

Integrity Management Services, Inc.

• United States
• Business Consulting and Services
• 1 - 100 Employee

• Investigator

  • Oct 2021 - Present



UnitedHealth Group

• Hospitals and Health Care
• 700 & Above Employee

• Senior Fraud Investigator

  • Sep 2020 - Oct 2021



Allianz Partners

• France
• Insurance
• 700 & Above Employee

• Product Specialist

  • Nov 2019 - Jun 2020

  Developed and deployed new products in collaboration with product managers. Completed competitive analysis of products within the insurance industry and performed quality and peer reviews for presentation to product implementation teams. Assessed and developed contract negotiations with partners and with sales teams. Managed and updated domestic master product list to be accessed by senior leadership team. • Contributed to 150% revenue increase year-over-year through support of competitive analysis. Show less



Virginia Premier

• United States
• Insurance
• 300 - 400 Employee

• Program Integrity Analyst II

  • Oct 2014 - Nov 2019

  Examined claims data; located aberrancies that indicated potential fraud, and audited records of medical providers. Assessed annual work plans, data analyses, and referrals to coordinate provider audits. Served as key resource in fraud, waste, and abuse reporting systems. Constructed dedicated reports for product lines and business units. Contributed to presentation of analytics-based business opportunities; liaised with insurance providers and external regulatory agencies to ensure steady processes. • Reviewed $30,000,000 in Medicaid insurance claims. Show less



CENN, Inc

• Ashland, va

• Resource Manager

  • Jul 2013 - Oct 2014

  Provided leadership with analytics in support of increasing profit margin; created staffing tool focused on client relationship development and enhancing organizational efficiencies. Ensured leadership team was informed and compliant with Affordable Care Act regulations—contributed to decision-making processes. • Coordinated development and maintenance of schedules for 70 to 90 home care aides through weekly Scheduling Team management and updates. Provided leadership with analytics in support of increasing profit margin; created staffing tool focused on client relationship development and enhancing organizational efficiencies. Ensured leadership team was informed and compliant with Affordable Care Act regulations—contributed to decision-making processes. • Coordinated development and maintenance of schedules for 70 to 90 home care aides through weekly Scheduling Team management and updates.



DISYS

• Onsite, Capital One, Richmond, VA

• Data Analyst

  • Jun 2012 - May 2013

  Organized and recorded business requirements to build forecasting model resource—provided analytics and reporting packages for Card CSEO. Issued ongoing process improvement recommendations and results of root cause analyses. • Reported for 1500+ member CIIG and Portfolio Health teams, presenting regular “business as usual” reports. Organized and recorded business requirements to build forecasting model resource—provided analytics and reporting packages for Card CSEO. Issued ongoing process improvement recommendations and results of root cause analyses. • Reported for 1500+ member CIIG and Portfolio Health teams, presenting regular “business as usual” reports.



Genworth

• United States
• Insurance
• 700 & Above Employee

• Business Analyst

  • Jul 2011 - Jun 2012

  Performed data collection, root cause analysis, training development, and process improvement planning. Led weekly root cause analysis meetings with organizational directors; provided expertise in processor error data. • Expanded sales footprint through coordination with sales team, data analysis, and exploring opportunities.

• Fraud Analyst

  • Nov 2009 - Jul 2011

  Designed workflow for Special Investigation Unit, and established reporting tools for business objects to facilitate tracking of case volumes and trends. Presented regular metrics updates for LTC Metrics and Fraud Council distribution. Documented and outlined SOPs and best practices for Fraud Response Team.• Formulated instructional materials outlining security and consistency.

• Operations Analyst

  • Aug 2008 - Nov 2009

  Performed data collection, root cause analysis, training development, and process improvement planning. Led weekly root cause analysis meetings with organizational directors; provided expertise in processor error data. • Expanded sales footprint through coordination with sales team, data analysis, and exploring opportunities.

• Problem Resolution Specialist

  • Jan 2006 - Aug 2008

  Spearheaded project affecting 2500+ contract holders; collaborated with 13-member team to troubleshoot complex issues for customers, brokers, firms, and sales team representatives within service center environment.

• Sales Solution Specialist

  • Sep 2005 - Jan 2006

  Assisted annuity agents—in call center—with contract inquiries. Performed at or above customer service goal levels.



BB&T

• United States
• Financial Services
• 700 & Above Employee

• Teller Supervisor

  • May 2003 - Sep 2005

  Guided branch teller staff in support of retail banking clients. Coordinated scheduling, and trained staff to exceed quarterly sales goals. Accurately presented currency shipment forecasts. Guided branch teller staff in support of retail banking clients. Coordinated scheduling, and trained staff to exceed quarterly sales goals. Accurately presented currency shipment forecasts.