LiveCareer-Resume

director resume example with 14+ years of experience

Jessica Claire
  • Montgomery Street, San Francisco, CA 94105 609 Johnson Ave., 49204, Tulsa, OK
  • Home: (555) 432-1000
  • Cell:
  • resumesample@example.com
  • :
Professional Summary

Dedicated professional with a history of meeting company goals utilizing consistent and organized practices. A Dynamic Director who oversees every facet of production with strong project management and decision-making skills.

Skills
  • Advanced experience in Microsoft Office (Word and PowerPoint)
  • Intermediate level with Excel and Visio
  • Operations Management
  • Operations Oversight
  • Business Development
  • Strategic Planning
  • Performance Monitoring and Evaluation
  • Strategic Partnership
  • Presentations and Demonstrations
  • Roadmap Development
  • Cross-Functional Team Management
Work History
Director, 03/2021 to Current
Hcl Technologies Ltd., ,
  • Responsibility for strategic direction and overall oversight for ACE Smart Edit program. Growth of program from 5 edits to over 700 edits with $300M+ in medical cost savings in less than 5 years
  • Manage roadmap, capital (financial) needs, technical work, testing, and deployment of new capabilities for program
  • Direct all technical changes, mapping, and upgrades for the program with product leads and developers
  • Manage direct and indirect reporting teams of business analysts, product managers, and associate directors to work with external partners, build business requirements, audit process, work with legal support, and all processes associated with deploying ACE editing and capabilities
  • Understanding of EDI submission process and the life cycle of a claim from provider practice management system through payer response and adjudication
  • Remained highly composed and calm in very fast-paced, stressful and constantly changing environments to provide optimal leadership and achieve desired results
  • Communicated program results with executive leadership in many different forums
Senior Product Manager, 02/2019 to 03/2021
Foundation Capital, ,
  • Build ACE Smart Edit capabilities with augmented data capabilities to grow from 5 edits to hundreds of edits in small timeframe
  • Established relationships with business partners to educate on ACE Smart Edits and process
  • Manage team of business analysts, release calendar, legal discussions and establish all processes for ACE Smart Edits
  • Increase relationships with external teams that collaborate with ACE Smart Edits but do not align to team this includes provider engagement, operations, content, technical teams, reporting team
Business Process Consultant, 04/2017 to 02/2019
Apex Systems, ,
  • Manage project Initiatives that are assigned
  • Follow agile project process including building features, user stories, and sprints
  • Organize business team and development team to deploy projects on time with high quality
  • Schedule stand-up meetings with development team and check-in meetings with business team
  • Report updates to all projects to leadership
Manager Claims, 04/2016 to 04/2017
Baylor Scott & White Health, ,
  • Manage Product Initiatives that are assigned
  • Manage a process consultant team with multiple fast-paced projects for self-funded and fully insured plans
  • Assign projects to team, performed capacity planning, and manage implementation of new projects deploying
  • Schedule weekly one on one calls with each member of team to review projects and assist with any concerns/delays in projects
  • Schedule bi-monthly development calls to continue to grow each member of team towards their goals
  • Attend project meetings throughout Analysis, Development, and Deployment of project.
Claims Business Process Consultant Sr, 03/2015 to 04/2016
United Health Care, ,
  • Project management of end to end Benefit Operations included Transactions and Rework
  • Attend project meetings and established process changes that would impact claims processing
  • Review project requirements and be sign off lead for each project assigned
  • Implement any training, SOP, or other documents needed for Transactions/Rework to be able to apply new process
Multiple Positions, 03/2009 to 02/2015
UnitedHealth Care, ,
  • Identified and resolved problems through root cause analysis and research.
  • Validated results and performed quality assurance to assess accuracy of data.
  • Applied knowledge of data modeling and statistical analysis to note trends and draw conclusions.
  • Documented procedures and business processes and shared information with appropriate stakeholders.
  • Researched and recommended process improvements designed to mitigate operational and financial risk.
  • Evaluated and adopted new technologies to address changing industry needs.
  • Generated reports detailing findings and recommendations.
Education
MBA: Business Intelligence, Expected in 07/2015 to Capella University - Minneapolis, MN
GPA:
MBA: Project Management, Expected in 07/2015 to Capella University - Minneapolis, MN
GPA:
Bachelor of Arts: Children's Ministry, Expected in 12/2003 to North Central University - Minneapolis, MN
GPA:
Accomplishments
  • Service Hero Award 2015 (UHC)
  • Emerging Leader Program Graduate 2017 (UHC)
  • Leaders in Action Graduate 2022 (UHC)
Certifications
  • Foundational Quality Six Sigma Yellow Belt Received in 2014
  • Six Sigma Green Belt Received in March 2016
,
Work History
Director, 03/2021 to Current
UnitedHealth Care,
  • Responsibility for strategic direction and overall oversight for ACE Smart Edit program. Growth of program from 5 edits to over 700 edits with $300M in medical cost savings
  • Manage roadmap, capital (financial) needs, technical work, testing, and deployment of new capabilities for program
  • Manage team of business analysts, product managers, and associate directors to work with external partners, build business requirements, audit process, work with legal support, and all processes associated with deploying ACE editing and capabilities
  • Formed strategic partnerships to drive business development
  • Remained highly composed and calm in very fast-paced, stressful and constantly changing environments to provide optimal leadership and achieve desired results
  • Communicated program results with executive leadership in many different forums
Senior Product Manager, 02/2019 to 03/2021
United Health Care,
  • Build ACE Smart Edit capabilities with augmented data capabilities to grow from 5 edits to hundreds of edits in small timeframe
  • Established relationships with business partners to educate on ACE Smart Edits and process
  • Manage team of business analysts, release calendar, legal discussions and establish all processes for ACE Smart Edits
  • Increase relationships with external teams that collaborate with ACE Smart Edits but do not align to team this includes provider engagement, operations, content, technical teams, reporting team
Business Process Consultant, 04/2017 to 02/2019
United Health Care,
  • Manage project Initiatives that are assigned
  • Follow agile project process including building features, user stories, and sprints
  • Organize business team and development team to deploy projects on time with high quality
  • Schedule stand-up meetings with development team and check-in meetings with business team
  • Report updates to all projects to leadership
Manager Claims, 04/2016 to 04/2017
United Health Care,
  • Manage Product Initiatives that are assigned
  • Manage team of 5 employees
  • Assign projects to team, performed capacity planning, and manage implementation of new projects deploying
  • Schedule weekly one on one calls with each member of team to review projects and assist with any concerns/delays in projects
  • Schedule bi-monthly development calls to continue to grow each member of team towards their goals
  • Attend project meetings throughout Analysis, Development, and Deployment of project.
Claims Business Process Consultant Sr, 03/2015 to 04/2016
United Health Care,
  • Project management of end to end Benefit Operations included Transactions and Rework
  • Attend project meetings and established process changes that would impact claims processing
  • Review project requirements and be sign off lead for each project assigned
  • Implement any training, SOP, or other documents needed for Transactions/Rework to be able to apply new process
Multiple Positions, 03/2009 to 02/2015
UnitedHealth Care,
  • Identified and resolved problems through root cause analysis and research.
  • Validated results and performed quality assurance to assess accuracy of data.
  • Applied knowledge of data modeling and statistical analysis to note trends and draw conclusions.
  • Documented procedures and business processes and shared information with appropriate stakeholders.
  • Researched and recommended process improvements designed to mitigate operational and financial risk.
  • Evaluated and adopted new technologies to address changing industry needs.
  • Generated reports detailing findings and recommendations.

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Resume Overview

School Attended

  • Capella University
  • Capella University
  • North Central University

Job Titles Held:

  • Director
  • Senior Product Manager
  • Business Process Consultant
  • Manager Claims
  • Claims Business Process Consultant Sr
  • Multiple Positions

Degrees

  • MBA
  • MBA
  • Bachelor of Arts

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