Livecareer-Resume
Jessica Claire
  • , , 100 Montgomery St. 10th Floor
  • H: (555) 432-1000
  • C:
  • resumesample@example.com
  • Date of Birth:
  • India:
  • :
  • single:
Summary

Ability to set and achieve professional goals and tasks Experienced in researching and interpreting state and federal guidelines Ability to work both cohesively in a team setting and independently Experienced in participating in formal business meeting discussions with internal and external stakeholders Proficiently skilled in technological functions (i.e. Microsoft Office Programs) Ability to adapt in new surroundings, use critical thinking, pay attention to detail, and produce deliverables A self-starter capable of installing applications onsite and from remote locations. A technology-driven Implementation Specialist known to have a high level of patience and for providing exemplary service and assistance to clients. Driven Healthcare Professional dedicated to holistic support with background in [Area of Expertise]. Quick learner dedicated to strengthening expertise through ongoing education, professional development and hands-on experience. Strong critical thinking skills with ability to quickly recognize and execute emergency interventions. Demonstrated success in forging relationships with patients and providing counseling, support and companionship.

Skills
  • Project plan understanding
  • Reporting and documentation
  • Implementation and configuration
  • Complex issue resolution
Experience
IMPLEMENTATION SPECIALIST, 04/2021 - Current
Factset Research Systems Inc. NJ, State,
  • Maintained Subject Matter Expertise in ACA-related topics.
  • Continued developing and maintaining professional relationships with teammates and leaders.
  • Facilitated HHS-Risk Adjustment Data Validation (RADV) Audit for BY2019 and BY2020.
  • Participated in Product Development and Benefit Configuration discussions to offer regulatory guidance.
  • Facilitated PY2022 QHP Application filing submission.
  • Interpreted new legislative benefit mandates and communicated updates to internal stakeholders.
Associate Policy Specialist , 05/2020 - 04/2021
Asset Mark Chicago, IL,
  • Researched CMS rules and regulations and applied them in daily tasks.
  • Assisted in completing the Qualified Health Plan (QHP) Certification Application for Marketplace Coverage.
  • Reviewed and updated relevant policy and procedure documents.Regularly communicated and held meetings with a designated CMS Regional Account Manager.
  • Lead CMS-required project: Annual Rate Renewal and Discontinuation Notices.
  • Monitored and organized access permissions to CMS Programs for internal individuals.
  • Identified operational and performance issues and worked with managers to resolve concerns.
  • Served as liaison between certain departments to implement new improvement plans and changes.
Compliance Intern, 12/2018 - 02/2020
Sanford Health Plan City, STATE,
  • Planned and executed compliance audits to check company policies, procedures and controls.
  • Maintained and revised policy procedures for general operation of compliance program.
  • Implemented new template procedure for software database system, “PolicyTech”.
  • Coordinated with department manager(s) to efficiently transform policy documents.
Education and Training
Bachelor of Business Administration: Health Service Administration, Expected in 2018
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UNIVERSITY OF SOUTH DAKOTA - VERMILLION, SD
GPA:
GPA: 3.4, Conducted research over health care practices in local clinic facilities as well as local communities Gathered data through patient surveys regarding health care accessibility and quality Utilized translator services when faced with language barriers to communicate with individuals
Masters of Business Administration: Health Service Administration, Expected in 2019
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UNIVERSITY OF SOUTH DAKOTA FA16, E.A.L - ,
GPA:
HONORS COYOTE COMMITMENT SCHOLARSHIP, USD Scholarship awarded by semester according to, DEAN’S LIST, Maintained a minimum GPA of 3.5 while completing at least 12 credit hours in a semester during Undergraduate coursework HEALTH EXECUTIVES ADVANCING IN LEADERSHIP, GPA: 3.6
BBA degree: , Expected in 2018
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- ,
GPA:
MBA degree: , Expected in 2020
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- ,
GPA:
Faculty-Led Program: Study Abroad Trip to Ghana, Africa
Accomplishments
  • Develop useful techniques and knowledge about professionalism and leadership.
  • Network with professionals and executives in the healthcare field.
  • Attend bi-weekly meetings and events to gain knowledge about Health Administration.
  • Learn proper business etiquette and communication skills PI BETA PHI – SD ALPHA CHAPTER (GREEK SORORITY) AUG 2015 – DECEMBER 2018 Current Membership Status: Alumni.
  • Attended meetings on a weekly basis.
  • Maintained an encouraged level of GPA achievement.
  • Fundraised for Read Lead Achieve; a philanthropy that focuses on children’s literacy.
  • Engaged in community service/volunteer activities (ex.
  • Serving dinner at welcome table in Vermillion, SD) Environmental Chair (Spring 2017 – Spring 2018).
  • Developed and implemented a recycling program for Pi Beta Phi residential house.
  • Created educational tools to inform others about engaging in sustainable lifestyle measures DANCE MARATHON – “DAKOTATHON” AUG 2015 – MAY 2019 Marketing Committee Member.
  • Fundraiser for the Children’s Miracle Network - Encourage friends and family to donate on a regular basis.
  • Participate in year round fundraising activities on campus and in the community.
  • Personally fundraised $500+ in support of Children’s Miracle Network/Dance Marathon Organization.
Certifications
Six Sigma Lean Black Belt Professional Virtual Course Completed online course through Management and Strategy Institute (MSI) FEBRUARY 2021 Certified Associate Project Manager (CAPM) Virtual Exam Prep Course Online Exam Prep Course completed June 2021 Certification Pending Exam Exam Scheduled for September 2021
Activities and Honors

COYOTE COMMITMENT SCHOLARSHIP AUG 2015 – MAY 2019
 USD Scholarship awarded by semester according to GPA level
DEAN’S LIST – UNIVERSITY OF SOUTH DAKOTA FA16, FA17, SU18, FA18
 Maintained a minimum GPA of 3.5 while completing at least 12 credit hours in a semester during Undergraduate coursework
HEALTH EXECUTIVES ADVANCING IN LEADERSHIP (H.E.A.L) AUG 2015 – MAY 2019
Member
 Develop useful techniques and knowledge about professionalism and leadership
 Network with professionals and executives in the healthcare field
 Attend bi-weekly meetings and events to gain knowledge about Health Administration
 Learn proper business etiquette and communication skills
PI BETA PHI – SD ALPHA CHAPTER (GREEK SORORITY) AUG 2015 – DECEMBER 2018
Current Membership Status: Alumni
 Attended meetings on a weekly basis
 Maintained an encouraged level of GPA achievement
 Fundraised for Read Lead Achieve; a philanthropy that focuses on children’s literacy
 Engaged in community service/volunteer activities (ex. serving dinner at welcome table in Vermillion

DANCE MARATHON – “DAKOTATHON” AUG 2015 – MAY 2019
Marketing Committee Member
 Fundraiser for the Children’s Miracle Network - Encourage friends and family to donate on a regular basis
 Participate in year round fundraising activities on campus and in the community
 Personally fundraised $500+ in support of Children’s Miracle Network/Dance Marathon Organization

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School Attended

  • UNIVERSITY OF SOUTH DAKOTA
  • UNIVERSITY OF SOUTH DAKOTA FA16, E.A.L

Job Titles Held:

  • IMPLEMENTATION SPECIALIST
  • Associate Policy Specialist
  • Compliance Intern

Degrees

  • Bachelor of Business Administration
  • Masters of Business Administration
  • BBA degree
  • MBA degree

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