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JC
Jessica Claire
, , 100 Montgomery St. 10th Floor (555) 432-1000, resumesample@example.com
Professional Summary

Insightful Manager with experience directing and improving operations through effective employee motivational strategies and strong policy enforcement. Proficient in best practices, market trends and regulatory requirements of industry operations. Talented leader with analytical approach to business planning and day-to-day problem-solving.

Skills
  • Policies and procedures
  • Strategic planning
  • Project Management
  • Process Improvement initiatives
  • Coaching and mentoring
  • Operations management
Work History
09/2020 to Current Manager, Business Configuration Fidelity National Information Services | Salem, NH,
  • Responsible for overseeing configuration design, testing and implementation of processes related to configuration and quality assurance testing for Magellan business systems.
  • Manage the planning, testing and execution of configuration logic changes to all environments.
  • Manage configuration and quality assurance analysts in the documentation of standards, requirements, and completion of configuration and testing activities in accordance with requirements.
  • Supervises and conducts audits of configuration and quality assurance analysts to these standards, documents and communicates the results, and follows-up on changes.
  • Facilitates development, documentation and signoff of related policies and procedures that will support efficient and effective business systems configuration and quality assurance activities.
  • Works with Business and IT leaders to set priorities of projects and associated tasks.
  • Responsible for prioritization and delegation of work of direct reports.
  • Develops and evaluates departmental policies/workflows to help ensure reliable and effective deployment releases.
06/2019 to 06/2020 Domain Lead Us Ecology, Inc. | Minneapolis, MN,
  • Served as portfolio owner, manager, and advisor and therefore accountable as portfolio owner, manager, and advisor and therefore accountable as revenue, cost and content authority within client domain and sub-systems. Responsible for monitoring delivery tactics and strategies and participate in governance rest with leaders.
  • Managed risk, issues, and complexity in program and project work efforts by collaborating with Business Analyst and technology experts.
  • Served as business expert influencing client and DXC Technology tactics and strategies.
  • Took part in client meetings, requirement sessions, testing efforts and governance leadership meetings to ensure and report reliability, timeliness of project activities.
  • Drove, assist and coordinated with various teams designated to accomplish various project tasks and assignments from initiation through execution.
  • Accountable for developing project charters including project scope, goals, milestones, deliverables, T-Shirt sizing, and presenting to client leadership for approval.
01/2018 to 03/2019 Agile Product Owner Anthem | City, STATE,
  • Served as voice to agile team, contact to end users and relayed expectations of product features to development team.
  • Created and managed product backlog, and user stories for implementation and to determine product features before release.
  • Conducted backlog grooming meetings with team of product owners and contracts agile team, allowing each person to view and agree on items that are, or will be prioritized for release.
  • Attended sprint planning and demo meetings, giving feedback on achievement and Scrum team.
  • Participated in Agile conferences, Agile Release Train (ART) and study relevant scrum material, updating job knowledge / skill.
  • Measured product performance and value delivered to clients, pivoting / changing course where necessary when faced with obstacles.
  • Guaranteed implemented product features add value to end users by doing due diligence, which in turn increased company revenue, saved overtime, and improved productivity.
01/2017 to 03/2019 Senior Manager (Compliance, Policy & Contracts) Anthem | City, STATE,
  • Led compliance, contract administration, and business analyst staff of 12.
  • Directed processing of policies and certificate fulfillment for individual, employer group and supplemental health products approved by Department of Insurance (DOI).
  • Served as project manager or subject matter expert (SME) for all compliance and contract matters.
  • Oversaw organizational contract development and management activities, enforcing business principals of integrity and compliance.
  • Conducted periodic internal reviews or audits, ensuring compliance procedures are followed.
  • Provided consultative services to sales and client groups in response to questions, offering appropriate alternatives in response to complex / non-compliant customized certificate requests.
  • Analyzed complex end-user needs, determining optimal means of meeting requirements.
01/2011 to 03/2019 Senior Manager (Enrollment & Billing) Anthem | City, STATE,
  • Oversaw customer care, production of ID cards, enrollment, and billing operations for dental and vision products for consumers over age 65.
  • Managed business analyst, trainer-auditor and enrollment and billing operations for staff of 10. (year: 2001 - 2019)
  • Directed 6 associates in Financial Ops, which consisted of handling financial aspects of Anthem Life Insurance Company.
  • Ensured information processed above target by creating check and balances and award system.
  • Enrollment Quality averaged 99.7%, Customer Care Quality 99.9%, and, Resolution of Custom Care 2-day turnaround time all over 8-year period.
  • Provided strategic decisions that affected functional areas of responsibilities and interconnected Medicare Supplement products, increasing in revenue.
  • Allowing members over age 65 to enroll online for coverage, giving members option to receive enrollment kits electronically, and pay premiums via ACH (one-time payment or recurring).
  • Implemented online payments for Life & Disability company and Anthem Extras, eliminating paper billing and viewing history on website, reducing delinquent accounts, and saving paper, time and postage.
  • Employed “Web Exception” for Life & Disability company and Anthem Extras, enabling associates to view financial documents sent to banking lockbox online and handle accordingly, reducing turnaround time from up to 5 business days to 24 hours.
  • 100% paperless for financial OPS and enrollment and billing.
  • Served as project manager or subject matter expert (SME) for Anthem Extras Packages (O65) and interrelated Medicare supplement products, permitting more involvement with team projects which in turn provided value to other areas, making decisions on how we could better service customers, and becoming the “go-to” contact.
to Manager (Life & Disability Implementation and OPS) Anthem | City, STATE,
  • L&D Implementation and Operations Directed team of 50, which consisted of overseeing receipt of new business through enrollment and billing.
to Operations Manager Managed Care Of America, Inc. | City, STATE,
  • Led staff of 25, including customer care, dental and medical claims adjudicators, claims adjusters, clerical support, and accounting.
Education
Expected in 12/2009 Bachelor of Arts (BA) | Business Ohio Dominican University, Columbus, OH GPA:
Websites, Portfolios, Profiles
  • www.linkedin.com/in/JessicaClaire
Certifications
  • Professional Management Professional (PMP) Certification, Columbus, OH, currently pursuing
  • SAFe Product Owner/Product Manager (POPM), Columbus, OH, currently pursuing
  • Six Sigma Black Belt Master Certification, Villanova University, Villanova, PA
Skills
  • Policies and procedures
  • Strategic planning
  • Project Management
  • Process Improvement initiatives
  • Coaching and mentoring
  • Operations management
Work History
09/2020 to Current Manager, Business Configuration Magellan Healthcare | Scottsdale, AZ (Remote)
  • Responsible for overseeing configuration design, testing and implementation of processes related to configuration and quality assurance testing for Magellan business systems.
  • Manage the planning, testing and execution of configuration logic changes to all environments.
  • Manage configuration and quality assurance analysts in the documentation of standards, requirements, and completion of configuration and testing activities in accordance with requirements.
  • Supervises and conducts audits of configuration and quality assurance analysts to these standards, documents and communicates the results, and follows-up on changes.
  • Facilitates development, documentation and signoff of related policies and procedures that will support efficient and effective business systems configuration and quality assurance activities.
  • Works with Business and IT leaders to set priorities of projects and associated tasks.
  • Responsible for prioritization and delegation of work of direct reports.
  • Develops and evaluates departmental policies/workflows to help ensure reliable and effective deployment releases.
06/2019 to 06/2020 Domain Lead DXC Technology, Inc [Ohio Department Of Medicaid] | Columbus, OH
  • Served as portfolio owner, manager, and advisor and therefore accountable as portfolio owner, manager, and advisor and therefore accountable as revenue, cost and content authority within client domain and sub-systems. Responsible for monitoring delivery tactics and strategies and participate in governance rest with leaders.
  • Managed risk, issues, and complexity in program and project work efforts by collaborating with Business Analyst and technology experts.
  • Served as business expert influencing client and DXC Technology tactics and strategies.
  • Took part in client meetings, requirement sessions, testing efforts and governance leadership meetings to ensure and report reliability, timeliness of project activities.
  • Drove, assist and coordinated with various teams designated to accomplish various project tasks and assignments from initiation through execution.
  • Accountable for developing project charters including project scope, goals, milestones, deliverables, T-Shirt sizing, and presenting to client leadership for approval.
01/2018 to 03/2019 Agile Product Owner Anthem | Columbus, OH
  • Served as voice to agile team, contact to end users and relayed expectations of product features to development team.
  • Created and managed product backlog, and user stories for implementation and to determine product features before release.
  • Conducted backlog grooming meetings with team of product owners and contracts agile team, allowing each person to view and agree on items that are, or will be prioritized for release.
  • Attended sprint planning and demo meetings, giving feedback on achievement and Scrum team.
  • Participated in Agile conferences, Agile Release Train (ART) and study relevant scrum material, updating job knowledge / skill.
  • Measured product performance and value delivered to clients, pivoting / changing course where necessary when faced with obstacles.
  • Guaranteed implemented product features add value to end users by doing due diligence, which in turn increased company revenue, saved overtime, and improved productivity.
01/2017 to 03/2019 Senior Manager (Compliance, Policy & Contracts) Anthem | Columbus, OH
  • Led compliance, contract administration, and business analyst staff of 12.
  • Directed processing of policies and certificate fulfillment for individual, employer group and supplemental health products approved by Department of Insurance (DOI).
  • Served as project manager or subject matter expert (SME) for all compliance and contract matters.
  • Oversaw organizational contract development and management activities, enforcing business principals of integrity and compliance.
  • Conducted periodic internal reviews or audits, ensuring compliance procedures are followed.
  • Provided consultative services to sales and client groups in response to questions, offering appropriate alternatives in response to complex / non-compliant customized certificate requests.
  • Analyzed complex end-user needs, determining optimal means of meeting requirements.
01/2011 to 03/2019 Senior Manager (Enrollment & Billing) Anthem | Columbus, OH
  • Oversaw customer care, production of ID cards, enrollment, and billing operations for dental and vision products for consumers over age 65.
  • Managed business analyst, trainer-auditor and enrollment and billing operations for staff of 10. (year: 2001 - 2019)
  • Directed 6 associates in Financial Ops, which consisted of handling financial aspects of Anthem Life Insurance Company.
  • Ensured information processed above target by creating check and balances and award system.
  • Enrollment Quality averaged 99.7%, Customer Care Quality 99.9%, and, Resolution of Custom Care 2-day turnaround time all over 8-year period.
  • Provided strategic decisions that affected functional areas of responsibilities and interconnected Medicare Supplement products, increasing in revenue.
  • Allowing members over age 65 to enroll online for coverage, giving members option to receive enrollment kits electronically, and pay premiums via ACH (one-time payment or recurring).
  • Implemented online payments for Life & Disability company and Anthem Extras, eliminating paper billing and viewing history on website, reducing delinquent accounts, and saving paper, time and postage.
  • Employed “Web Exception” for Life & Disability company and Anthem Extras, enabling associates to view financial documents sent to banking lockbox online and handle accordingly, reducing turnaround time from up to 5 business days to 24 hours.
  • 100% paperless for financial OPS and enrollment and billing.
  • Served as project manager or subject matter expert (SME) for Anthem Extras Packages (O65) and interrelated Medicare supplement products, permitting more involvement with team projects which in turn provided value to other areas, making decisions on how we could better service customers, and becoming the “go-to” contact.
to Manager (Life & Disability Implementation and OPS) Anthem | Columbus, OH
  • L&D Implementation and Operations Directed team of 50, which consisted of overseeing receipt of new business through enrollment and billing.
to Operations Manager Managed Care Of America, Inc. | Columbus, OH
  • Led staff of 25, including customer care, dental and medical claims adjudicators, claims adjusters, clerical support, and accounting.

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Resume Overview

School Attended

  • Ohio Dominican University

Job Titles Held:

  • Manager, Business Configuration
  • Domain Lead
  • Agile Product Owner
  • Senior Manager (Compliance, Policy & Contracts)
  • Senior Manager (Enrollment & Billing)
  • Manager (Life & Disability Implementation and OPS)
  • Operations Manager

Degrees

  • Bachelor of Arts (BA)

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