Suzanne D
Performance Improvement | Data Analyst | Contract Administration | Customer Service
Profile
Versatile professional with experience in network management, customer service, and the financial performance management of contracted managed care plans. A strength in communication and quick grasp of details drove success in various business aspects of healthcare. Using an ability to deal with dynamic situations, and manage details for others, successfully contributed to Education as the inhouse rotating sub and tutor in an elementary school.
Key Skills & Competencies
Customer Service | Communications | Conflict Resolution
Data Analysis | Contract Administration | Office Support
Budgeting | Project/Program Management | Microsoft Office
Professional Experience
Glastonbury Public Schools, Glastonbury, CT | 8 years
Building Substitute (Tutor), School Substitute, Elementary & Middle School
• Oversee students as assigned by Principal/Assistant Principal: present classroom material and lead activities and ensure a safe learning environment for students
• Monitor students in class, recess, and lunches and assist in activities and programs as needed
• Answer phones, laminate, copy, file, and shred (sensitive materials) as needed
Caritas Christi Health Care (CCNS), Brighton, MA | 2 years
Data Analyst – Managed Care
• Analyzed financial performance of CCNS contracted managed care plans (including medical groups)
• Created group and individual physician utilization data and recommended performance improvements
• Recruited from Tufts Health Plan due to strong contract administration, negotiation and analysis skills
Tufts Health Plan, Waltham, MA | 4 years
Financial Performance Consultant – Network & Performance Management
• Created and developed action plans for medical groups and hospital networks
• Established and communicated daily/monthly operational and financial protocols and requirements
• Designed developed and presented internal and external training on insurance appeals and grievances
• Recognized for exceptional performance - earned successive promotions from Customer Service
Representative to Senior Appeals/Grievance Coordinator, and to Contract Administrator
Community Experience
Clark House Assisted Living and Nursing Home, Glastonbury, CT – Volunteer | 2 years
• Design, develop, and deliver activities for residents and support staff in event planning and preparation
• Responsible for ensuring activities and projects are on/under budget and delivered per schedule
Buttonball Lane Elementary School, Glastonbury, CT - Classroom Volunteer | 7 yrs
Orchard Hill Club, Glastonbury, CT - Volunteer | 4 yrs
Education
B.S. Communications/Public Relations, Salem State University, Salem, MA
Other Experience/Awards/Publications