CATHERINE L. NEWMAN

510-***-****

Fremont, CA 94539

aceslk@r.postjobfree.com

Qualifications Highlights

Over 20 years experience in health care with concentration on high volume end to end production

work in developing legal documents (i.e. EOC’s, COI, SOB’s etc.) for the Core portfolio book of

business.

Sound knowledge on legal research and proofreading.

Ability to collect data, establish facts, and draw valid conclusions.

Produced accurate, timely and actionable research information, and ability to manage multiple

projects,

Ability to read and interpret regulatory documentation from Department of Managed Health and

California Department of Insurance.

Possess strong communication and leadership skills, with the ability to manage on-going multiple

priorities

to maximize productivity.

Strong ability to work collaboratively with stakeholders as well as other Company professionals.

Experience in processing and maintaining confidential material and communications.

Professional Experience

Blue Shield of California - San Francisco CA 12/2002 – 9/2013

Intermediate Contract Analyst - Customer Contracts Division

As part of the Core Portfolio team I developed language for Contracts and EOCS to support changes resulting

from the introduction of new products by Blue Shield, as well as policy and legislative changes within agreed upon

timeframes. This process requires detailed analysis of existing language and benefits to ensure complete and

correct new language replacements to promote ease of understanding by our members and synchronization of our

language with other stakeholders in the administration of the provisions. Many efforts resulted in receiving

Special Bonus Recognition.

Production work involved the creating of the following documents:

63 COIs/EOCs including HMO, Local Access, Baja & 3 versions of master benefit pages for Mid/Large and

Core Flex plans Small Group

18 Small Group Summary of Benefits 4 Policies/Contracts for Mid/Lg and Small Group

55 Mid/Large Summary of Benefits 24 DMHC Supplements

Multiple iterations of Small Group Text Masters 13 DOI Inserts

including HMO, Local Access, Baja & Core Flex plans

14 Mid/Lg Summary of Benefits which included Baja Vision EOC text master and Contract

translations and Custom Baja Dependent-only plans

Analysis and development of a new hybrid plan (HiLo)

project to reduce administrative work and improve

performance of department in producing new and

renewal documents.

1

Recent Key Accomplishments

Acted as SME on numerous special projects such as Shield Advance Benefit Standardization for Small Group

and Plan Configurator ToolSet (PCT) audits. Completed the following key initiatives

Hi/Lo Project

Lead content drafter on project team to develop a process and criteria for DMHC regulatory filings inclusive of

medical and pharmacy expanded benefit ranges, and standardized EOC text language (text models). The

expected outcome is to reduce multiple filings (portfolio and custom level one ) into a single yearly cycle filing in

essence moving from 37 medical plan HMO, PPO, POS, and PSP portfolio filings to 7 and moving from 50

pharmacy plan portfolio filings to 6.

In drafting hybrid documents found 150 discrepancies of language between Custom and Portfolio Evidences of

Coverage. Found 3 major errors in the PPO Evidence of Coverage which mitigated potential losses for the

company. Received special Bonus recognition for this initiative.

Exchange Project (Covered California)

Audited and revised documents as project team member for Exchange submission and approval.

Regulatory Filings

Created Contract and Evidence of Coverage (EOC) language for new plans/products for regulatory submission

within agreed upon timeframes. Documents included HMO, PPO, POS, and PSP plans and specialized

language for Vision, Baja and Local Access Plans. Responsibilities involved identify, communicating and

resolving benefit and implementation issues and regulatory concerns.

Custom Contracts

Analyzed and interpreted group orders for new and renewing groups and subsequently developed Custom

documents in SharePoint and Microsoft Word. Completion of several plans resulted in receiving a Spot Bonus

for helping reduce inventory. Responsible to develop a revamped Internal Schedules and Checklists for current

and upcoming cycles. Managed the printing of all documents done by the agreed upon timeframes. This

includes issuing bids to printers, providing document specifications with document names, volumes, form

numbers, etc. to the Procurement Department, transferring all documents to the printer’s web site and

organizing and managing the review and approval of proofs.

Lifeguard Inc., Milpitas CA 12/1992 – 11/2002

Contract Coordinator I & II (11/96 – 11/02)

Managed the following:

• Overseeing administration and production of HMO, POS, PPO and OOA group contracts plus all supporting

riders.

• Reviewing contracts to ensure benefits, rates and provisions properly reflect agreements and capabilities

and also assure that contracts meet all regulatory requirements.

• Coordinated workflow and daily production between the coordinator and the underwriter assistant.

• Acquired all materials from marketing and legal departments needed to complete current contracts.

• Interacted with membership accounting, member services, sales and claims to resolve contract inquiries,

inconsistent information and confirmation of renewal commitments.

• Worked with legal department to incorporate contract language to reflect amendment and addendum

changes.

• Coordinated with marketing department on “Avenue” program to mail merge small group contracts with

excel and word, producing monthly small group contracts.

Contract Specialist (05/96 – 11/96)

Managed the following:

• Overseeing administration and production of group contracts for HMO and POS products.

• Working with sales staff to assure timely submission and completion of renewal paperwork.

• Producing and overseeing distribution of group enrollment information.

• Supporting underwriting and contract department goals.

• Processing renewal paperwork for I.D. cards, group contracts and internal information within designated

time frames.

• Assisting in the development of the contract distribution process, legal updates and benefit changes.

Contracts Assistant – Underwriting (10/93 – 05/96)

Managed the following:

• Producing original and revised group contract agreements for both large and small groups.

• Organized and completed pages, which include rate amounts and specific information for each individual

group.

• Assisting contract specialist with typing and proofreading as needed.

• Supporting account managers with contractual issues as well as supporting their needs for documentation.

• Maintaining files and input data on SPS system.

Administrative Assistant – Marketing Department (05/93 – 10/93)

Managed the following:

Provided clerical and administrative support to director of communications, communications specialist and

supervisor of support services.

Maintained schedules for supervisor and assisted department staff with clerical needs.

Updated printing and incentive program files.

Handled incentive program orders.

Word Processor/Receptionist (01/93 – 04/93)

Managed the following:

Prepared all correspondence, memos, policies and procedure manuals for the human resource department.

Interfaced with clients, customers and employees.

Managed delivery files.

Proficient in Microsoft Outlook and Word. Knowledgeable in Excel and PowerPoint, also WebEx.

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