Marlisa Wright, MPA

**** * ***** ***, **** * Chicago, IL 60637 acn23f@r.postjobfree.com 773-***-****

Healthcare Administration Professional

Extensive background in Healthcare Administration, including experience in new candidate hiring,

mentoring, internal training, product process development, career coaching and data integrity

management.

Healthcare Quality

Demonstrate success with negotiating compromise, assist in development of new departmental processes

in utilization management, experience and extensive knowledge of the Managed Care system, traditional

health care delivery, as well as, governmental programs such as Medicare and Medicaid.

Strong analytical and organizational skills, advanced knowledge in radiological outpatient coding, sleep

management, radiation therapy, cardiology management, internal quality review auditing, ability to utilize analytical

database to manipulate datasets on a large scale to identify areas for improvement, clinical operations liaison for

plans such as HMO, PPO, POS including FEP, NASCO, MAPPO and WellPoint affiliated health plans.

Professional Experience

WellPoint/AIM Specialty Health 2006-2013

Medical Referral Specialist Team Lead

Manage and coordinate the day to day activities of referral specialist, monitor employee activities

utilizing Nortel symposium, review daily reports, new candidate interviewing and employee data management.

Responsible for completing customer services quality assessments.

Assist with developing innovative processes to improve clinical operational work flow, appropriately address

performance issues, develop performance improvement plan for team members, handle supervisory calls to resolve

client and provider issues and track employee attendance, record on demanding monitoring, calibrate and analyze

call center phone calls for quality review call center phone calls.

Train employees on new clinical and client processes, primary lead to facilitate Anthem North East manual

member adds to accurately update profiles and analyze other Client Performance Management problematic client

issues, developed workflow process for member shopper program. Responsible for reporting system errors

noncompliant with the organizational business rules to IS&T. Lead team members to educate healthcare professionals

and members on product and services such as sleep management, member shopper program and radiation therapy.

Developed the internal quality assessment platform used to evaluate call center employees services level for the

member shopper program. The program grossed 4 million in healthcare cost saving in the first quarter of

implementation.

Referral Specialist/System Matters Expert 2004-2006

Responsible for entering and evaluating non-clinical information given by an ordering provider or servicing provider

office. Answer incoming calls with an average speed of answer less than 30 seconds. Input intake information into

the preauthorization/Imasis analytical database used to screen preauthorization request using approved American

Medical Association criteria and guidelines, identify and appropriately refer cases to nurses/MD for clinical review.

Assist referral specialist with health plan knowledge, new employee mentor, assisted manually adding physician into

active cases, monitor departmental voicemail, follow up with ordering Medical Doctors office to initiate a

preauthorization request needed after business hours. Responsible for creating monthly departmental quality exams

for the clinical operations department and participated in UA testing. Knowledge of CPT, ICD-9 and HCPCS coding.

The Edwards Group Consultants, Inc. 2003-2004

Drug Collection/Specimen Collection

Sub-contracted to proficiently manage and administer pre-employment and random drug testing for the Department Of

Transportation and Custom Patrol across the United States.

Secure collection location, verify donor information, educate donors of collection, process and appropriately

fill-out chain of custody form.

Spectrum Health Services 2001-2002

Office Coordinator/Medical Assistant/Phlebotomist

Responsible for maintaining patient charts, ensure accuracy of all patient records, patient vitals, inpatient billing, patient

insurance verification and facilitate patients preauthorization request for diagnostic radiological procedures.

Create excel workbooks for patients’ claims issues.

Educations & Certifications

Roosevelt University

Graduate Certification in Performance Consulting

8/2010-present

Roosevelt University

Masters of Public Administration in Health Services Management

5/2010

National Louis University

Bachelors in Science in Healthcare Leadership

5/2004

Malcolm X College

Phlebotomy Certification

7/2001

Computer Skills

Proficient: SPSS, Access, Oracle

Advanced: MS Word, Vista Excel, PowerPoint, Outlook, Imasis, Nortel Symposium, Visio, Nice call monitoring

system, Qlickview statistical database

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