Quality Assurance Manager

CARLA J. SALVO

**** *. ******** ******, #** ( Chicago, Illinois 60610

(H) 312-***-**** ( (C) 312-***-**** ( ***********@*****.***

Results-driven operations professional with extensive experience improving

organizational performance through skilled alignment of data analysis and

technical resources with company goals. Market research specialist with

proven history of success assuring integrity of complex data and developing

innovative query and reporting systems. Demonstrated technical skill with

experience serving as liaison to IT consultants and support teams, software

vendors, clients and stakeholders regarding departmental technologies and

systems. Proven leader with talent for building and training professional

teams and assuring retention of skilled employees.

AREAS OF EXPERTISE

Process Improvement ( Project Management ( Policy & Procedure Development (

Regulatory Compliance

Technical Documentation ( Quality Assurance

Business Intelligence ( Business Process Development ( Technical Liaison

Data Analysis & Reporting ( Relational Databases ( Process Automation (

Data Management & Integrity

( Employee Management & Mentorship ( Training & Development

PROFESSIONAL SYNOPSIS

WALGREENS HEALTH INITIATIVES, Deerfield, Illinois ( 2005-Present

Manager, Eligibility: Oversee operations of two (2) teams of five (5) and

eight (8) employees spanning escalated member eligibility issue resolution

and data management. Build cohesive teams through skilled management of

hiring, training, review, and benefit time allocation. Manage staffing to

assure timely resolution of escalated eligibility problems. Introduce new

processes and procedures as needed. Serve as expert liaison to IT

department regarding system capabilities, problem resolution and

enhancements. Liaison with proposal development and client services teams

regarding contracts and performance guarantees.

. Developed innovative training programs, Client Service Initiative

(CSI), to boost customer service and morale.

. Ensured timely invoicing through monthly collaboration with IT,

accounting and client services teams.

. Enhanced AARP line of business through cooperation with internal

operations, IT, accounting, customer call center and client services

teams to introduce controls and reconciliation processes.

. Improved quality assurance through implementation of processes

managing client eligibility setup and manual / automated entry.

. Slashed data file processing time from 48 hours to fewer than 8 hours

through key role in development of new web-based automatic file

processing system.

. Managed creation of training manuals for file enrollment, eligibility

coordinator, and eligibility clerk roles.

. Assured staff competency through development of orientation program

for new employees. Manage 20-hour operations overview program serving

over 300 team members in more than 15 departments.

. Mentored 6 team members to roles of higher responsibility within

Walgreen's Health Initiatives.

SXC HEALTH SOLUTIONS, Lisle, Illinois ( 2005

Solutions Consultant: Consulted with clients to conduct business needs

analysis for State of Washington Medicaid Pharmacy Program. Developed

detailed plans for goal achievement utilizing RxClaim and online processing

systems.

AMERICAN SOCIETY OF PLASTIC SURGEONS, Arlington Heights, Illinois ( 2004

Health Informatics Manager: Directed all daily business and technical

functions of Tracking Operations and Outcomes for Plastic Surgeons (TOPS)

web-based application. Supported TOPS committee and work groups.

Interfaced with TOPS vendor to assure timely problem resolution and

upgrades. Delivered plastic surgery data for publication of white papers

and position papers, media relations and public relations initiatives as

needed.

Played key role in assuring recruitment and retention of members. Served

as first line of support to members regarding effective use of TOPS

application.

CARLA J. SALVO ( Page 2 ( ***********@*****.***

. Improved data reporting through development of new system. Oversaw

development of programming staff; implemented test strategy and

coordinated user training and testing during implementation.

. Secured over $10,000 per year through research and negotiation of

licensing agreement with software vendor to integrate TOPS into

billing and software packages marketed to plastic surgeons.

. Boosted regular data input by 22% within 9 months, drastically

improving metrics relevance.

. Assured data integrity by developing validation processes spanning

demographics, diagnosis and post-op results.

VERISPAN, LLC / SMG MARKETING GROUP, Chicago, Illinois ( 2000-2004

Payer Reference Manager (2003-2004): Assured data integrity for company

databases storing prescription claim and third party payer information for

employer groups and managed care.

. Developed processes and procedures in coordination with technical

teams.

Manager, Managed Care (2002-2003): Promoted to oversee all functions of

data collection process. Orchestrated follow-up calls to survey respondents

regarding missing or inaccurate data; data entry; and quality assurance.

Managed scheduling and allocated benefit time for staff. Implemented new

and improved processes as needed. Liaised with IT support staff regarding

system enhancements and problem resolution. Consulted with pharmaceutical

clients regarding Verispan products.

. Played critical role in all stages of development lifecycle for HMO

Profiling Solution, company's flagship product. Coordinated with

clients and internal resources to implement product improvements.

. Assured exceptional client satisfaction on numerous projects.

. Developed Managed Care Matrix and other sophisticated analysis tools

through leverage of expertise in relational databases, spreadsheet

modeling and other technical tools.

. Boosted amount of data collected by 13%, improving relevance of data

metrics.

Project Lead, Managed Care (2000-2002): Collected, organized, edited, and

queried key information regarding health care facilities. Oversaw research

projects regarding managed care products.

. Acted as project lead for managed care products. Ensured timely

project completion and data accuracy.

. Verified accuracy of data used in national managed care publications.

EVEREST HEALTH SERVICES CORPORATION, Oak Park, Illinois ( 1999-2000

Regulatory & Development Coordinator: Served as key liaison between outside

counsel and project management staff regarding regulatory and financial

data for acquisitions, expansions and purchase of new facilities. Prepared

and submitted proper documentation for Certificate of Need, State

Licensure, Medicare certifications, and assured compliance with all ESRD

regulations throughout 13 states.

. Achieved Medicare certification and licensure for approximately 15 new

facilities within 19 months.

FIRST AMERICAN GROUP OF COMPANIES, Matteson, Illinois ( 1997-1998

Compliance and Grievance Coordinator: Served lead role in development,

implementation and maintenance of company state and federal compliance

program. Reviewed in-place policies and improved as needed. Monitored

changes in state and federal laws; planned for impact of changes on company

policies and procedures. Communicated with regulatory authorities on

company's behalf. Assured staff knowledge of regulatory and compliance

issues. Oversaw project management for initiatives involving business

strategy changes and operating improvements.

. Cooperated with department leadership to develop company response to

Market Conduct Examination by Illinois Department of Insurance in

under 1 week.

. Assured successful response to Office of Personnel Management request

for health benefits proposal.

EDUCATION & CERTIFICATION

Bachelor of Science in Management

University of Illinois at Springfield, Springfield, Illinois

PROFESSIONAL AFFILIATIONS

American College of Healthcare Executives (ACHE)

Chicago Healthcare Executives Forum (CHEF)

Leads, supports and prepares teams to conduct continuous

improvement activities and events using appropriate tools

and techniques such as 5S, Standard Work, Managing for

Daily Improvement, Problem Solving, Value, Process

Mapping,. Utilizes key business skills to guide

leadership and team members in achieving the stated

business objectives such as oral and written skills,

group and process facilititation. Provides Project

Management and works with teams to develop and execute

work plans, drive metrics and sustainment of continuous

improvement initiatives and drive overall project

efforts. Demonstrates ability to collect, analyze and

communicate business data to Senior Management teams.

Lead work team in data analysis to identify the impact of

solutions and quantify project finanacial impact of

change.

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