Jenny B. Lewis, AIDM
Palm Harbor, FL 34683
941-***-**** C / 727-***-**** H
abmquu@r.postjobfree.com
http://www.linkedin.com/in/jennyblewis
PROFESSIONAL PROFILE
A recognized specialist in insurance policy and claim administration for
workers compensation, specifically electronic regulatory compliance
reporting; pharmaceutical reporting & analytics, medical services &
equipment reporting and analytics, professional expertise in data
management best practices, data warehouse development and maintenance, data
stewardship, data governance, HIPAA requirements, data analytics and
informatics. Demonstrated leadership and initiative to accomplish directive
to build a new department for a pharmaceutical company under new ownership.
Orchestrated process and work flow improvements to achieve organizational
objectives by providing informatics and analytics presentations to PMSI
Clients. As an Insurance Data Compliance officer, exhibited the ability to
fulfill electronic reporting compliance requirements, articulate technical
communication, project/program development, people development, self
directed, and total quality management that maximizes customer service
potential (aka "Six Sigma"). Well versed in insurance and pharmaceutical
information cycles, and developing system strategies to maximize
organizational efficiency.
Informatics & Analytics Medical Bill Reporting Data Stewardship
Medicare Secondary Payer Healthcare Informatics Electronic Data
Interchange
Unit Statistical Reporting HIPAA Requirements First Report of Injury &
Pharmaceutical/MS&E data Data Governance Subs
reporting & analysis Process Improvement and Electronic Regulatory
Data Warehouse Development turn-around-time Compliance
Information Cycles efficiency Training & Development
Project Management Problem Solving
Processes
Professional Accomplishments
Director of Informatics at PMSI - Pharmaceutical / Medical Services &
Equipment Reporting and Analysis
. Directed the development and improvements in robust client stewardship
packages to give analytical insights into the pharmaceutical spend
affecting work comp medical costs per claim/injured worker.
. Established a process improvement of the timeline and scheduling of
the production steps to produce client stewardship packages.
. Improved the process turn-around times of client report requests and
the line of business owners' operational analysis needs.
. Directed the production of analytical packages with robust analytics
of graphs/charts through use of the Microstrategy BI Tool.
. Business owner of the development of a new Enterprise Data Warehouse
(EDW) project that encompassed the "Out-of-Network" pharmaceutical
transactions through "Third Party Billers" of PMSI clients.
. Directed the IT EDW Development Team, along with the "Operations
Leadership" toward the development of completing organizational
transactions in star schema structure and the ETL process by studying
transactional data and associated information cycles.
. Project owner of resolving major client's data anomalies by working
with IT and the business operations to resolve these obstructers to
data quality in the data warehouse.
Insurance Data Compliance Officer - Zenith Insurance
Unit Statistical Reporting - electronic data reports of policyholder
information and loss experience to national data agents and/or state
rating organizations. Directed the migration of all USR's from multiple
system platforms into a data warehouse through the use of "Informatica"
tool due to mergers/acquisitions and various databases.
. Improved Zenith's NCCI Report Grade of "D / F" rating [which could lead
to loss of operating license] to an "A" within one year, to 100%
accuracy/timeliness in 3 years; a leader in the industry today since 2003.
. Achieved 10% incentive credits from NCCI invoices as a result of
exceeding industry data standard
. Reduced data errors from 500 pages a month in 1998 to less than one page
of errors in 2009
Policy Data Reporting
. Improved Zenith's NCCI Report Card grade from 86% accuracy/timeliness to
99.2%
. Pursued technical advances in electronic policy reporting across the
nation that eliminated all penalties and/or processing fees for each
policy submitted
. Pursued leading technical enhancements with NCCI to maximize job
proficiency for underwriters, that included the electronic experience mod
distribution, electronic industry manuals, electronic invoicing, data
processing tools, underwriting tools. I also negotiated the terms of the
bulk contract for usage to maximize the cost savings.
EDI - Electronic Data Interchange of IAIABC FROI/SROI, Medical Bill Data
. Directed this operation through the development of a direct report, by
arranging membership with the IAIABC EDI Committees involving state
regulators, developing training and depth of the IAIABC standards and
guidelines, along with state implementation guidelines.
. Reported First Report of Injury (FROI) and Subsequent (SROI) in twelve
states with 98% accuracy and timeliness
. Reported FL Medical Bill Reports that exceeds the industry in timeliness
and accuracy
Data Stewardship/Governance Role
. Established a Data Stewardship and Governance role to assure Zenith's
source system changes met all regulatory data compliance standards and
specifications resulting in significant cost savings within system
development and enhancements.
. Instituted "User Acceptance Testing" and "No Harm Testing" requirement
for system changes to preserve data integrity in compliance reporting.
. Member of the NCCI Committee Workgroup developing the "Medical Data Call"
approved by the NCCI Board of Directors to resolve industry issues within
rising medical costs, a designated concern by state regulators.
Member of internal task force to develop corporate accountabilities of
reporting the federal requirement of "Medicare Secondary Payer"
PROFESSIONAL experience
PMSI - Pharmaceutical Benefit Manager, Tampa, Florida
2009-2010
Director of Informatics
Built and developed a team of 7 Analysts responsible for reporting and
analyzing pharmaceutical and durable medical equipment (DME/MS&E)
transactions and spend by clients and for operational effectiveness.
Provided leadership in the production of client stewardship reports
including pharmaceutical spend and transactions encompassing a NDC/drug
analysis within Therapeutic classes, specifically Narcotics Analgesics due
to work comp injury. Business owner of directing the development of the
new "Enterprise Data Warehouse", accomplishing first phase of development
with "Out-of-Network" pharmaceutical transactions through "Third Party
Billers". In the EDW development, I worked with Sr. Architect, ETL, and
PM's in assignments, scheduling and working with offshore teams in design,
infrastructure, QA and problem resolution.
ZENITH INSURANCE COMPANY, Sarasota, Florida
1996 - 2009
Since 1977, Zenith is a specialist in the workers' compensation insurance
Vice President - Data Reporting Services 2003 - 2009
Developed and directed two departments that included an AVP and 12
employees. Instituted operational procedures and performance standards to
assure accurate, complete, and timely electronic data reports and
transmissions. The insurance data management responsibilities included
Electronic Data Interchange (EDI) of policy, claim/loss, and medical data
to statistical reporting agents and state regulators to administer workers
compensation to fulfill regulatory compliance requirements of reporting.
The EDI unit was located in Woodland Hills, California requiring the
leadership and fortitude to manage effectively through the AVP.
Established Sarbanes Oxley performance indicators to validate regulatory
compliance.
Assistant Vice President (2000 - 2003); Manager (1998 - 2000); Information
System Leader (1997 - 1998); Information System Liaison (1996 - 1997)
DICKINSON & GIBBONS, P.A., Sarasota, Florida 1993 - 1996
Systems Administrator (Novell Network 3.12)
Administered a Novell Network system for a 23 attorney law firm.
Duties included, but not conclusive, were: Administered the purchasing,
repair and maintenance of all computer hardware and associated equipment.
Administered the conversion of the legacy accounting and billing system
from an AS400 platform to a PC based application. Negotiated the "online
legal research" contracts which included Lexis-Nexis. Administered all
system applications and replacements, along with ordering software and
installing software. Achieved the highest cost reduction the law firm
experienced in several years that enabled a profit margin at end of year.
FPL Electric Utility, Ft. Lauderdale & Miami, Florida
1975 - 1993
Customer Service Manager of Cashiers and Service Representatives - managed
12 employees who collected money for electric bill accounts, processed and
balanced the cash drawers daily.
Collections Manager - improved past due receivables from the worst in
division to the best in one year. Managed 24 employees.
Supervisor of Call Center in Broward County- managed 21 employees.
TQM Lead Facilitator - being first American company to win coveted quality
award, "Deming Prize". Utilizing Statistical Analysis & Quality Control
techniques for continuous improvement. Trained and facilitated "Problem
Solving Teams" by utilizing statistical quality control techniques for
continuous improvement and process efficiency. Received extensive
leadership training (i.e. "Situational Leadership", "KT", "Executive
Development", and "Managing Diversity") and also became instructor to
other leaders in the use of statistics in decision making. Received "Train
the Trainer" instruction that led to instructing the "Leadership for
Managers" series, "Supervising Quality", "Supervising Teams", "Quality In
Daily Work", and "Employee Orientation". Being a TQM trainer required "Day
Plans" and maintaining training schedule timeline and curriculum for adult
professionals in leadership.
Budget Analyst - responsible for multi-million dollar budget of both
operating and capital expenditures for Broward County Division.
Labor Relations Specialist
Loaned Executive to United Way of Broward County - multiple public
speaking engagements achieving beyond campaign goals
Education
Southern California University, Santa Ana, California
MBA (concentrated in Information Systems); Graduated Magna Cum Laude
Barry University, Miami, Florida
Bachelor in Business Management & Professional Studies, graduated with
honors - GPA 3.83
Certification in "Healthcare Informatics" at University of Phoenix (ETA
8/2010)
Certification focus on EMR/EHR, interoperability and interchangeability of
data, HIT standardization developments.
Professional memberships
International Association of Industrial Accident Boards and Commission
(IAIABC) EDI Committees
Data Control Process Committee for National Council of Compensation
Insurance
Insurance Data Management Association and obtained Associate Insurance Data
Manager Certification (AIDM)