Insurance Health

Louis A. Sorbo

** ***** ****** * **** Hartford CT 06108 n 860-***-**** n *****.*****@*******.***

EXPERIENCE

Health Plan Process Coordinator April 2016- May 2017 Connecticut Insurance Exchange, Access Health CT – Hartford, CT

• Facilitated exchange of information, including enrollment transactions, between Access Health Connect- icut (“AHCT”) and participating issuers.

• Led projects to enhance accuracy and timeliness of eligibility and enrollment information between AHCT, issuers, and the Department of Social Services (“DSS.”)

• Worked on processes and procedures to enable call center staff to verify and validate members’ eligibil- ity information (e.g., eligibility for special enrollment periods.)

• Resolved issues pertaining to data transfer between AHCT and participating issuers.

• Analyzed production 834 on a daily basis to identify issues.

• Created documentation for the use of Maptitude, software used by AHCT to analyze adequacy of the is- suers’ provider networks.

• Researched and analyzed data, including rates and benefit information.

• Supported the development of criteria and reporting specifications used to monitor issuer compliance.

• Worked with policy and plan management teams to assess quality improvement measures and regula- tions required of the issuers to adhere to the ACA requirements.

• Served as a liaison between the AHCT’s IT department and external stakeholders such as DSS, Depart- ment of Insurance (“DOI”), and external consultants.

• Documented policies and procedures to support plan management portal and the integrated eligibility system used by AHCT and DSS.

• Reviewed and provided feedback on Business Design Documents (BSD) and Technical Design Docu- ments (TDD) for system related enhancements.

Health Plan Analyst May 2015-March 2016

Connecticut Insurance Exchange, Access Health CT – Hartford, CT

• Assisted with the annual certification of Qualified Health Plan (“QHPs”) and Stand-Alone Dental Plan

(“SADPs.”)

• Worked with AHCT’s policy team to assess quality improvement measures and regulations required of the issuers to adhere to the ACA requirements.

• Provided resolution on 834 related issues for Anthem, Connecticare, Healthy CT, and United Health.

• Reviewed issuers’ form and rate filings to ensure compliance with AHCT’s standards.

• Assisted with reviewing and uploading issuers’ data in SERFF into AHCT’s plan management portal.

• Conducted analysis of issuers’ provider network information to assess network adequacy and ensure suf- ficient member access.

• Assisted with review of eligibility data and reports, as well as issuers’ websites and marketing materials to ensure compliance with federal and state laws and regulations, as well as the issuer agreement with AHCT.

• Worked with internal teams, committees of the board of directors, and the DOI to design AHCT stand- ardized plan options.

• Assisted with assessment of the impact of regulations on issuers and AHCT and created and implement- ed project plans to ensure compliance.

• Collaborated with AHCT’s IT department to resolve system issues affecting plan management portal’s functionality.

Louis A. Sorbo

27 Clark Street n East Hartford CT 06108 n 860-***-**** n *****.*****@*******.*** Sr. Operations Associate June 2014 – May 2015

Connecticut Insurance Exchange, Access Health CT – Hartford, CT

• Responsible for overseeing resolution of escalated issues and concerns from government agencies and the Governor’s office.

• Determined root cause of system issues, developed project plans to mitigate and resolve such issues and communicated with stakeholders as necessary.

• Translated business goals into operational strategies and solutions by ensuring viability of systems and processes.

• Monitored electronic data transfer activities for EDI trading partners. Outreach worker August 2013 – May 2014

Connecticut Insurance Exchange, Access Health CT – Hartford, CT

• State Health Insurance Exchange Certified In-Person Assister responsible for enrolling hundreds of in- dividuals into affordable health insurance.

• Educated and engaged consumers on the new Connecticut Insurance Exchange, eligibility criteria, and enrollment process.

• Participated in local events and fairs to promote AHCT mission.

• Researched opportunities to facilitate lead generation and target consumers through a variety of outreach tactics.

Field Organizer November 2012 – April 2013

Keystone Progress – Third Congressional District

• Built coalitions by engaging and educating community groups and organizations on campaign goals.

• Communicated and engaged local media (Butler Eagle, Meadville Tribune, Record Argus, and Sharon Herald) to promote political goals and agenda.

• Managed volunteers in the Third Congressional District to represent national campaign objectives. Field Organizer August 2012 - November 2012

Organizing for America Pennsylvania – Mercer County, PA

• Recruited and motivated seven individual teams to support the reelection campaign of President Obama.

• Managed offices, phone banking, and canvassing for over 200 volunteers to help get out the vote.

• Responsible for national database management for storing volunteer information.

• Supervised and trained interns.

• Led team responsible for gathering over 23,000 votes for President Obama supporters. Education

Slippery Rock University, Slippery Rock, PA

2009-2012

Bachelor of Arts in Political Science

Minor: American Politics and Foreign Relations

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