Fabian Eluma ● ac9om8@r.postjobfree.com● 240-***-****

SUMMARY

Results driven strategist recognized for expertise in project management, clinical services, and business operations. Over 20 years of wide-ranging business experience, skilled communicator able to present complex issues to diverse stakeholders to build consensus and deliver results. Core competencies include: data management, program management, and patient services.

EXPERIENCE

Cigna Healthspring, MD, March 2016 – May 2017

PROVIDER DATA SPECIALIST

Responsible for management and analysis of provider data and recommending changes to drive organizational efficiency

Supported training efforts by delivering actionable insights that will allow greater focus on client and service delivery

Analyzed data entry process and recommended process improvement efforts to maximize operations.

Managed and operationalized the entry, execution of provider data, and trained associates on QNXT.

Performed quality review of sensitive data information, and led correction efforts to guarantee accuracy of information captured.

Delivered value add services and influenced service performance to ensure best customer experience

Inovalon, Columbia, MD, August 2014 – January 2016

SPECIALIST, TECHNICAL COMMUNICATIONS

Oversaw end-to-end communication initiatives and client management designed to enhance growth, profitability and retention

Consulted, informed and negotiated with senior stakeholders to ensure that perspectives and ideas were incorporated into the decision-making process

Served as subject matter expert in technical support communications, client management, and Facets.

Led program benefit and enrollment management with prospects and clients

Managed and spearheaded the implementation of compliance and procedural goals resulting in 95% adoption rate

Recognized by management for creating key measurement criteria to evaluate business and product effectiveness

Delivered marketing and policy presentation to potential clients and healthcare providers

Led call management practices and recommended strategies to expand portfolio and improvement opportunities

United Healthgroup, Columbia, MD, March 2013 - April 2014

SENIOR SPECIALIST, PROVIDER SERVICES

Designed integrated approaches to individual quality standards that include consideration of member and provider services, physician assignments, communication plans and treatment authorization

Performed a broad scope of business procedures from identifying and resolving client issues, collaborating with cross-functional teams to managing benefit and eligibility information

Implemented individual best practices to continuously improve the overall effectiveness of quality and member data entry while maintaining an average monthly performance score of 98%.

Internal expert on explanation of member benefits and management of communication strategies that drove member satisfaction scores and leveraged by over 50 associates

Provided transaction and processing services to healthcare providers and clients

Orthopedic Maryland, Baltimore, MD, September 2011 – March 2013

SENIOR CLIENT ASSOCIATE, PATIENT MANAGEMENT

Developed and lead strategies to improve client experience, increase engagement and maintain high satisfaction rate

Responsible for ensuring that the teams executed against both strategic imperatives and tactical responsibilities Designed and implemented process improvement efforts to reduce client wait time by 25%

Acted as primary liaison between patients and medical staff and facilitated effective communication strategies

Coordinated patient information entry and scheduling efforts to increase satisfaction and efficiency.

Developed and executed strategy to reduce client wait time by 20%

Supported new clinical initiatives by reinforcing changes with patients to ensure 100% compliance and identifying opportunities for business success

Trained and mentored new associates on business objectives, internal functions and individual roles

Patient First, Baltimore, MD, October 2008 - 2011

PATIENT SERVICES ANALYST

Managed end-to-end business operations, new capabilities and implementation of client resolution techniques to position the business for success

Led implementation of real-time customer interaction management system to identify valuable patterns, trends and Voice of the Customer insights, improving client experience and call quality

Recognized over 29 times as one of the top 10 employees by exceeding company benchmarks and implementing processes to obtain outstanding balances.

Facilitated the planning, development and implementation of solutions to address business and client needs

Identified and instituted best-in-class approach to help deepen practices and maintain a high standard of 99% client satisfaction while growing offerings

Established internal processes to expedite services of a weekly average of over 500 patients.

Performed a broad scope of clinical procedures from posting fees to resolving to priority issues Coordinated all volunteer shifts of over 15 associates to ensure resource coverage.

Prepared and balanced daily financial registers and coordinated fee transfers to the fiscal and business management team

EDUCATION

B.S, Emergency Health Services / UNIVERSITY OF MARYLAND - Baltimore County, MD

Contact this candidate