Project Medical

LORRAINE M. MUNDANGEPFUPFU

**** ********** **. #**** *******, Texas 75019 ********.****@*****.*** 469-***-****

EDUCATION: Associates Business Administration Studies, North Lake College

EXPERIENCE:

2014-2015: Insurance Broker, Core Benefits Group, specializing in Life, Health, Medicare and Annuities

Working with various insurance companies and also facilitating with Markertplace open enrollment for Healthcare.Govt. and Medicare senior services and supplements.

2012–2013: Licensed Insurance Agent, American Life Insurance, Life, Health and Accident plans. Specialized in Final Expenses and Term Life policies and signed up many clients in the Dallas-Fort Worth metroplex.

2000-2010: Care Management Associate, Aetna

Coordinate service delivery including attention to customers’ sensitive issues, proactive identification and resolution of issues to promote positive outcomes for members.

Research and triage cases for nurses and medical directors

Facilitate screening and authorization of medically necessary procedures as opposed to cosmetic ones

Support administration of pre-certification process in compliance with applicable laws and regulations

Approve cases that do not require medical services staff

Maintain accurate and complete documentation of member information and case notes

Promote internal and external communications to enhance effective medical management services

Perform medical research, eligibility verification, benefit verification and coordination of benefits

Screen and appropriate referrals and task cases to medical staff for precertification

Identify special needs for cases requiring case management and processing activities for active members

1999-2000 New Account Specialist, MBNA America Bank

Use telesales and marketing skills to aqquire new customers

Cross sell additional products and services to existing customers

1993-1998 : Southern Africa Regional Administrator, Terre des homes

Management and administration of four countries, Zimbabwe, Mozambique, South Africa and Namibia

Implement corporate initiatives across these diverse cultures, languages, traditions and socio economics

Promote and coordinate community development projects with emphasis of education and health, to facilitate income generation.

Community relations and networking within the Regional Governments and Germany, the International funding country.

Negotiate and secure funds from Germany by submitting project proposals meeting criteria.

Procurement of all office needs and materials for the project partners, shipping, handling and customs clearances.

Train and mentor project staff and run project partner workshops and conferences

Manage all banking operations including disbursements of project funds and supervising office cash flow within all four countries.

Manage staff payroll, tax issues, insurance matters and all human resource needs for the region.

Prepare monthly financial statements, bank reconciliations, cash flow reports

Perform analysis of financial reports from project partners and maintain records for external audits

Prepare office budgets and country project budgets

1979-1993 : Financial Controller, Founders Building Society Bank

Perform banking and mortgage operations

Prepare monthly financial statements, bank reconcilliations and cash flow reports

Maintain all financial records for board of directors meetings and internal and external audits

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