Chad D. Terra

***** ****** ******, ****** ***, TX 75068 ad4754@r.postjobfree.com 469-***-****

Professional/ TRICON ROOFING & CONSTRUCTION – PLANO, TX

Experience Acting President/Co-Owner/Vice-President – August 2017 to Present

Directly report to Owner in all operational duties of company; serve as Acting President in his absence (took over briefly while father received treatment for medical condition; now wants to hand over company to me, but prefer my own career)

Exceed sales quota and accumulate increased business leads and contracts using knowledge-based, persistent and persuasive, techniques and negotiation strategies

Interview potentially new employees, coordinate and supervise contracted labor workforce and manage internal/external disputes up to and including terminations and complaints

Manage payroll, purchase materials, negotiate new business and follow-up on leads, including implementing and managing quarterly/annually operating budgets, revenues, ROI’s and operating expenses while managing numerous projects, quality and risk inspections to ensure deadlines are met within budget

BLUE CROSS BLUE SHIELD – RICHARDSON, TX

Performance and Results Consultant/Manager – February 2017 to August 2017

Direct multiple meetings with different departments to obtain better control on Cost Containment, develop solutions to decrease unnecessary expenditures and increase revenue.

Research and manage multiple Projects to develop and amend new policies

Responsible for conducting needs analysis and assessment, managing projects, evaluating performance gaps, recommending and developing performance solutions and coaching employees and mentoring team members

HEALTH MANAGEMENT SOLUTIONS (HMS) – IRVING, TX

Carrier Relationship Manager/Carrier Account Manager – Feb 2016 to Feb 2017

Maintain existing relationships and ensure assigned clients contribute to our success regarding performance, growth and financial initiatives

Provide expertise to Carriers and Vendors regarding performance improvement, analytics, metrics and methodologies; familiar with B2B for Medical and Pharmacy management

Run data queries and initiate “Rebills” to receive payments and exceed minimum financial goals for the year; Maintain 95% or higher on all existing reports required as part of my annual performance goals and investigate and resolve financial discrepancies with Carriers

TRICON ROOFING & CONSTRUCTION INC., PLANO, TX

Operations Director – June 2013 to February 2016

Exceed sales quota and accumulate increased business leads and contracts using knowledge-based, persistent and persuasive, techniques and negotiation strategies

Interview potentially new employees, coordinate and supervise contracted labor workforce and manage internal/external disputes up to and including terminations and complaints

UNITEDHEALTH GROUP, LITTLE ELM, TX

Sr. Quality Manager of Accreditation and CAHPS, Vendor Manager, Data Analyst,

Sr. Auditor – April 2011 to June 2013

Support and Implement improvements in CAHPS Star Rating Measures

Support Regional Accreditation efforts to achieve Accreditation of Excellent, Accredited or Commendable and ensure locations maintain compliance with regulations, accreditation and license requirements; Assisted HEDIS team with data collection and improvement

Completion of 2011 Corporate Survey with 100% credit for all submitted standards

Independently coordinated NQOC/RQOC/NSOC/NDOC meeting preparation from top to bottom and implemented ways of increasing efficiency

Vendor Manager for all third-party companies, directed and maintained professional working relationship with external vendors, clients and customers

Experienced Auditor of medical records, appeals, financial payments, risk management, quality assurance, compliance with Federal and State laws, logistics and inventory

Experienced Data Analyst that worked to not only improve upon quality measures and metrics, but understand reasoning behind findings and develop ways to improve and predict future trends and results

CIGNA GROUP INSURANCE, DALLAS, TX

Fraud Investigator (SIU) Vendor Manager, Settlement Negotiator, Auditor, Claims

Manager I, II, III, Sr. Claims Manager – August 1997 to April 2011

Investigated potentially fraudulent disability, life and healthcare claims via referrals, data-mining, anonymous tips for red flags and performed comprehensive investigation of claim

Managed 10-15 Field Investigators across the U.S. and directed every step of Investigation from beginning to end; Audited summary of findings and ensured process was completed properly, deadlines met, budget and payments distributed using best business practices.

Investigated Fraud using surveillance, background and activity checks using investigative tools as national comprehensive sites, databases, internet searches and 3rd Party Vendors

Closed over $12 million dollars annually due to my individual fraud investigations

Maintained professional working relationships with Dept. of Insurance, Attorney General’s Office, State and Local Law Enforcement in each state/county/parish and City Prosecutors to share information, prosecute individuals for fraud and attempt to recover payments

Managed extensive reports for compliance and metrics and Managed Data-Mining Projects

Member of Complex Claims Unit responsible for difficult claims and Staff Manager tasked for leading the direction of staff meetings

Analyzed, prepared and presented key reports utilized in cost containment, new project development initiatives, quality assurance and to increase efficiency and productivity

Collaborated with SIU, attorneys, physicians, and all levels of policyholder staff

Direction and resolution of team Any Occupation Project, which led to substantial decrease in delinquent claims, resulting in first time team compliance within Dallas office standards

Certifications I am a certified Fraud Investigator and a member of “International Association

of Special Investigations Unit (IASIU), Vendor Manager, Auditor, Data Analytics

Analyst, Quality Assurance/Risk Manager, Sr. Manager of Accreditation & CAHPS,

Settlement Negotiator, Appeals Manager, Complex Claims Investigator, Claims

Manager I II & III, SharePoint Technical Expert & National Committee Coordinator

Education/ UNIVERSITY OF LOUISIANA, MONROE, LA

Training Criminal Justice, BA and Sociology minor – May 1997

LOUISIANA ARMY NATIONAL/TEXAS ARMY NATIONAL GUARD

Specialist - April 1993 to February 1999

Recognized as Top Recruit at Basic Training for Leadership and HAZMAT Certification

Skills Access, Adobe Pro, Excel, Hyperion, Lotus, Microsoft Office, Passport, PeopleSoft,

SharePoint, Power Point, Release 5.0: Worksheets, SRO Mainframe, Terra-data, Word

Honors/ President’s List, Dean’s List, Pi Kappa Alpha Fraternity – Public Relations Alumni

Activities Chairman, Sergeant at Arms, University of Louisiana Alumni Association

References: Available upon request

Contact this candidate