Operations Manager Business Development
Resume:
Terrance J. Scanlon, M.S. **** Lansing St, Phila., PA, 19136 267-***-**** linkedin.com/in/terrancejscanlon/ - ****************@*****.***
Professional Skills
Experienced in Reporting, Analytics, and System Improvements.
Coursework knowledge of Fair Market Value, Provider Networks, RCM, and Market Research.
Able to navigate healthcare informatics as well as extensive research in computer-based patient records.
Proficient in Microsoft Access, Visio, and Excel as well as Tableau.
Excellent navigation skills and research in CRMs.
Education
St. Joseph’s University, Philadelphia, PA December 2019
Master of Science in Health Care Administration
West Chester University, West Chester, PA May 2016
Bachelor of Science in Public Health
Professional Experience
Amerihealth Caritas
Medicare Sales Operations Manager November 2021– Present
Reports to the Director of Business Development with the responsibility of Managing Medicare & ACA health plan development while monitoring FMO channel movement by tracking Agent onboarding.
Has also developed and maintained relationships with the Directors of Enrollment, Sales, and Marketing by analyzing and distributing daily, weekly, and monthly reporting for multiple departments to provide up to date inventory reporting
Familiarized with specific State contracts to keep the expansion of Medicare and ACA healthcare plans in constant growth
Creates desktop learning procedures for operational systems as a means of training and developing increased knowledge to employees across the company.
Keeps accurate information in CRM and also creates Tableau dashboards for accessibility to up to date data and statistics
Oversees Agent Commissions, Bonuses, and Broker Support.
Independence Blue Cross
Medicare Production Analyst February 2018 – November 2021
Was the Team Lead who had full responsibility of making sure enrollment applications were completed by enrollment processors within 7 calendar days to adhere to CMS guidelines.
Trained new employees on Medicare education as well as step by step details on processes
Maintained current provider data such as NPN, office address information and plan contracting.
Highly skilled in Medicare claims, daily inventory reports, payments, and compliance guidelines.
Distinguishes any problems with a member’s account from the beginning to the end for claims payment.
Focus on Revenue Cycle Management including demographics, EMR/treatment review, claims payments, and ensuring the Medicare Advantage member full access to care.
Creates work around solutions internally to ensure access to care as well as reviewing that the claims invoices to monitor trends for Medicare research solutions.
Contact this candidate