Business Analyst Administrative Specialist

Dr. Gabriel Muzanenhamo

**** * ********* ***** **********, KY 40291 617-***-**** admzhl@r.postjobfree.com

Administrative Management -RESOLUTION OPPORTUNITY SPECIALIST

Dedicated, results-oriented professional with hands-on experience in administrative management, public relations, leadership, and team building. Continually strives to meet and exceed corporate goals.

~ Administration

~ Operations

~ Project Coordination

~ Public Relations

~ Team Leadership

~ Communication/Technology

Exceptional administrator. Proven results within managerial directives, public policy, file maintenance, detailed reports, operational compliance, and policy interpretation.

Demonstrated leader. Administer and evaluate social programs to facilitate proposed solutions. Expertise in team collaboration and project management.

Hands-on training professional. Exceptional knowledge regarding legislation, public relations, problem resolution, scheduling, program analysis and creative strategies.

Professional Experience & Achievements

ADMINISTRATIVE & APPEALS SPECIALIST III, HUMANA, Louisville, KY

06/2019 -01/15/2021

Expertly conduct and manage research projects to gather information regarding critical and pending legislative issues.

Craft over 600 claim appeals to constituent inquiries, detailing information and providing resource data.

Manage special projects with a focus on timeliness, content, and accuracy.

Attend managerial briefings, taking accurate notes and highlighting critical discussion points.

Engage in direct public contact with diverse employees from the resolution team with the focus of streamlining case resolution processes.

Maintain accurate and current knowledge of issues regarding heath care, education, insurance economic policy, compliance, and the risk management.

Intake/Assess, investigate, conciliate, and/or resolve complex, highly sensitive and difficult allegations of discrimination related to healthcare accessibility.

Assist in performing compliance reviews of the fair claims processing policies/practices of recipients of federal monies, i.e., Medicare Recipients, Assisted Living Seniors, and other third subsidized plan programs.

Assist in assessing program effectiveness by reviewing fair health program plans for consistency with program objectives. Identify operational problems and recommend corrective action.

Conduct analysis, fact-finding, facilitation, and negotiations to bring about solutions to civil rights problems in a given locality using information technology and the fair healthcare planning process.

Conducts Appeals conferences for the settlement of tax cases in which taxpayers have appealed determinations made by the Service or have filed petitions with the U.S. Tax Court for redetermination of tax liability.

Research case issues to determine and apply the law to the facts presented. Where issues are unclear or where a clear precedent is lacking, determines the appropriate resolution based upon relevant factors including reasonableness, adjudication trends and settlement practices.

Analyze case files, supporting documents and other information that relate to insurance liability. Reviews cases for adequate technical development of issues. Remedies defects or inadequacies in cases or on issues either independently or collaboratively with other team members, or by referral to the appropriate Service component.

Deals professionally and effectively with taxpayers, representatives and co-workers. Conducts Appeals conferences and negotiations in a dignified and orderly manner, with displayed impartiality. Negotiates settlements of cases based on facts developed and applicable law and regulations, considering the hazards of litigation.

As appropriate, provides effective neutral assistance as a mediator to resolve insurance claim disputes between the organization and the patient. Conducts separate or joint conferences to assist the parties of the tax dispute to arrive at a resolution to avoid litigation and minimize costs.

STATISTICAL BUSINESS ANALYST, US CENSUS BUREAU, Jeffersonville, IN

09/2016 - 06/2019

Analyzed and interpreted statistical methods to solve specific survey problems in various critical fields such as economics, public health, biology, and population growth.

Performed a wide range of personnel/administrative duties such as assign and review work on a daily, weekly, and monthly basis; assure that production and accuracy requirements are met; approve leave and recommend performance standards; set and adjust short-term priorities; and prepare schedules for completion of work.

Directed technical discussions of staff and documents needed procedural changes and suggested changes.

Identified relationships and trends in data, and process large amounts of data for statistical modeling and geo-graphic analysis, UR analysis using BARCA applications.

Prepared data for processing by organizing information, checking for any inaccuracies, and adjusting and weighting the raw data.

Provided operational training; assists associates by answering day-to-day technical questions

Managed complex case research and resolution, reviews

Performed disclosure analysis to assure adherence to confidentiality and determined necessity for imputation.

Communicated with other agencies and coordinates projects, office functions and departmental activities

CLINIC COORDINATOR, Norton Healthcare, Louisville, KY 09/2013-06/2016

Focused on major projects including the developing of a model of patient flow of cancer patients to improve coordination of care between providers and their patients.

Evaluated work performance of subordinates, hear and resolve complaints from employees, and effect minor disciplinary measures, such as warning and reprimands.

Conducted software application testing related to data collection operations across various surveys.

Participated in technical meetings with sponsoring division’s branches and subject-matter experts to resolve problems and enhance control and tracking systems for more efficient check-in and document preparation operations.

Implemented strategies incorporating broader organizational deliverables into programs for sub-contracted agencies in maintaining hospital CMS quality standards.

Keenly evaluated inconsistencies in the provided study document and compliance in close collaboration with research nurses, study team personal, principal investigator, as well as Regulatory Team

Streamlined patient flow during practice hours; thus, minimizing patient wait time from 1 hr. to 45 mins.

Made major contribution in improving customer satisfaction and patient experience ratings index from 85% to 93%.

Developed and implemented several well-received team and morale-building programs, which decreased staff turnover by 10% in one year.

PATIENT FLOW MANAGER, Dana Farber Cancer Institute, Boston, MA 01/ 2010 – 08/2013

Performed administrative tasks in support of the training function, such as evaluating training and trainee performance, attending department meetings and soliciting feedback from management and prepares and distributes training documentation such as instructional material, handouts, evaluation forms and visual aids; uses multimedia presentation equipment

Managed 25 patient access associates with main duties including hiring, training, coaching, metric reporting in operations of hospital patient flow, staff development and commitment to improving quality standards of patient experiences.

Controlled day-to-day administration of training policies and procedures, ensuring the data accuracy and suggesting ways to excel in administrative effectiveness and efficiency

Partnered with Oncology Team, Clinical Trial Team and Led Patient Flow Risk Management which reduced no show by 50% over 8 months period.

Coordination of inter-department workflow with a hospital administration, physicians, healthcare staff, improve patient schedule timeliness.

PATIENT ACCESS ADMINISTRATIVE SPECIALIST, Caritas Medical Group, Boston,

MA 06/2004-01/2010

Provided expert research and analysis for healthcare applications education program and worked with IT team and improvement process.

Reviewed administrative procedures, analyzing processes, and making innovative changes to expedite workflow and improve patient quality performance.

Researched insurance and financial patient accounts discrepancies and provided accurate resolution.

Teamed with clinical support team and departmental managers to coordinate accurate patient scheduling logistics, booth coverage, adequate material supplies and Medicare compliance in presentation.

Answered telephones, providing insightful information and directing callers to internal parties.

Provided special project management for trade shows to ensure budget compliance and operational goals.

Education

Doctor of Healthcare Administration 2020

Walden University, Minneapolis, MN

Master of Healthcare Administration 2016

Walden University, Minneapolis, MN

Bachelor of Science - Healthcare Administration 2014

University of Kaplan, Lauderdale, FL

Medical Administrative Assistant 2010

Lincoln Tech Institute, Union, NJ, USA

Bachelor of Science - Accounting & Business Studies 1996

University of Zimbabwe

Training And Certifications

Fellow of the American College of Healthcare Executives (FACHE) 2020

Technology

Expert in Microsoft Office (Word, Excel, PowerPoint, Access, Outlook, MS Project)

Lean and Six Sigma Tools

Affiliations

Member - National Society of Leadership and Success

Member - Walden University Alumni Association

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