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Authorization Representative Manager Service

Location:
Minneapolis, MN
Posted:
December 23, 2022

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Resume:

RODGER G. HARRIS

Elk River, MN 553**-***-*** **** adt7rl@r.postjobfree.com

Professional Summary

I have extensive experience in technical management and a record of improving efficiency, productivity, and profitability through motivational team building and process improvement. I am Assertive, Confident, Flexible, Motivated, Organized, Polished, and Tenacious. My success is in the fact that I can keep everyone aligned, connected, and overcome the daily dilemmas.

Skills

Project Management

Project Implementation

Project Delivery

Process Engineering

Technical Management

Work History

Midwest Disability 04/19/2022 to 05/13/2022

Open Case Management Specialist

Reviewed and processed client received documents, re-send documents to clients as needed, and enter follow up information into client database system

Participate in various clerical support projects including mailings and data entry that may require fact checking, faxing, scanning, attaching documents to client the database system, and/or document formatting

Inbound/Outbound phone calls answering client questions concerning their paperwork, representation forms and/or the Social Security Process

Promote and provide an exceptional level of customer service to our clients, internal co-workers, and SSA offices. Displayed a willingness to empathize with our clients’ needs, to dedicate the time needed to properly resolve all inquiries and ensure clients’ satisfaction with our services provided.

Other clerical duties as needed

Medtronic 06/2021 to 8/2021

Prior Authorization Medicare

JOB DESCRIPTION

The Prior Authorization Representative is responsible for verifying prior authorization requirements and obtaining authorization when required. Works directly with physician offices and payers to facilitate patient access to various therapies. Representative will ensure patient insurance coverage and benefits, identify requirements for prior approval and submit for authorization. Assists with appealing prior authorization denials, retro authorization or other special cases

• Validates insurance patient’s coverage, communicate any issues with benefits or coverage to the appropriate managers

• Checks the requirements for prior authorization and initiates as required

• Coordinates required paperwork, clinical notes and forms for submission to support request and initiates as required

• Follows up frequently to ensure visibility on authorization status throughout the approval process

• Basic knowledge payer payment process with detailed knowledge on the payer prior authorization process

• Basic ICD9/10 and CPT code familiarity, expert knowledge on subset of Medtronic therapy codes

• Superior customer service skills with outstanding communication skills to use with various stakeholders; physicians, sales representatives, payer representatives, utilization reviewers, various internal and external stakeholders,

• Advanced Microsoft Excel skills. Ability to learn and use multiple CRM software programs as needed

• Good organizational skills with ability to handle multiple inquiries at the same time and critical problem-solving skills with high attention to detail. Worked with Primary Medicare and Secondary Clients to submit PA Prior Approval for Medtronic Spinal Cord Stimulators.

Sales Associate Customer service 04/2020 to 6/2021

The Home Depot – Elk River, MN

Plumbing & Electrical Greet customers as they enter the store and inquire into their purpose of visit.

Engage customers in conversation to determine their home furnishing and related requirements.

Lead customers to the right aisles and shelves and provide them with information on available products.

I won the Presidential Award for excellent customer service.

Assisted Customers in their individual DIY project in Plumbing & Electrical.

Delivered high level of assistance by locating products and checking store system for merchandise at other sites.

Trained and developed new sales team associates in products, selling techniques and company procedures.

Tracked stock using company inventory management software.

Solved customer challenges by offering relevant products and services.

Project Manager 11/2019 to 01/2020

Target Corporation – Minneapolis, MN

Projects Alarm and Security Capital This role helps support the execution and planning of capital projects taking place across the country in Target stores.

Lead kick-off meetings with key stakeholders.

Create and route contract documents.

Coordinate project start and completion with Central Monitoring Station.

Field questions in general email inbox.

Presented project status via Powerpoint presentation.

Review projects for final acceptance at completion.

Hold scheduled calls with vendors.

Establish routine for updating project tracker.

Create workovers to repair failed assets.

Problem solve with support of Program Owner.

Communicate site connectivity details to technicians.

Highlight project deficiencies in project scope and deadlines to Program Owner.

Responsible for Project Delivery.

Archive project documents.

Record requests for information and change orders.

Update access permissions in project tools.

Create/update process documents.

Project Manager 06/2019 to 10/2019

Cargill – Minnetonka, MN

Project Specialists Strategic Sourcing & Procurement.

Project Specialists and Support for 11,.

Attended project status meetings took notes for distribution to the team.

Created Share Point document library for CSSP.

Maintained Share Point document library/file system for each individual CSSP Project.

Created the standardization naming conventions for project documents to upload to Share Point and organized file structure.

Tracked and uploaded project status reports to Share Point document library.

Created email template for notification to all PM and Leaders to upload project status and Leadership to update Project Tracker.

Tracked and updated Project Tracker that we accessed by 11 Project Mangers.

Created PowerPoint slides for presentation to executives on project status.

Assisted in individual project meeting took notes and distributed to the team.

Department Head 08/2017 to 06/2019

Home Depot – Elk River, MN.

Department Head Plumbing & Electrical

Electrical and Plumbing Responsible for 10,000 SKU inventory within the Plumbing and Electrical Departments Train, coach and develop associates in each department to ensure customers receive excellent service and can easily find the merchandise they need.

In addition, they provide valuable input into merchandising decisions to the Store Management Team and Operations Team.

Department Supervisors have strong product knowledge and the ability to lead and develop others.

Won Presidential award for customer service

Specific store departments may include Building Materials, Décor, Electrical, Flooring, Gardening, Hardware, Kitchen & Bath, Lumber, Millwork, Paint, Plumbing, Pro Account Sales, Tool Rental, Front End, Freight, Receiving, Associate Support, Special Services, and Merchandising Execution.

Major Tasks, Responsibilities & Key Accountabilities:.

Supervise the work activities of Associates within the Plumbing and Electrical Department.

Communicate store objectives to Associates using the appropriate programs and tools.

Train and develop Associates within the work team, through the management of training calendar and curriculum.

Engage in coaching for the development of Associates.

Participate in the interview process for hiring of new Associates and partner with store management on recommendations.

Provide input into appropriate discipline decisions related to Associates.

Provide input to the Associates on performance appraisals and make recommendations on promotion of associates in his/her area.

Work with home owner and contractor finding the correct part for repair and installation of plumbing and Electrical projects.

Held DIY seminars for customers Plumbing and Electrical.

Mitigation down stocking of skus for stocking aisle and bays.

Merchandise all products in accordance with HD guidelines.

Process Engineering 02/2016 to 07/2017

Mayo Clinic – Rochester, MN

Process Engineering Asset Inventory Team.

Serving on Asset Management project team for the IT Executive Services department.

Held Common Process kick off meetings utilizing Power Point presentation to business groups.

Scheduled training for incoming process engineering.

Engage with organizations across the enterprise to define & assess asset attributes & operational support criteria.

Process Engineering – Scheduled and Held stake holder process engineering meeting to gather current state processes.

Build of Visio Process Diagrams of “Current State” and “Future State”.

Scheduled and conduct gap analysts of “Common Process” and individual department “Future State” process flows.

Created Dashboard CIO Score Card reporting via Access DB.

Facilitate team analysis, diagram asset workflows & define processes to meet operations & security requirements.

Held executive meetings for sign off of individual processes

Ensure requirements are fully defined per SDLC and project management processes.

Serves as project level liaison between the internal customer community, IT development teams, & end customers.

Present requirements in a concise, measurable, and flexible manner to meet project and stakeholder needs.

Process Engineering 06/2015 to 01/2016

Zeiss Metrology – Maple Grove, MN

Building Business Process Maps using VISIO.

Held meeting with team members in the Deployment Department to build processes.

Installation.

Calibration.

Repair.

Updating and developing written Business Procedures.

Held executive meetings for sign off of processes.

Deployment Operations EUC Services Manager 09/2014 to 05/2015

Cargill – Minneapolis, MN

Managing Field Service Techs providing desktop support and peripheral support to various client offices across the global markets.

Projects Schedule TCS Transitions - Latin America LATAM - Europe – Middle East - Africa EMEA - Asia Pacific APAC.

Crated MS Project Plans – Lead international project meetings – Tracked issues/roadblocks and risks.

Updated status reports, QA Gates and tasks spreadsheet.

VIP Services - Latin America LATAM - Europe – Middle East - Africa EMEA - Asia Pacific APAC.

Created MS Project Plans

Build MS ACCESS DB to track tasks and monitor all projects Held project meetings with offshore international teams both Cargill and TCS for VIP Services - LATAM - Europe – Middle East - Africa EMEA – Asia Pacific.

Crated MS Project Plans – Lead international project meetings – Tracked issues/roadblocks and risks.

Process Engineering Improvements created Visio/ Tibco Process Maps for VIP/Star Service call process flows to include Service Desk, Field Service Support, and Escalation process to L2 and managers.

Held project progress meetings presentation with executive committee.

Senior Project Manager 03/2013 to 07/2014

COMCAST – Minneapolis, MN

Implementation Telecommunications Project Deployment PM (NVDE National Video Deployment Engineering).

Financial Tracking built Access Data Base to track costs of project financials and resource tracking.

Resource Management (internal and external contractors).

Attended project initial plan financial meetings and provided updates via Access DB.

Worked with Engineering teams on technical resource scheduling and availability by initiating skills matrix.

Agile focused facilitated progress meetings and reported out for the following projects: IPCDN IBONE 12 server deployment; IPCDN server installation; cDVR Cloud build out; Zenith Capacity speed increase OSP Outside Plant splicing nodes; NVDE TEAM processes/procedures; RPMO ACCESS Database.

Deployment focus on managing critical deployment initiatives related to improving video reception, increasing server speed and upgrading equipment.

Initiated R.A.C.I documentation to the NVDE group to help with establishing rolls and responsibilities for projects.

Setup Projects and monitored using Clarity Network Project Controller.

Created high level project decks for executive management.

Held project update meeting with executive management.

Assisted in the development of SLA targets and project/service-related metric using Jira and MS Project Plans to create CIO Scorecard and Operational Scorecards.

Submitted and tracked Change Requests as part of Cloud DVR project.

Developed MS Project plans/maps, coordinated installations, ordered the appropriate equipment,.

Agile environment.

Process Engineering 04/2012 to 03/2013

WELLS FARGO HOME PRESERVATION – Minneapolis, MN

Process Control Team (PCT).

Provided exceptional support for Home Preservation (HP) operation stakeholders by creating and maintaining process maps that complied with organizational business process modeling.

Developed Change Management CR process and attended Change Request meetings “Go No Go”.

Expertly handled all aspects of process mapping for WF (Wells Fargo) Hardest Hit Funds, Cease and Desists and Collections areas.

Administered/updated SharePoint by creating calendars, updates and surveys as directed.

Project Manager 01/2011 to 04/2012

Ameriprise Financial – Minneapolis, MN

Service Delivery EUC

Developed process mapping for IEDB Hosting requests that included requirements gathering, project status meetings and tracking CR.

Setup Projects in Clarity Network Project Controller monitored.

Columbia Management Acquisition Change Management Request Manager between IBM network and Project Managers.

Submitted and tracked all CR.

Developed processes and escalations procedures to ensure that all CR were completed per the Project Plan.

Facilitated productive JAD meetings with technical architects and stakeholders.

Created high level project progress decks and presented to executives and all stake holders. Used self developed Access Database, PowerPoint and Visio to manage and communicate status on projects.

Operations Manager Service Delivery 10/2010 to 12/2010

Wells Fargo – Minneapolis, MN

Develop Process Flow for W.I.S.H.

Hosting requests.

Worked Jira tickets – Open, Update, Close.

Created requirements gathering process and documentation for business lines.

Work with architect to correctly design and estimate the project.

Setup Projects in Clarity and resource time tracking in Stamp.

Work with the resource managers to make sure the right resources are assigned to the project.

Worked with the technical teams to understand what needs to be built.

Develop SLA/OLA documentation with business line.

Outlined hosting services W.I.S.H.

Created Project Status documentation.

Held final process meeting with all stakeholders including executives

Deployment Operations Manager 11/2009 to 09/2010

Carlson Marketing Group – Minneapolis, MN

Service Delivery EUC Project: End User Computing (EUC- Active Directory - SCCM – File & Print Servers- BPOS SharePoint – BPOS Exchange -Multifactor Authorization- VPN – Workstation Encryption) Towers Architecture – Applications Migration – Security – Network & Telephony – Hosting – IT Facilities – Software Contract – Internal Capabilities – Service Desk.

Held Kick Off Meetings.

Gathered Business and Technical requirements Visio and Power Point.

MS Project Created and updated detailed project plans.

Facilitated Weekly Status Meetings Power Point.

Created executive level decks and held presentation of upper management

Held large scale meetings utilizing executive decks

Created Executive Summary DASHBOARD Power Point.

Held Technical Design Meetings using Visio and PowerPoint.

Created Critical Decisions tracking.

Status Reporting major milestones.

Submitted CR to network engineers for network changes – Open Ports – Network Changes.

Created/Updated PMO SharePoint Site.

Issue and Risk tracking and mitigation.

Developed project management roadmap to define project objectives, timelines and milestones.

Implementation Project Business Continuity Manager 11/2006 to 09/2009

IBM/Ameriprise Financial – Minneapolis, MN

Implementation of Service Delivery Enterprise wide.

Worked with IBM RFS (Request for Service) Utilized IBM PMOR to base line and track all project deliverables, financials, resources, and project closeout.

Did requirements gathering, financial priced projects; wrote concept/process design, written technical documentation, and scope of work/closure details.

Resource Management responsible for all resource planning, tracking forecasting cost and all scheduling developed project plans and updated all support documentation.

Tracked and managed Risk and Issue Resolution Monitors and maintains processes for key project tracking efforts: issues, risks, mile stone, decisions, project change requests, purchases, time reporting, expense reporting.

Resource Management developed resource skills matrix of IBM desktop technicians to help with the resource allocations for projects and to continue to meet SLA within the IBM contract.

Financial forecasting estimated project costs and technician hour costs for individual projects via IBM PMOR.

Seeded individual project house into IBM time tracking application and monitored those individual efforts for any potential resource cost overruns.

Resource Management external contractor to complete Wall to Wall Inventory identifying 9500 for assets tagged.

Coordination/Implementation of $1.6 Million in RFS projects 33% Gross Profit IBM targeted 20%.

Process engineering developed process flows for desktop technician to follow.

Resource Management facilitated all project staff training managed time off and vacation schedules.

Setup projects in and monitored IBM PMOR and Clarity Network Project Controller.

Utilized Remedy to create and assigned/track project initiated Remedy Tickets.

Created MS Project Built MS Access DB to create a tracking system/CIO and Operational Scorecard.

10,000 User Lotus Notes Upgrade - 2400 End User remediation of issues at the desktop level MAC-Move – Add – Change 300 Desktop and 150 printers and decommission Integration Service 1300 Desktop roll out integration encryption Service Deliver desktop roll out integration – and decommission printers/desktop and laptops 900 Service Delivery refresh/MAC Business Continuity Plan laptop delivery – Reimagine – Event Support.

Implemented and tracked CR and attend “Go No Go” meetings.

Created work schedule for 7x24 coverage of help desk.

Maintained all internal work schedules for 16 Service Center analysts.

Wrote operations manual maintained all updates of internal processes and procedures.

Supported business continuity and disaster recovery.

Education

Fissure – Business Analysis Workshop Minneapolis PMI Member – PMP Certification Examination Workshop

Bell & Howell - Chicago, Illinois

Bachelor's Degree: Electrical Engineering – ATTENDED DID NOT GRADUATE.



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