Management, Business/Project Analyst

MARTIN SCHWARTZ

Cell 281-***-****

******.**********@*****.***

OBJECTIVE

Healthcare Management

Business Management

Business Analyst

SUMMARY

Over 20 years of experience in various positions in the healthcare industry. Successfully managed operations and business processes, which exceeded targeted financial results. Achieved a 60% overall increase in customer satisfaction. Proven track record of streamlining workflow processes, analyzing critical data and the ability to develop and build successful teams. Recognized for excellent interpersonal and team leadership skills by employees at all levels of the organization.

PROFESSIONAL EXPERIENCE

UNIVERSAL AMERICAN – Houston, Texas 2007 – 2011

Production Manager – Metrics (2010 – 2011)

• Developed reports for key performance indicators for business owners and executives which provided vital information for managing the business.

• Directed a SQL team of up to 10 both domestic and international, developing them into a highly productive unit that helped reduce operating costs while increasing production. Produced daily, monthly, and yearly reports that were error free and accurately represented all data analyzed.

• Developed a systematic approach for business owners to request ad hoc reports which were produced within the regular work day, or no later than 24 hours from time of request depending on complexity.

• Promoted to this position based on performance and past experience which improved overall performance.

Business Analyst/Project Analyst (2008 – 2010)

• Analyzed and reported key performance indicators and trends of production, quality, and general operations derived from complex data mining and external sources which provided the basis for management decision making.

• Facilitated meetings between operating departments, vendors, and clients which addressed critical issues and helped participants reach consensus on an appropriate resolution.

• Reviewed department operations by mapping workflow processes to identify areas for improvement and implemented continued quality improvements which increased productivity and overall customer satisfaction.

Facilities Manager (2007 – 2008)

• Enhanced the relations with building management which increased services required as well as lowering response time.

• Served as contact for repairs, coordinated work and ensured 100% completion.

• Responsible for renovations and build outs of operations.

• Managed the mailroom intake and document scanning center directing the activities of a staff of up to 10. Reduced the backlog of document scanning from 3 months on hand to 1 day on hand within 6 months.

THERAPEUTIC MASSAGE SERVICES (Self employed) – Houston, Texas 1998 – 2007

Therapist/Instructor

• Provided therapeutic services to clients.

• Marketed and grew business to 100+ clients in a period of three years.

• Earned a certified instructor designation from the state of Texas and served as a school based instructor in Houston. For one school, served as school Director which included responsibility for student admissions, retention, financial accountability, scheduling classes, and the management of the intern clinic.

HEALTH SOURCE MEDICAL GROUP – Los Angeles, California 1995 – 1997

General/Operations Manager

• Managed all department operations of the Medical Group, including claims, enrollment, customer service, health plan contracting, provider relations, UM, quality assurance, case management, human resources and finance departments. Reported to the Vice President/Medical Director of this company employing approximately 100.

• Maintained a constant level of operating expenses in a highly volatile market of increased competition and rising costs.

• Ensured compliance with all federal and state regulatory agencies, as well as company and client audits, passing all audits when initially conducted.

• Established company policies & procedures and work flow processes which assured operations were conducted as efficiently as possible.

• Approved contract negotiations with carriers and providers ensuring agreements were favorable to the company.

• Responsible for all facets of facility management of medical group and two additional medical offices.

CAREAMERICA – Woodland Hills, California 1993 – 1995

Claims Manager

• Managed the Commercial and Medicare HMO and PPO claims processing and customer service departments. Coached and mentored staff of 75 employees. Reduced turnover significantly by encouraging individual contribution, the opportunity to grow, and being open to new and innovative ideas.

• Developed policies and procedures that increased efficiency and ensured consistency of resolving problems.

• Reviewed production and quality performance meeting targets 99% of the time.

• Conducted performance reviews and disciplinary actions.

• Prepared and managed the annual budget forecast.

• Performed client presentations and system demonstrations which increased the clients’ understanding and by-in to the services provided.

PRUDENTIAL INSURANCE – Woodland Hills, California 1976 – 1992

Associate Claims Manager (1989 – 1992)

• Managed Indemnity, PPO, and HMO claims processing, coaching and mentoring a staff of 50 employees. Increased internal employee satisfaction by providing tools and training to be successful and realize advancement opportunities.

• Developed policies & procedures that ensured consistency and developed production and quality standards that were a stretch, however attainable.

• Conducted performance reviews and disciplinary actions.

• Prepared and managed the annual budget forecast.

• Performed client presentations and system demonstrations which increased the clients’ understanding and by-in to the services provided.

Claim Consultant (1986 – 1989)

• Conducted claim reviews and audits of home office and field office locations which ensured compliance with company policies and state and federal mandates.

• Developed policies and procedures which reflected new or revised company standards, as well as, State and Federal regulations.

• Oversaw project management for the development, enhancement, and testing of systems.

• Communicated to DOI and DOC inquiries and complaints, both verbally and in writing.

• Reviewed high dollar claims, BR, and multiple surgeries for appropriate adjudication.

PRUDENTIAL INSURANCE – Woodland Hills, California 1976 – 1992

Provider Relations Manager (1985 – 1986)

Medical and Dental Claims Supervisor (1981 – 1985)

Medical and Dental Claims Technician (1979 – 1981)

Medical and Dental Claims Examiner (1976 – 1979)

EDUCATION

AA Degree in Business Administration – Valley Jr. College, Van Nuys, California

TECHNICAL SKILLS

Facets

Macess

EZ-CAP

AS400

Excel

Word

Visio

PowerPoint

SharePoint

Outlook

Medicare HMO, PPO & FFS

Medical Terminology

CPT, ICD and HCPC coding

ADDITIONAL EDUCATION

Time Management – Franklin and Time Institute

Managing Priorities – Zinger Miller

Managing Diversity – Coleman Management Consultants

Managing Professional Development – Prudential

Team Building/Problem Solving – Prudential

Medical/Dental Coding – Prudential

Risk Management, Integrated Framework of Control – Prudential

Injury and Illness Prevention – CareAmerica

Age Sense and Aging Awareness – CareAmerica

Teaching Adult Learners – Texas Department of Health Services

Contact this candidate