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Click here or scroll down to respond to this candidateCandidate's Name
EMAIL AVAILABLE PHONE NUMBER AVAILABLE Phoenix, AZ Street Address
PROFILEExperienced administrator with over 25 years of expertice in compliance, administrative, operational, privacy, marketing, and outreach program functions. Proven track record in work-related training and development programs to improve organizational performance while managing multiple with a positive attitude. Willingness to take on added responsibilities to meet team goals.EXPERIENCECOMPLIANCE AUDITOR HEALTH PLANS CENTENE FEBRUARY 2020 MAY 2023Responsible for conducting audits and regulatory reviews of health plan operations, policies, procedures, and practices improving to a 98% compliance with applicable laws and regulations conforming to the management of contractual obligations.Oversaw and monitored business operations, reported infractions, reviewed company policies for possible risk and liabilities, and researched legal requirements for new initiatives.Managed a team of compliance members in various departments in reviews and investigations of any suspicious health plan activity or compliance issues, and activities that violates state and federal rules and regulations.COMPLIANCE ANALYSIS NTT DATA FEBRUARY 2015 DECEMBER 2019Managing audit flow timelines from start of audit through completion working closely with subject matter experts, auditors, and business partners to analyze audit questions.Responsible for ensuring the organization complies with regulatory requirements through meticulous data analysis and executing reviews of identified control deficiencies to drive to appropriate dispositions.Coordinated and monitored audit improvements and corrective action plans of customer service operations to confirm compliance with state and federal quality standard requirements.DIRECTOR, DATA PRIVACY BANNER HEALTH JANUARY 2011 - JANUARY 2015Responsible for overseeing data privacy and protection policies to ensure the entire organization processes the personal data of their customers, employees, and partners in accordance with company policies and regulatory compliance requirements.Implemented and managed strategic improvement plans to integrate solutions to audit findings and workflow process issues.Managed the Data Privacy program to ensure compliance with applicable laws, regulation and industry standards.COMPLIANCE SPECIALIST II BANNER UNIVERSITY MEDICAL CENTER JULY 2007 - JANUARY 2011Responsible for the quality and safety compliance audits of all Ancillary Hospital Services identifying, investigating, and reporting all non-compliance violations and irregularities.Coordinated the creation of corrective action plans in collaboration with department leaders to ensure identified non-compliant findings and processes are improved and maintained in accordance with applicable laws, regulations, and industry standards.Developed and implemented training programs to educate medical staff on quality and safety standards, maintaining detailed records of inspections, audits, incidents, and corrective actions completed.EDUCATIONCAPELLA UNIVERSITYMASTER OF SCIENCE IN HEALTH ADMINISTRATIONJAN 2011 - APR 2013TOURO UNVISERSITY CALIFORNIABACHELOR OF SCIENCE IN HEALTH MANAGEMENTMARCH 2002 - MAY 2004SKILLS & ABILITIESOperational Oversight Compliance ManagementCompliance Training Policy and Procedure ImprovementsRegualtory Compliance Quality AssuranceProject Management Data Protection & AnalysisRisk Management Team Leadership |
