Carolina Care Plan
Industry: Company
DescriptionHeadquarters: Columbia, SC Founded: 1984
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Carolina Care Plan Employees
UCI Medical Affiliates March 2014 - Present
UCI Medical Affiliates November 2013 - March 2014
Medical Mutual of Ohio January 2010 - November 2013
Medical Mutual of Ohio 2007 - 2010
Carolina Care Plan 2005 - 2007
Carolina Care Plan 2002 - 2005
Skills
Health Insurance, Provider Relations, PPO, Network Development, Medicare, Managed Care, HMO, HIPAA, Insurance, Employee Benefits, Claim, Credentialing, Healthcare, Healthcare Management, Claims Management, Analysis, Training, Recruiting, Medical Coding, Contract Negotiation, Management, Workers Compensation, Process Improvement, Benefits Administration
Education
University of Phoenix 2009 — 2013
Bachelor of Science (B.S.), Business Administration and Management, 3.98
University of Minnesota-Twin Cities 1986 — 1989
Sutter Health June 2014 - Present
EPIC May 2013 - June 2014
AVI Companies November 2012 - April 2013
Kaiser Permanente November 2003 - May 2012
Carolina Care Plan April 2003 - July 2003
Blue Shield of California October 1999 - April 2003
Forte Integrated Benefit Services April 1998 - September 1999
InnOvus Integrated Benefit Services March 1997 - April 1998
AAA NCNU Insurance Exchange October 1989 - October 1994
Skills
Insurance, Health Insurance, Employee Benefits, Underwriting, Brokers, Workers Compensation, Reinsurance, Property & Casualty..., Recruiting, Microsoft Word, Casualty, Financial Risk, Life Insurance, Risk Management, Problem Solving, Strategic Planning, Training, Managed Care, Customer Service, Time Management, Analysis, Health Policy, Account Management, Management, Medicare, Marketing, Team Building, Performance Management, Coaching, General Insurance, Self-funded, Healthcare Management, Business Planning, Human Resources, Negotiation, Budgets, Change Management, Forecasting, Lotus Notes, Customer Retention, HMO, Health Savings Accounts, Health Care Reform, PPO, Benefits Administration, Data Analysis, Access, Critical Illness, Accident, Organizational...
Education
Diablo Valley College 1994 — 1995
Business Administration and Management, General
Carolinas Healthcare System May 2012 - Present
Carolinas Healthcare System June 2010 - May 2012
CIGNA Healthcare July 2008 - June 2010
Great-West Healthcare July 2006 - July 2008
MedCath, Inc July 2005 - July 2006
UnitedHealth Group May 2002 - July 2005
BlueCross BlueShield of SC July 2000 - May 2002
Carolina Care Plan 1995 - 2000
Department of Pediatrics, UNC-Chapel Hill May 1994 - August 1995
Skills
Network Development, Managed Care, Healthcare Management, Healthcare, Hospitals, Health Insurance, PPO, HMO, Healthcare Industry, Contract Negotiation, Process Improvement, Analysis, Management, Physicians, Healthcare Consulting, Provider Relations, Healthcare Reimbursement, Strategy, Healthcare Analytics
Education
University of South Carolina-Columbia 1997 — 1999
MHA, Healthcare Administration
University of North Carolina at Chapel Hill - Kenan-Flagler Business School 1989 — 1991
BSBA, Operations Strategy
Penn State University 1987 — 1989
Quantitative Business Analysis
Michigan Works! Livonia Service Center/ Ross I.E.S. December 2014 - Present
Triumphant Tree Wood Shop September 2012 - May 2015
US Staffing Agency September 2014 - November 2014
(Ross IES) Michigan Works! Livonia Service Center March 2014 - September 2014
Private Home Owner November 2010 - August 2011
St. Raphael Academy August 2009 - May 2010
Emerson Centre September 2007 - April 2008
Carolina Care Plan June 2002 - June 2004
Professional Development and Research Institute on Blindness January 2001 - July 2002
Skills
Strategic Planning, Career Counseling, Workforce Development, Organizational..., Microsoft Excel, Microsoft Word, Research, Team Building, Outlook, Public Speaking, Customer Service, Community Outreach, PowerPoint, Microsoft Office, Management, Case Managment, Organizational Structure, Nonprofits, Training, Case Management, Leadership Development
Education
The Chicago School of Professional Psychology 2014 — 2015
Consulting, Management & Employee relations, Industrial and Organizational Psychology
Pastoral School of Theology (ROCOR) 2011 — 2013
PTh.D, Pastoral Theology
Louisiana Tech University 2005 — 2009
B.A., Sociology
Michigan Works! Association 2015 — 2015
Business Solution Professional
Michigan Manufacturing Technology Center MMTC 2015 — 2015
Lean Office Champion
Benefit Advisors of Charleston, LLC April 2012 - Present
Carolina Care Plan June 2012 - October 2013
TCC of SC March 2008 - April 2012
Antigenics, Inc September 2002 - October 2003
Skills
Health Insurance, Insurance, Public Speaking, Marketing, Strategic Planning, Customer Service, Healthcare, Retirement Planning, Long-term Care, PowerPoint, Account Management, Microsoft Excel, New Business Development, Small Business, Negotiation, Sales, Microsoft Office, Team Building, Employee Benefits
Education
The Citadel 2004 — 2007
MBA, Business Administration and Management, General
Merrimack College 1997 — 2001
BS, Health Science
America's 1st Choice June 2011 - Present
Carolina Sunshine for Children 2010 - 2015
America's 1st Choice September 2010 - June 2011
Carolina Crescent Health Plan October 2006 - July 2010
United Health Care 2005 - 2006
Carolina Care Plan 2000 - 2004
Skills
Provider Relations, Network Development, Health Insurance, Healthcare, Contract Negotiation, Negotiation, Managed Care, Medicaid, Medicare, Medicaid Managed Care, Medicare Advantage, Credentialing, Healthcare Management, HEDIS, Provider Network..., Healthcare Consulting, Healthcare Industry, Physician Relations, HIPAA, Healthcare Information..., Leadership, Team Building, Strategic Planning, Management, Process Improvement
Education
University of Phoenix 2003 — 2006
BSM, Management
University of Phoenix 2003 — 2004
Associates, General Education
BrightStar of Lexington/West Columbia June 2011 - Present
Centene Corporation September 2007 - November 2010
Absolute Total Care, Inc, Centene Corporation September 2007 - November 2010
Absolute Total Care September 2007 - November 2010
Carolina Care Plan July 2002 - May 2007
Skills
Home Care, Seniors, Medicare, Finance, Healthcare, Managed Care, Health Insurance, Strategic Planning, Customer Service, Medicaid, Team Building, Healthcare Management, Process Improvement, Employee Benefits, Management, Team Leadership, Insurance, HIPAA, Budgets, Microsoft Excel, Healthcare Information..., Leadership
Education
University of South Carolina-Columbia 1990 — 1991
Accounting
Georgia State University 1982 — 1986
BS, Chemistry
McAngus Goudelock & Courie 2004 - Present
Carolina Care Plan 2002 - 2004
Lutheran Homes of South Carolina 1999 - 2002
Centers for Disease Control and Prevention 1990 - 1999
Skills
Cloud Computing, Telecommunications, Virtualization, Citrix, Enterprise Software, Leadership, Management, Disaster Recovery, Networking, Data Center, Information Technology, VMware, Active Directory, SharePoint, Windows Server, SaaS, System Administration, Security
Education
University of Alabama 1986 — 1989
Bachelor of Science (BS), Health/Health Care Administration/Management
Alpha Business Essentials July 2014 - Present
Colonial Life July 2013 - July 2014
MBM (Parent Company) May 2008 - June 2013
Thunder Tower Harley-Davidson November 2006 - May 2008
Carolina Care Plan August 2005 - November 2006
South Carolina Education Lottery August 2003 - January 2005
Skills
Advertising, Event Management, Press Releases, Marketing, Marketing Management, Management, Sales, Brand Management, Budgets, Marketing Communications, Customer Service, Sponsorship, Media Relations, Social Media Marketing, Account Management, Strategic Planning, Public Relations, Marketing Strategy, Online Advertising, Social Media, Television, Fundraising, Email Marketing, Event Planning
Education
University of South Carolina-Columbia 2003 — 2005
Master of Mass Communication, Integrated Communications
Furman University 1999 — 2003
BA, Communication Studies
ATI Associates, LLC November 2010 - Present
Blue Cross Blue Shield of Florida April 2011 - October 2011
Palmetto Physician Connections July 2010 - March 2011
Guardian Healthcare September 2009 - July 2010
Centene Corporation January 2009 - June 2009
Centene Corporation May 2007 - September 2008
Carolina Crescent Health Plan, Inc. December 2006 - March 2007
Carolina Care Plan June 2001 - December 2006
MedQuest Associates July 2000 - June 2001
Skills
Network Development, Contract Negotiation, Start-up Environments, Provider Relations, Managed Care, Medicaid, PPO, Medicare, Healthcare Management, Provider Contracting, HMO, Contract Management, Excel, Problem Solving, Operations Management, Healthcare, Health Insurance..., Leadership, Training, Medical Billing, Health Policy, Microsoft Excel, Start-up Environment, Healthcare Industry, HIPAA, Healthcare Consulting, Healthcare Information..., Health Insurance, Credentialing, Policy, Revenue Cycle, Physician Relations, Disease Management, Medical Coding, Claim, Medicare Part D, EHR, Utilization Management
Education
University of South Carolina-Columbia 1988 — 1992
BS, Business
York High School 1984 — 1988
Mo' Envy Hair Salon January 2007 - Present
Carolina Care Plan September 2002 - June 2004
Education
Bryant & Stratton College 1985 — 1986
business
Carolina Care Plan 2009 - 2013
Carolina Care Plan 2007 - 2009
Carolina Care Plan 2005 - 2007
Carolina Care Plan 2003 - 2005
Carolina Care Plan 2000 - 2003
Skills
Health Insurance, Employee Benefits, Customer Service, Teamwork, Research, Teaching, PowerPoint, Negotiation, Editing, Team Building, Project Management, Social Media, Event Planning, Management, Public Relations, Event Management, Project Planning, Microsoft Word, Lotus Notes, Networking, Microsoft Excel, Account Reconciliation, Organizational..., Self-starter, HMO, Managed Care, Group Insurance, Insurance, Customer, Medicare
Education
Midlands Technical College
Associates Human Services, Human Services, General
Consumers' Choice Health Plan October 2013 - Present
Carolina Care Plan April 2012 - October 2013
Herlong Bates Burnett Insurance April 2010 - April 2012
AT&T August 1988 - September 1998
Skills
Health Insurance, Insurance, Employee Benefits, Medicare, Disability Insurance, Customer Service, Life Insurance, Managed Care, Sales, Account Management, Strategic Planning, Negotiation, Healthcare, Microsoft Office, Long-term Care, Training, Brokers, Leadership, Sales Management, Health Savings Accounts, Group Insurance, Provider Relations, Management, Workers Compensation, Term Life Insurance, Property & Casualty..., Health Care Reform, Marketing
Education
Mary Brewer School of Insurance 2002 — 2002
Life & Health License
University of South Carolina-Columbia 1977 — 1979
Business
Southern Wesleyan University
Bachelor of Business Administration (B.B.A.), Business, Management, Marketing, and Related Support Services, 4.0 GPA
Capital Stone & Landscape LLC February 2014 - Present
Capital Stone & Landscape June 2011 - March 2014
Wade Investigations August 2012 - August 2013
BlueCross BlueShield of SC October 2004 - June 2011
Carolina Care Plan 1996 - 2005
Skills
Business Objects, Highly detail oriented, SAS programming, Mainframe, Systems Analysis, SQL, DB2, Office Management, Report Writing, Invoicing, Accurate Data Entry, Public Speaking, Analitical, Organization, Microsoft Office, Access Database, Notary Public, PowerPoint, Bookkeeping, HIPAA, Concealed Weapons Permit, Private Investigations, Access, Customer Service, Contract Negotiation, Budgets
Education
Midlands Technical College 2005 — 2007
Associate's degree, Computer Technology/Computer Systems Technology
SAS Institute 2001 — 2002
Certificate, SAS Programming
WellCare Health Plans March 2015 - Present
WellCare Health Plans July 2013 - March 2015
WellCare March 2013 - July 2013
UnitedHealth Group June 2007 - March 2013
SC Medical Group Manager's Association 2008 - 2013
Carolina Care Plan 2002 - 2007
Carolina Care Plan April 2002 - November 2002
Skills
Microsoft Excel, Department Budgeting, Business Travel, Job Coaching, Team Building, Healthcare, Health Policy, Management, Call Centers, Claim, Outlook, Microsoft Word, Insurance, Leadership, Microsoft Office, PowerPoint, Process Improvement, Strategic Planning, Training
Education
University of South Carolina-Columbia 1997 — 2001
Bachelor of Arts (BA)
WellPoint February 2014 - Present
WellPoint September 2011 - February 2014
Centene Corporation March 2010 - September 2011
Carolina Crescent Health Plan April 2009 - April 2010
Carolina Crescent Health Plan January 2008 - April 2009
WellCare October 2007 - February 2008
Carolina Care Plan 2002 - 2007
Electronic Data Systems (EDS) 1997 - 2002
Skills
HEDIS, Medicaid, Provider Relations, Process Improvement, Network Development, HMO, Quality Improvement, NCQA, Data Analysis, Managed Care, Healthcare, Contract Negotiation, Recruiting, HIPAA, Credentialing, Disease Management, Employee Benefits, Health Policy, Insurance, Medicaid Managed Care, Medicare
Education
Francis Marion University
Sedgwick October 2013 - Present
QBE North America July 2013 - September 2013
Custard Insurance Adjusters February 2008 - April 2012
Direct General Insurance March 2004 - February 2008
Carolina Care Plan February 2002 - December 2003
Continental American Insurance Company March 1997 - 2002
Seibels March 1996 - March 1997
Southeastern Claims Services, Inc. September 1991 - February 1996
Skills
Insurance Adjusting, Personal Injury, Insurance Negotiations, Subrogation, Insurance Background, Litigation, Customer Service, Adjusters, Citrix, Guidewire, Insurance Fraud, Microsoft Office, Microsoft Word, Medical Terminology, AS400 system, Adjustments, Claims Resolution
Education
Midlands Technical College 1986 — 1987
Accounting
Mary Brewer School of Insurance 1993 — 1993
SC Adjuster's License
Drive Medical Design & Manufacturing October 2014 - September 2015
Drive Medical Design & Manufacturing October 2011 - October 2014
ActiveCare Medical May 2007 - October 2011
Carolina Care Plan 2005 - April 2007
University of South Carolina 1998 - 2005
Skills
Marketing Communications, Public Relations, Event Management, E-commerce, Marketing, Product Launch, Marketing Management, Marketing Strategy, Corporate Communications, Leadership, Direct Marketing, Product Marketing
Education
University of South Carolina-Columbia 1991 — 1995
Bachelor of Arts, Journalism
BlueCross BlueShield of South Carolina January 2013 - Present
Hospice Care of Tri County December 2010 - Present
ITT Technical Institute September 2008 - May 2011
Carolina Care Plan February 2006 - April 2007
Blue Cross and Blue Shield of South Carolina October 1995 - February 2007
Pizza Hut April 1991 - June 1998
C&S Bank June 1990 - March 1992
Education
ITT Technical Institute 2010 — 2012
Associate of Science (A.S.), Computer Drafting and Designed (Architect)
Claflin College
Midlands Technical College
Phoenix University Online
Pendleton Street Advisors, LLC July 2013 - Present
WHM Capital Advisors, LLC March 2008 - June 2013
WHM Capital Advisors, LLC 2008 - June 2013
Keenan Suggs Bowers Elkins March 2006 - March 2008
Carolina Care Plan January 2002 - March 2006
City of Warwcik 1993 - 1999
City of Warwcik 1993 - 1999
Skills
Insurance, Employee Benefits, Customer Service, Outlook, Sales, Health Insurance, Leadership, Strategic Planning, Benefits Administration, Microsoft Excel, Process Improvement, Team Building, Account Management, Life Insurance, Medicare, Contract Negotiation, Investments, Disability Insurance, Microsoft Word, Access, Training, Management, Budgets, Payroll, Accounts Payable, Accounting, HR Management
Education
Community College of Rhode Island 1987 — 1994
Pilgrim High 1982 — 1986
High School Diploma, Business
Weichert Realtors At The Rockies March 2015 - Present
Self December 2013 - Present
MHealth Inc. June 2012 - December 2013
Benefit Advisors Insurance Agency July 2011 - July 2012
Mayo Clinic Health Solutions October 2005 - September 2011
Carolina Care Plan 2004 - 2005
HealthAmerica 2001 - 2004
FHP Insurance 1995 - 1998
Skills
Health Insurance, Underwriting, Insurance, Employee Benefits, Pricing, Management, Strategic Planning, Medicare, Process Improvement, Customer Service, Managed Care
Education
California State University-Hayward - School of Business and Economics 1984 — 1986
MBA, Finance
Brigham Young University 1971 — 1978
B.S., Psychology with Education and Spanish
Palmetto Health October 2014 - Present
University of South Carolina School of Medicine September 2011 - Present
University of South Carolina Columbia August 2007 - August 2011
Carolina Care Plan 2002 - 2007
Fleet Mortgage October 1998 - April 2002
Skills
Customer Service, PowerPoint, Microsoft Office, Outlook, Public Speaking, Higher Education, Staff Development, Training, Leadership Development, System Administration, Teaching, Healthcare, Leadership, Organizational..., Curriculum Design, Community Outreach, E-Learning, Instructional Design, Curriculum Development, Distance Learning, Program Development
Education
University of South Carolina-Columbia 2005 — 2007
Master of Education (MEd), Educational/Instructional Technology
University of South Carolina-Columbia 1993 — 1998
Bachelor's degree, Administrative Information Management
Lower Richland High School 1989 — 1993
Carolina Care Plan November 2004 - Present
Education
Southern Wesleyan University 1999 — 2003
Bachelor's in Business Administration, Business
WellCare September 2013 - Present
Absolute Total Care June 2009 - September 2013
Qualis Health Plan December 2008 - June 2009
Carolina Crescent Health Plan July 2007 - December 2008
Carolina Care Plan 2007 - 2008
POMCO June 1993 - February 2006
Skills
Medical Coding, Health Policy, Employee Benefits, Quality Assurance, Healthcare Consulting, Software Documentation, Network Development, Medical Terminology, Access, Data Analysis, Informatics, Analysis, Leadership, Physicians, Pharmacy, Call Centers, Provider Relations, Provider Network..., Quality Improvement, NCQA, Medicaid Managed Care, Process Improvement
Education
University of Phoenix 2014 — 2016
MHA, Informatics
Saint Joseph's College 1988 — 1995
BSPA, Health Care Administration
Onondaga Community College 1984 — 1985
AS, Nursing
Absolute Total Care-Centene Corporation March 2013 - Present
Absolute Total Care--Centene Corp. June 2009 - Present
Absolute Total Care - Centene Corporation March 2008 - June 2009
Carolina Care Plan October 2001 - October 2007
BlueChoice, a subsidiary of Blue Cross Blue Shield of South Carolina 1992 - 2001
South Carolina Department of Corrections 1986 - 1992
Skills
Medicare, Provider Relations, Medicaid, Managed Care, Healthcare, Utilization Management, HIPAA, Disease Management, Healthcare Management, Quality Improvement, Credentialing, Health Insurance, Medicaid Managed Care, Healthcare Information..., Case Managment, Hospitals, NCQA, HEDIS, Clinical Research, HMO, PPO, Nursing, Claim, Long-term Care, Inpatient, Health Policy, Healthcare Consulting, Healthcare Industry, Software Documentation, Physicians, Network Development
Education
Central Carolina Technical College 1999 — 2000
nursing/computer technology
University of South Carolina-Columbia 1994 — 1997
BA, Business Management
George C Wallace State Community College-Selma 1975 — 1976
diploma, Practical Nursing
APS Healthcare May 2010 - Present
Coventry Health Care March 2009 - May 2010
Coventry Health Care December 2005 - March 2009
Carolina Care Plan September 2000 - December 2005
Education
Penn State University 2007 — 2009
Masters, Health Administration
Lebanon Valley College 1995 — 1999
BS, International Business and French
Carolina Care Plan July 2008 - September 2014
Highmark April 2001 - July 2008
Skills
Underwriting, Account Management, Managed Care, Sales, Brokers, Health Insurance, Insurance, Employee Benefits, Health Savings Accounts, Leadership, Life Insurance, Strategic Planning, Team Building, Medicare, Disability Insurance
Education
University of Pennsylvania - The Wharton School 1992 — 1994
Two semesters in Eecutive MBA program / CEBS, Risk Management
The University of Georgia 1983 — 1987
BSA, Ag Engineering & Economics
Valdosta State University 1982 — 1983
Applied Economics
Perez Software Service Inc for BCBS of SC October 2011 - February 2013
Medical Mutual of Ohio February 2008 - September 2011
Carolina Care Plan February 2002 - February 2008
Skills
Training, Medicare, HIPAA, SharePoint, Insurance, Process Improvement, Customer Service, Health Insurance, Access, Visio, Business Analysis, Leadership, Management, Employee Benefits, Quality Assurance, Analysis, Claim, Software Documentation, Medicaid, Claims Management, Healthcare, Healthcare Information...
Education
Southern Wesleyan University 2007 — 2011
Business Administration and Management, General
Midlands Technical College
WellPoint January 2014 - Present
Centene Corporation 2008 - Present
Centene Corporation March 2013 - January 2014
Absolute Total Care June 2009 - March 2013
Carolina Care Plan 2001 - 2007
Education
University of South Carolina-Columbia 1993 — 1997
BA, Interdisciplinary Studies
Hospice care of South Carolina September 2011 - June 2012
Butterfly Medical Respite Care October 2009 - November 2010
CHC cares of South Carolina February 2008 - June 2009
Wellcare of South Carolina October 2007 - February 2008
Carolina Care Plan July 2001 - June 2007
Carolina Care Plan May 2000 - July 2001
Merck-Medco Rx Services June 1998 - May 2000
Skills
Hospitals, Managed Care, Medicaid, Provider Relations, Healthcare, HIPAA, Insurance, Credentialing, Process Improvement
Education
Saint Leo University 2004 — 2007
Bachelor of Science, Healthcare Administratio
Saint Leo
Bachelor, Business Administration; Health Service Management
University of Maryland University College
Associate, Pharmacy
Consumers' Choice Health Plan May 2012 - Present
Coventry Health Care August 2005 - May 2012
Carolina Care Plan November 2000 - August 2005
Laboratory Corporation of America March 1998 - November 2000
Skills
Managed Care, Provider Relations, Health Insurance, Medicare, Microsoft Office, Insurance, Microsoft Word, Process Improvement, Management
Education
University of South Carolina-Columbia
BA, History
Companion Data Services, LLC. May 2013 - Present
Companion Data Services, LLC May 2007 - May 2013
Carolina Care Plan 1998 - 2007
Skills
General Ledger, Account Reconciliation, Fixed Assets, Accounting, Variance Analysis, Accounts Payable, Internal Controls, Accounts Receivable, Cost Accounting, Financial Reporting, Payroll, Auditing, Access, Process Improvement, Financial Analysis, Cash Flow, Budgets, Finance, Microsoft Excel, Outlook
Education
University of Phoenix 2011 — 2014
DBA, Business Administration
University of Phoenix 2004 — 2006
MBA, Accounting
University of Phoenix 2001 — 2004
Bachelor of Science in Business, Accounting
Midlands Technical College 1991 — 1996
Associates Degree, Accounting
Truven Health Analytics November 2008 - Present
Truven Health Analytics October 2005 - November 2008
Palmetto GBA July 2005 - October 2005
TriCenturion March 2004 - July 2005
TriCenturion September 2002 - March 2004
Carolina Care Plan October 2000 - September 2002
Carolina Care Plan October 1998 - October 2000
Carolina Care Plan March 1994 - October 1998
Governors Office of South Carolina October 1993 - March 1994
Governor's Office of South Carolina September 1991 - October 1993
Skills
Business Intelligence, Healthcare Information..., SQL, Data Analysis, Microsoft Excel, Insurance, Data Mining, Analysis, Analytics, Healthcare, Leadership, Databases, Data Management, SAS, Research, Data Warehousing, Process Improvement, Business Analysis, Product Development, Statistics
Education
University of South Carolina-Columbia 1988 — 1990
MA, Ecnoomics
Ripon College 1984 — 1988
BABu, Business Managment, Economics
SC Solutions March 2013 - October 2013
United Healthcare July 2012 - March 2013
Universal Healthcare August 2010 - June 2012
WellCare August 2007 - August 2010
Carolina Care Plan 2004 - 2007
Skills
Contract Negotiation, Strategic Planning, Network Development, Provider Relations, Medicaid, Medicare, Managed Care, Health Insurance, HMO, Healthcare Management, Healthcare, HIPAA, Health Policy, Insurance, Process Improvement, Team Building, Healthcare Information..., Medicare Part D, Healthcare Consulting, Leadership, Software Documentation, Executive Management, Hospitals, EMR, Healthcare Industry, EHR, Credentialing, PPO, Quality Improvement, Physicians, Physician Relations, Claim, Revenue Cycle, Practice Management, Medical Coding, Informatics, Revenue Cycle Management
Education
SUNY at Buffalo 1991 — 1993
MBA, Healthcare Systems Management
Allegheny College 1987 — 1991
BA, Psychology
WellPoint April 2013 - Present
Managed Health Services - Centene Corporation November 2010 - March 2013
Carolina Care Plan September 2008 - November 2010
Carolina Care Plan October 2004 - September 2008
Senior Primary Care Practice November 1996 - October 2004
Skills
Utilization Management, Managed Care, Medicaid, Medicare, Healthcare Management, Provider Relations, Hospitals, Case Managment, Nursing, Disease Management, BLS, ACLS, Network Development, Long-term Care, Insurance, HIPAA, ICD-9, Pediatrics, PPO, Quality Improvement, Medicine, Case Management, Healthcare
Education
University of South Carolina-Columbia 1981 — 1986
BSN, Nursing
Spring Valley High School
WellCare September 2013 - Present
Aflac June 2013 - September 2013
Carolina Care Plan 2002 - 2013
Carolina Care Plan 2002 - 2013
Mutual Health Services 2002 - 2012
BlueCross BlueShield of Tennessee May 1992 - August 2001
Skills
Claims Resolution, Claims Auditing, Claims Handling, Claim, Insurance, Medicaid, Training, Analysis, Process Improvement, Quality Assurance, HMO, Provider Relations, Claims Management, PPO, Management, Claim Investigation, Health Insurance, Subrogation
Education
Hiwassee College 1984 — 1987
Associate's degree, Liberal Arts and Sciences, General Studies and Humanities
UnitedHealth Group April 2013 - Present
UnitedHealth Group 2006 - April 2013
Carolina Care Plan 2000 - 2006
Skills
Managed Care, Health Insurance, Healthcare, Medicare, Healthcare Information..., HIPAA, Medicaid, Account Management, Hospitals, Salesforce.com, Healthcare Industry, Employee Benefits
Education
University of South Carolina-Columbia