Experience
Neighborhood Health Plan  June 2008 - Present
BMC HealthNet Plan   June 2005 - June 2007
East Boston Neighborhood Health Center  March 2004 - April 2005

Skills
Computer Proficiency, Microsoft Office, Microsoft Excel, Microsoft Word, Community Outreach, Customer Service, Problem Solving, Investigation, Sales, Organizational..., Project Coordination, PowerPoint, Troubleshooting, Training, Communication, Meeting Planning, Goal Oriented, Service Providers, Client Liason, Bilingual, Service Improvement, Provider Relations, Medicaid, HIPAA, Healthcare, Healthcare Management, Claims Resolution, Health Insurance, HMO, Medicaid Managed Care, Healthcare Information..., Network Development, Healthcare Industry, Insurance, Healthcare Reimbursement, Managed Care, Medicare, Process Improvement, Team Building, Leadership

Education
Bunker Hill Community College   1998 — 2000

Brockton High School   1996 — 1998
Diploma, Accounting

Experience
VillageCare  June 2013 - Present
Tufts Medical Center  February 2012 - June 2013
BMC HealthNet Plan   December 2010 - January 2012
Boston Children's Hospital  January 2008 - October 2010

Skills
Healthcare, Nonprofits, Hospitals, Healthcare Management, PowerPoint, Community Outreach, Technical Support, Fundraising, Program Development, Research, Access, Outlook, Event Planning

Education
University of Massachusetts Dartmouth   2009 — 2010
BA, Marketing

Cambridge College   2007 — 2010

Experience
Commonwealth Care Alliance  May 2015 - Present
BMC HealthNet Plan   June 2014 - February 2015
Network Health  November 2012 - June 2014
North Shore Community College  January 2010 - June 2013
Network Health  October 2008 - November 2012
Greater Lawrence Family Health Center  January 2005 - June 2007
Lawrence General Hospital  1999 - 2005

Skills
Healthcare Management, Hospitals, Nursing, Managed Care, HIPAA, Medicaid, EMR, Medicare, Case Management, Medical Terminology, Inpatient, BLS

Education
Capella University   2010 — 2015
Master of Science in Nursing, Nursing Education

University of Massachusetts Boston   2006 — 2008
Bachelors degree, Nursing Science

Middlesex Community College   1987 — 1989
Associate degree in nursing, Nursing

Experience
Boston Medical Center  January 2014 - December 2014
Bath & Body Works  September 2009 - December 2014
Boston Medical Center  January 2013 - January 2014
BMC HealthNet Plan   September 2008 - March 2011
Tuft's New England Medical Center  March 2007 - September 2008
Tufts Health Plan  December 2005 - October 2006
Tufts Health Plan  August 2003 - December 2005
Tufts Health Plan  May 2001 - August 2003
Tufts Health Plan  February 2001 - May 2001
Tufts Health Plan  September 1999 - February 2001

Skills
Healthcare Information..., Healthcare Management, HIPAA, Healthcare, Data Analysis, Managed Care, Access, Microsoft Office, Microsoft Excel, Business Analysis, Medicare, Customer Service, Hospitals, Medisoft, Appeals, Denials, UB04, hcfa, SQL, Macess, cpt, HCPCS, ICD-9-CM, ICD-9, CPT, Medical Coding, Microsoft Word, Medicaid, Data Entry, Health Insurance, Medical Terminology, Medical Billing, Claim, Insurance, Outlook

Education
Bunker Hill Community College   2014 — 2017
Associate's degree, Business

Kaplan Career Institute-Boston   2011 — 2012
Medical Billing & Coding, Certificate

Snowden Int'l at Copley   1991 — 1995
High School, Diploma

Experience
The Boston Consulting Group  January 2015 - Present
The Boston Consulting Group  October 2012 - December 2014
CBRE  October 2011 - September 2012
BMC HealthNet Plan   June 2011 - September 2011
Hill Holliday  January 2011 - April 2011
Sun Life Financial  July 2010 - August 2010
Sun Life Financial  June 2009 - August 2009
Sun Life Financial  June 2008 - August 2008
Weber Shandwick  July 2007 - August 2007

Education
Bentley University   2007 — 2011
Bachelor of Science, Marketing

Universitat Pompeu Fabra   2010 — 2010
Coursework in EU Finance, International Marketing, and Spanish

Boston Latin Academy

Bottom Line

Experience
Massachusetts Department of Transportation  September 2014 - Present
LeapFrog Systems  December 2013 - September 2014
BMC HealthNet Plan   January 2013 - November 2013
Healthways  July 2011 - August 2012
UMass Medical School  March 2010 - July 2011
Service Employees International Union, Local 888  August 2009 - March 2010
Biogen Idec  June 2007 - October 2008
Staples  January 2007 - October 2008
Monster Worldwide  June 2006 - June 2007
OnProcess Technology  April 2004 - April 2006

Skills
CRM, Project Planning, Customer Service, Cross-functional Team..., Call Center, PMP, SDLC, Vendor Management, Project Management, Management, Integration, Sales Operations, Testing, Enterprise Software, Program Management, Call Centers, Leadership, Strategy, Process Improvement, Business Analysis, Recruiting, Databases, E-commerce, Software Development, Budgets, Business Intelligence, Telecommunications, Networking, PMO, Software Documentation, SharePoint

Education
PMI   2007 — 2007
PMP Certification

Berklee College of Music   1982 — 1986

Experience
BMC HealthNet Plan   December 2013 - Present
Cengage Learning  January 2013 - October 2013
Pork and Mead Magazine   December 2011 - December 2012
Knowledge Universe  October 2011 - December 2012
GuardUp!   July 2012 - August 2012
Ivy Schools International Academy   August 2010 - April 2012
Etonkids International Education Group   August 2008 - July 2010
Blue Ocean Network  April 2010 - June 2010
Mort Crim Communications  January 2007 - June 2007
CompUSA  March 2002 - March 2005

Skills
Public Speaking, Journalism, Critical Thinking, Microsoft Office, Word, Writing, Technical Writing, Creative Writing, Feature Writing, Speech Writing, Report Writing, Interviewing, Acting, Hosting, Excel, Premiere, Photoshop, Photography, Television, Teaching English, Teaching/mentoring, Teaching Skills, Computer Hardware, Short Sales, Sales Support, Customer Satisfaction, Customer Experience, Customer Retention, Multitasker, Diligent, Trusted, Professional..., Lotus Notes, SEO, Wordpress, Multi Tasking, Teaching, Microsoft Excel, Feature Articles, Interviews, Teaching English as a..., Copy Editing, Microsoft Word, Blogging, Research, Press Releases

Education
Oakland University   2004 — 2008
BA, Journalism, 3.5

China Foreign Affairs University   2006 — 2006
Certificate of Completion, Chinese Studies, 4.0

Experience
BMC HealthNet Plan   July 2014 - Present
BMC HealthNet Plan   January 2012 - July 2014
BMC HealthNet Plan   July 2007 - January 2012
BMC HealthNet Plan   September 2005 - July 2007

Skills
Fluent in English,..., Capable of working with..., Experience as a teacher..., PowerPoint, Analysis, Research, Program Management, Leadership, Visio, Software Documentation, Medicaid, Microsoft Office, Management, Contract Management, HIPAA, Healthcare, Data Analysis

Education
Boston University   2012 — 2016
Bachelor of Science (BS), Management Studies

University of Massachusetts, Amherst   2001 — 2005
Mathematics and Education

Bridgewater State University
Applied Mathematics

Experience
Tufts Health Plan  April 2011 - Present
Beacon Health Strategies  May 2010 - August 2010
BMC HealthNet Plan   October 2007 - August 2009
BMC HealthNet Plan   July 2006 - September 2007
Ohio Department of Job & Family Services - Office of Medicaid   August 2005 - May 2006

Skills
Healthcare Management, Medicare, Managed Care, Medicaid, Hospitals, Data Analysis, Health Insurance, Healthcare Industry, Public Health, Leadership, Strategy, Analytics

Education
Boston University Graduate School of Management   2009 — 2011
MBA/MPH, Health Care Management

Boston University School of Public Health   2008 — 2011
MPH, Health Care Policy and Mangement

The College of Wooster   2000 — 2004
B.A., Communication Studies

Experience
State of Connecticut  June 2012 - Present
Adelbrook  May 2008 - Present
United States Air Force  March 2003 - Present
Citi  September 2006 - March 2008
Brightside for Families and Children  March 2004 - October 2006
Subaru of America  November 2003 - May 2004
BMC HealthNet Plan   January 1999 - May 2003
AmeriCredit Financial Services  January 2001 - February 2003
Farmstead Telephone Group  August 1996 - January 1999

Skills
Software Documentation, Customer Service, Leadership, Training, Outlook, Customer Satisfaction, Process Improvement, Team Building, Microsoft Excel, PowerPoint, Microsoft Office, Insurance

Education
Community College of the Air Force   2007 — 2007
Certificate, Foods, Nutrition, and Wellness Studies, General

Community College of the Air Force   2003 — 2003
Certificate, Health/Health Care Administration/Management

Charter Oak State College
Associate of Science (AS), General Studies

Charter Oak State College
Bachelor's degree, American/United States Studies/Civilization

Southern Illinois University, Carbondale
Bachelor's degree, Workforce Development and Training

Experience
Collette  January 2011 - Present
BMC HealthNet Plan   October 2006 - January 2011
Volunteer Center of Rhode Island  February 1999 - October 2006
Points of Light Foundation  2002 - 2005
University of Rhode Island  1998 - 1999
United Way of Rhode Island  March 1992 - December 1998
March of Dimes  September 1990 - March 1992

Skills
Community Relations, Relationship Development, Adult Education, Program Development, Public Speaking, Community Outreach, Inter-personal, Fundraising, Public Relations, Volunteer Management, Program Management, Non-profits, Community Development, Nonprofits, Event Management, Event Planning, Leadership, Training, Organizational..., Strategic Planning, Team Building, Management, Budgets, Marketing, Grant Writing, Staff Development, Marketing Communications, Social Networking, Social Media, Editing, Leadership Development, Strategy, Media Relations, Newsletters, Proposal Writing

Education
Roger Williams University   2010 — 2015
MS

Harvard Business School   2014 — 2014
Certficiate

LeadershipRI   2006 — 2006
Certificate

Harvard Business School   2005 — 2006
Certificate

RI Foundation Fellowship   2005 — 2005
Certificate

University of Rhode Island   1998 — 2002
MA

Boston College - Wallace E. Carroll Graduate School of Management   1996 — 1996
Certificate

University of Rhode Island   1986 — 1990
BA

Naperville North High School   1982 — 1986
High School Degree

Experience
BMC HealthNet Plan   May 2014 - Present
BMC HealthNet Plan   April 2012 - May 2014
Blue Cross Blue Shield of Massachusetts  March 2011 - March 2012
BMC HealthNet Plan   2009 - 2010
BMC HealthNet Plan   December 2008 - July 2009
Beacon Health Strategies  July 2006 - April 2007
ValueOptions  January 2002 - July 2006

Skills
Social Services, Medicaid, Case Managment, Behavioral Health, Healthcare Management, Strategic Planning, Team Building, Managed Care, Program Development, Healthcare Information..., Health Insurance, Case Management, HIPAA, Healthcare, Medicare

Education
Boston College   1994 — 1996
Masters of Social Work, Clinical

University of Vermont   1989 — 1993
Bachelor of Arts, Sociology

Experience
Biopolymers Facility, Department of Genetics, Harvard Medical School   October 2011 - Present
Sweet Auburn soaps   2007 - Present
BMC HealthNet Plan   2008 - 2009
BMC HealthNet Plan   2006 - 2008
BMC HealthNet Plan   2003 - 2006
John Hancock Life Insurance Company (U.S.A.)   1999 - 2002

Skills
Budget, Community Outreach, Management, Access, Training, Social Media, Event Planning, Research, Public Speaking, Project Management, Team Building, Fundraising, Healthcare, Program Development, Marketing, Customer Service, Microsoft Excel, Marketing Strategy, Nonprofits, Budgets, Event Management

Education
Emerson College   1997 — 2000
MA, Integrated Marketing Comunication

University of Southern Maine   1988 — 1992
BA, Communication w/Media Arts Specialization

Experience
Boston University  September 2012 - Present
BMC HealthNet Plan   May 2013 - August 2013
Beth Israel Deaconess Medical Center  July 2010 - August 2010

Skills
Microsoft Excel, Microsoft Word, PowerPoint, Laboratory, Data Analysis, Teaching, Microsoft Office, Spanish, Public Speaking, Higher Education, Data Entry, Analysis

Education
Boston University   2011 — 2015

Experience
Hill Holliday  January 2014 - April 2014
Brigham and Women's Hospital- Channing Lab   November 2007 - December 2013
BMC HealthNet Plan   June 2013 - August 2013
Talented and Gifted Program   June 2012 - August 2012
CVS Caremark Corporation  October 2011 - May 2012

Skills
Spanish, Word

Education
Boston University   2010 — 2014
Marketing and Organizational Behavior

Boston Latin Academy

Experience
Campus Entertainment, LLC  September 2012 - Present
Sneakers for Success   September 2011 - Present
Vers Clothing   January 2010 - Present
Service Desk   August 2012 - May 2013
Hill Holliday  June 2012 - August 2012
BMC HealthNet Plan   June 2011 - August 2011
University of Massachusetts Amherst Dining Commons   January 2011 - May 2011
Niketown Boston   October 2007 - April 2009

Skills
Social Media Marketing, Selling, Marketing Communications, Entrepreneurship, Social Entrepreneurship, Social Networking

Education
Isenberg School of Management, UMass Amherst   2009 — 2013

Isenberg School of Management
Bachelor of Business Administration, Marketing

University of Massachusetts, Amherst

Experience
BMC HealthNet Plan   December 2013 - Present
Boston Medical Center  December 2013 - Present
Boston University School of Medicine  December 2013 - Present
Boston University  November 2009 - Present
UMass Medical School  August 2004 - Present
South End Community Health Center  August 2009 - November 2013
Family Health Center of Worcester  2004 - 2009
University of Connecticut Health Center  1999 - 2004

Skills
Public Health, Healthcare, Healthcare Management, Medical Education, Treatment, Prevention, Board Certified, Patient Education, Family Medicine, Evidence-based Medicine, Patient Safety, Quality Improvement, EMR, Informatics, Disease Management, Epidemiology, Health Policy, Medical Research, Pediatrics, Physicians, Program Development

Education
Harvard School of Public Health   2011 — 2013
SM, HCM

The University of Connecticut Health Center   2001 — 2004
Family Medicine, Family Medicine Residency Program

The University of Connecticut Health Center   1999 — 2001
None, General Surgery Residency Program

Universidad Central de Venezuela   1989 — 1996
Doctor of Medicine (M.D.)

San Ignacio   1978 — 1988
Bachelor of Science (BS)

Experience
NYC Health and Hospitals Corporation  March 2015 - Present
NYU Langone Medical Center  July 2013 - March 2015
NYU Langone Medical Center  March 2012 - June 2013
NYU Langone Medical Center  July 2010 - March 2012
BMC HealthNet Plan   January 2009 - July 2010
BMC HealthNet Plan   June 2008 - August 2008
Fenway Community Health  January 2008 - May 2008

Skills
Program Development, Project Management, Quality Measurement, Pay For Performance, Healthcare Quality, Healthcare Strategy, Healthcare Management, Public Health, Managed Care, Healthcare, Medicaid, Hospitals, Medicare, Pay for Performance, Product Quality, Nursing, Clinical Research, HIPAA, Program Management, Health Policy

Education
Boston University   2007 — 2008
MPH

Connecticut College   2002 — 2006
BA, Anthropology

Experience
UnitedHealthcare  June 2013 - Present
BMC HealthNet Plan   December 2002 - June 2013
Southcoast Hospitals Group  June 1999 - December 2002

Skills
Program Development, Healthcare, Hospitals, Community Outreach, Healthcare Management, Community Development, Medicaid, Medicare, Mental Health, Managed Care, Case Management, Utilization Management, Public Health, HIPAA

Education
Bristol Community College
Associates, Business Administration/Marketing

Experience
Randstad USA  June 2014 - Present
The MENTOR Network  November 2010 - June 2014
BMC HealthNet Plan   February 2008 - July 2009
Biogen Idec  September 2007 - December 2007
HCA  September 2001 - February 2007
Concord Hospital  1998 - 2001
Lundgren Chiropractic   1996 - 1998

Skills
Outlook, Administrative Support, PowerPoint, Word, Event Planning, Excel, Administration, Access, Customer Service, Research, Editing, Database Administration, Documentation, Scheduling, Writing, Teamwork, Team Building, Visio, Billing, Windows, Office Management, Compliance, Healthcare, Lotus Notes, Payroll, Strategic Planning, Conferences, Microsoft Office, Supervisory Skills, Administrative..., Software Documentation, Employment Law, Microsoft Word, Microsoft Excel, Invoicing

Education
University of Massachusetts Lowell   2014 — 2014
Certificate of Paralegal Studies, Paralegal, 3.85

Kaplan University   2009 — 2011
Bachelors of Science, Legal Studies, General, GPA 3.80

Mount Washington College   1991 — 1993
Associates, Business Science - Legal/Medical, GPA 3.75

Experience
Im Wonderfully Made   July 2014 - Present
Jewelz   August 2009 - Present
Kalamazoo psychiatric Hospital  2008 - Present
BMC  March 2000 - September 2008
BMC HealthNet Plan   1998 - 2000

Skills
Medical Transcription, Typing, Office Administration, Schedules, Telephone Triage, Administrative..., Admissions Counseling, Critical Care, Crisis Intervention, Patient Education, Vital Signs, Healthcare, Triage, Software Documentation, Behavioral Health, Nursing Care, Hospitals, Cardiac Monitoring, Fundraising, Cardiac Care, IABP, Treatment, Direct Patient Care, Fetal Monitoring, Cpr Certified, Medical Terminology, CPR Certified, Grant Writing, Volunteer Management, Nonprofits, Event Planning

Education
Everest Kalamazoo   1997 — 1997
Certification for Medical Assistant, Registered Medical Assistant

Kalamazoo Institute of Arts
Metal and Jewelry Arts

Kalamazoo Valley Community College
Registered Nursing/Registered Nurse

Experience
BMC HealthNet Plan/Well Sense Health Plan  January 2015 - Present
BMC HealthNet Plan   January 2014 - January 2015
BMC HealthNet Plan   April 2012 - January 2014
BMC HealthNet Plan/Well Sense Health Plan  March 2011 - April 2012
Target  November 2010 - March 2011
Target  April 2007 - November 2010
Blue Cross Blue Shield of Massachusetts  July 2005 - December 2007
Blue Cross Blue Shield of Massachusetts  July 2004 - August 2004

Skills
Customer Service, Outlook, Data Entry, Microsoft Word, PowerPoint, HIPAA, Microsoft Excel, Microsoft Office, Supervisory Skills, Health Insurance, Time Management, Administrative..., Telephone Skills

Education
Boston University   2007 — 2011
Criminal Justice

Experience
Casa Esperanza  April 2015 - Present
TimeCapsule Photography   September 2008 - Present
Fogo de Chão  November 2013 - June 2015
New England Tractor Trailer Training School (NETTTS)   February 2014 - March 2015
Individual Enrichment Program -MCLA   June 2014 - July 2014
BMC HealthNet Plan   November 2013 - February 2014
Harvard Medical School  October 2013 - October 2013
Harvard University Alumni Affairs   August 2013 - September 2013
MCLA Individual Enrichment Program   June 2012 - July 2013
MCLA Office of the President   January 2013 - May 2013

Skills
Bilingual-English/Spanis..., Microsoft Office, Photoshop, Photography, iMovie, iPhoto, Editing, Proofreading, Event Planning, Event Photography, Coordinating Events, Organizational..., Leadership, Team Building, Public Relations, Community Outreach, Advertising, Publicity, Facebook, Social Networking, Press Releases, Final Cut Pro, Social Media Marketing, Social Media, Publications, Sales, Marketing Communications, Time Management, International Relations, Video, Data Entry, Media Relations, Public Speaking, Student Development, Broadcast, Microsoft Publisher, Video Production, Digital Photography, Spanish, PowerPoint, Internal Communications, Image Editing, Marketing, Creative Writing, AP Style, Laser Scanning, Event Management, APA Style, Student Recruiting, Strategic Communications

Education
Suffolk University College of Arts and Science   2013 — 2015
Master's Degree, Public Relations, Advertising, and Applied Communication, Graduate Student

Massachusetts College of Liberal Arts   2009 — 2013
Bachelor of Arts (B.A.), English and Communications, 3.4

Polytechnic of Namibia   2012 — 2012
Non Diploma Purposes, Communication and Media Studies, N/A

Experience
H.C. Starck   November 2012 - May 2015
CIRCOR International, Inc.   2015 - 2015
BMC HealthNet Plan   July 2012 - October 2012
GSI Group  October 2011 - April 2012
EMD Serono, Inc.   January 2011 - October 2011
The Broad Institute  May 2009 - June 2010
Broad Institute  March 2008 - May 2009
H.P. Hood   February 2006 - January 2008
Children's Hospital  June 2001 - April 2006
Fresenius Medical Care  August 1995 - June 2001

Skills
Benefits Administration, HRIS, Compensation, COBRA, ERISA, Leave of Absence..., FMLA, ADA compliance, Employee Benefits, Wellness, Outsourcing, Vendor Management, Deferred Compensation, Employee Relations, New Hire Orientations, Applicant Tracking..., Onboarding, Human Resources, Personnel Management, Policy, Succession Planning, Payroll, HR Policies, Legal Compliance, Compensation & Benefit, Job Descriptions, Management, Talent Management, Workforce Planning, Talent Acquisition, ADP Payroll, Performance Management, Labor Relations, PeopleSoft, Exit Interviews, Employee Engagement, Job Evaluation, Executive Pay, HR Consulting, Organizational..., Employment Law, Recruiting, HR Transformation, Strategic HR

Education
Boston University   1984 — 1989
BS, Human Resources

Middlesex Community College   1980 — 1982
Associates, Business Administration

Experience
BMC HealthNet Plan   January 2014 - Present
The Greeley Company  March 2013 - January 2014
Beacon Partners  August 2010 - March 2013
Merrill Lynch  February 2010 - May 2010
Gragil Associates, Inc   June 2008 - August 2009
Gragil Associates, Inc   June 2005 - August 2007

Skills
Advertising, Promotions, Trade Shows, Marketing Strategy, Social Media, Email Marketing, Event Planning, Webinars, Marketing, Sales, Marketing Research, Blogging, Media Planning, Integrated Marketing, Healthcare, Marketing Communications

Education
Fairfield University   2006 — 2010
BS, Marketing

Fairfield University   2006 — 2010
Bachelor of Science, Marketing, Management

Australian Catholic UniversityBrisbane   2008 — 2009
Marketing

Experience
BMC HealthNet Plan   October 2013 - Present
BMC HealthNet Plan   July 2012 - October 2013
BMC HealthNet Plan   November 2011 - June 2012
BMC HealthNet Plan   January 2011 - November 2011
BMC HealthNet Plan   May 2009 - January 2011
BMC HealthNet Plan   March 2008 - May 2009
New England Baptist Hospital  September 2007 - March 2008
MIT  July 2006 - September 2007

Skills
HRIS, Abra, ADP Payroll, SuccessFactors, SumTotal, Open Hire, Compensation, Access, Excel, Reporting & Analysis, Deferred Compensation, Microsoft Excel, OpenHire, Process Improvement, HIPAA, Employee Relations, Payroll

Education
Gordon College   2002 — 2006
B.S., Mathematics, Psychology

Haverhill High School

Experience
BMC HealthNet Plan   May 2014 - Present
Cambridge Health Alliance  May 2012 - August 2013
Boston Medical Center  September 2007 - May 2012
Whittier Street Health Center  May 2006 - July 2007
Whittier Street Health Center  November 2003 - May 2006
Pine Street Inn  June 2001 - June 2003
Boston Health Care for the Homeless Program  July 1996 - June 2001
Brookline Visiting Nurse Service   1984 - 1996

Skills
Nursing, Case Management, Patient Advocacy, Healthcare, Public Health, Healthcare Management, Community Outreach, Informatics, Quality Improvement, Medical/Surgical, Patient Safety, Home Care, Healthcare Information..., Pediatrics, EMR, Health, Nurses, Adults, Women's Health, Homelessness, Underserved populations, Special Populations, Program Management, Program Development, Clinical Supervision, Research, Education, Health Education, PCMHI, Patient Centered..., Communication Skills, Networking

Education
Boston College   1994 — 1996
MS

Boston College   1979 — 1983
BSN

Experience
Blue Cross Blue Shield of Massachusetts  November 2014 - Present
Blue Cross Blue Shield of Massachusetts  October 2013 - October 2014
Blue Cross Blue Shield of Massachusetts  August 2012 - October 2013
Blue Cross Blue Shield of Massachusetts  October 2008 - August 2012
Boston Medical Center HealthNet Plan  February 2008 - October 2008
BMC HealthNet Plan   November 2007 - February 2008
Boston Medical Center HealthNet Plan  February 2006 - October 2007
Boston Medical Center HealthNet Plan  January 2005 - February 2006
Thom Boston Metro Early Intervention  September 2003 - January 2005
Department of Social Services  July 2002 - August 2003

Skills
Certificate in the..., Certified Interqual..., Healthcare, Clinical, Behavioral Health, Treatment, Documentation, Health, Motivational..., Utilization Management, Managed Care, Mental Health, Clinical Supervision, Program Development, Case Managment, Clinical Research, Case Management, Disease Management, Group Therapy, HIPAA, Health Insurance, Health Policy, Healthcare Consulting, Healthcare Information..., Healthcare Management, Home Care, Medicaid, Leadership, Medicare, Mental Health Counseling, Policy, Provider Relations, Psychotherapy, Quality Improvement, Software Documentation

Education
Boston College Graduate School of Social Work   2000 — 2002
MSW

Boston University   1994 — 1998
BS Elem Ed, Early Education

Experience
Southern New Hampshire University  November 2014 - Present
NH Department of Health & Human Services   December 2012 - Present
Strobe Approach Lighting Technology, LLC.   October 2010 - December 2012
BMC HealthNet Plan   September 2008 - November 2009
BMC HealthNet Plan   May 2005 - September 2008
BMC HealthNet Plan   February 2002 - May 2005
KANA Inc   October 2000 - February 2002
BJ's Wholesale  October 1998 - October 2000
New Boston Systems  April 1998 - October 1999
Au Bon Pain Inc   January 1995 - April 1998

Skills
Disaster Recovery..., Business Continuity..., HIPAA Security..., Mass Data Breach Law..., IT Project Management..., IT Program Management..., Data Center Design &..., IT Strategy Development..., IT Purchasing &..., Vendor Management (10..., Cisco Hardware..., eCRM Software..., Avaya Systems..., Data Center Management..., IT Security (5 years ), Vmware & Citrix (4..., IT Security Assessment..., Data Center Relocation..., Security Policy &..., MS Exchange (6 years ), EMC SAN Implementation..., Disaster Recovery, Business Intelligence, Data Center, IT Strategy, Program Management, IT Management, Servers, VMware, Project Management, Security, HIPAA, Virtualization, Training, Windows Server, Microsoft Exchange, ITIL, Enterprise Software, Strategic Planning, Networking, Process Improvement, Enterprise Architecture, IT Operations, Information Technology, SDLC, Management Consulting, Management, CRM, Cisco Technologies

Education
Daniel Webster College   2004 — 2007
MBA, Business Administration

Daniel Webster College   2002 — 2007
BS, Managed Information Systems

PVMHS

Experience
Hertz  2010 - Present
BMC HealthNet Plan   August 2007 - August 2009

Education
Boston University Questrom School of Business   2000 — 2004

Chelsea High School

Experience
State Street  April 2015 - Present
state street corporation  December 2012 - Present
State Street  February 2008 - December 2012
BMC HealthNet Plan   2003 - 2007
State Street Corporation  January 1991 - October 2002

Skills
Alternative Investments, Bloomberg, Equities, Financial Analysis, Financial Services, Fixed Income, Fund Accounting, Insurance, Investments, Leadership, Management, Mutual Funds, Private Equity, Process Improvement, Team Management, Training, Finance, Hedge Funds

Education
Northeastern University   1994 — 2002
Bachelor of Business Administration (B.B.A.), Business Administration, Management and Operations

Bryant College   1988 — 2000
Accounting

Bryant University   1988 — 2000
Marketing

Scituate Highschool   1984 — 1988
Highschool Diploma

Experience
Tufts Health Plan  November 2013 - Present
P&L Professional Associates,LLC   September 2009 - October 2013
BMC HealthNet Plan   September 2007 - August 2009
BMC HealthNet Plan   August 2005 - September 2007
BMC HealthNet Plan   May 2004 - August 2005
Harvard Pilgrim Health Care  April 2004 - April 2004

Skills
Communication Skills, Client Presentation, Manage Client..., Client Liaison, Customer Engagement, Managed Care, HIPAA, Provider Relations, Medicare, Health Insurance, Medicaid, Healthcare Management, Hospitals, HMO, Access, Customer Service, Healthcare, Network Development, Credentialing, PeopleSoft, Provider Network..., Provider Enrollment, Provider Education, Healthcare Industry, Strategic Planning, Management, Insurance, Health Policy, Physicians, PPO, Healthcare Consulting, Revenue Cycle, Case Management

Education
Lesley University
Bachelor of Arts (B.A.), Human Services, 3.506

Experience
BMC HealthNet Plan   February 2012 - Present
BMC HealthNet Plan   December 2009 - February 2012
BMC HealthNet Plan   October 2008 - December 2009
BMC HealthNet Plan   2007 - 2008
BMC HealthNet Plan   2004 - 2007
Brockton Area Multi-Services, Inc  October 2002 - October 2003
Child and Family Services, Inc   October 1996 - October 2001

Skills
Behavioral Health, Managed Care, Government Liaison, Clinical Integration, Vendor Relations, Contract Management, Crisis Intervention, Medicaid, Provider Relations, Healthcare, Program Management, HEDIS, Clinical, Clinical Supervision, Training, HIPAA, Clinical Research, Hospitals, Treatment, Healthcare Management, Process Improvement, Leadership, Health Insurance, Management, Clinical Psychology

Education
Salem State University   1994 — 1996
MSW, Social Work

Allegheny College   1989 — 1993
BA, psychology

Experience
Boston Medical Center HealthNet Plan  March 2012 - Present
BMC HealthNet Plan   July 2004 - March 2012
BMC HealthNet Plan   December 2002 - July 2004

Skills
Provider Relations, Managed Care, Medicaid, Medicare, Healthcare Management, Hospitals, Healthcare, Network Development, Credentialing, Utilization Management, Health Insurance, Contract Management, Healthcare Industry, Disease Management

Education
Bristol Community College

Experience
OptumCare - UnitedHealth Group   July 2014 - Present
UnitedHealthcare  September 2010 - July 2014
UnitedHealthcare  March 2009 - September 2010
Harvard Pilgrim Health Care  June 2006 - March 2009
BMC HealthNet Plan   February 2005 - December 2005
Harvard Pilgrim Health Care  February 2002 - February 2005

Skills
Account Management, Group Presentations, Claims, Contract Management, Network Development, Medicaid, HIPAA, Revenue Cycle, Insurance, Process Improvement, PPO, Medicare, Healthcare Information..., Healthcare Industry, Hospitals, Credentialing, Team Leadership, Management, Utilization Management, EHR, Policy, Physicians

Education
Boston University   1989 — 1994
Bachelor of Science, Health Studies

Boston University
Bachelor of Science (B.S.), Health Studies

Experience
Senior Whole Health  July 2015 - Present
Lesley University  October 2013 - Present
American Jewish Committee  November 2014 - January 2015
Biogen Idec  October 2014 - October 2014
Optum Healthcare   2014 - 2014
Randstad  October 2008 - October 2013
Mount Ida College  November 2005 - April 2011
USA Athletes International  October 2005 - July 2010
BMC HealthNet Plan   December 2005 - July 2008
Genzyme  June 2005 - December 2005

Skills
PowerPoint, Marketing, Microsoft Excel, Microsoft Office, Customer Service, Microsoft Word, Social Media, Coaching, Public Speaking

Education
Marist College   1989 — 1999

Natick High School

Experience
New York Presbyterian Hospital  April 2011 - Present
New York Presbyterian Hospital  January 2009 - April 2011
Columbia University Mailman School of Public Health  September 2008 - January 2009
BMC HealthNet Plan   June 2008 - August 2008
Honeywell  2005 - 2007

Skills
Healthcare Information..., Hospitals, EHR, Healthcare Management, Public Health, Public Speaking, Clinical Research, Research, Critical Care, ACLS, Medicine, Healthcare, Quality Patient Care, Patient Safety, Oncology, Pediatrics, EMR, Program Development, Data Analysis, ICU, Inpatient, HIPAA, Informatics, Program Evaluation, BLS, Healthcare Consulting, Acute Care, Managed Care, Nursing, Community Outreach

Education
Columbia University Mailman School of Public Health   2007 — 2009
MPH, Health Policy & Management (Management track)

Fairleigh Dickinson University-Florham Campus   2003 — 2007
BS, Biology/Chemistry

Experience
BMC HealthNet Plan   April 2013 - March 2015
MultiPlan  2006 - 2012
Private Healthcare Systems  1990 - 2006

Skills
Managed Care, Provider Network..., Physician Network..., Contract Management, Provider Relations, Provider Education, Provider Support, IPA/PHO, Ancillary and..., Contract Lifecycle..., Leadership and Mentoring, Communication Skills, Microsoft Office, Salesforce.com, Healthcare, Healthcare Information..., Hospitals, Healthcare Management, Network Development, Medicaid, Cross-functional Team..., Healthcare Industry, PPO, Medicaid Managed Care, ACA/PCMO Contracting, Management, Strategy, Medicare, HIPAA, Health Insurance

Education
Lesley College
Master of Science in Applied Management

Saint Anselm College
Bachelor of Arts (BA), Political Science

Experience
BMC HealthNet Plan   October 2009 - Present
Gardner Resources Consulting, LLC  November 2008 - October 2009
Dell Perot Systems  June 2003 - November 2008
Blue Cross Blue Shield of Rhode Island  August 1994 - June 2003

Skills
Business Analysis, EDI, Visio, HIPAA, Quality Assurance

Education
Johnson and Wales University   1997 — 2005
Bachelor of Science, Information Science, 3.97

Experience
BMC HealthNet Plan   March 2013 - Present
BMC HealthNet Plan   October 2009 - March 2013
Blue Cross Blue Shield of Massachusetts  September 2007 - October 2009
Neighborhood Health Plan  October 2006 - September 2007
MBHP  January 2001 - October 2006
Greater Lynn Mental Health and Retardation Assn   June 1987 - December 2000

Skills
Process Improvement, HIPAA, Medicaid, Healthcare Management, Behavioral Health, Visio

Education
Salem State University   1991 — 1993
MS, Counseling and Psychological Services

Gordon College   1983 — 1987
BS, Sociology, Music Education

Experience
BMC HealthNet Plan   QI Program Manager, Credentialing Project ManagerTufts Health PlanJuly 1997 - November 2007

Skills
Managed Care, Credentialing, Medicare, Utilization Management, Accreditation, Healthcare Management, Medicaid, HIPAA, Healthcare Information..., Provider Relations, Health Insurance, Healthcare

Education
Boston University   1999 — 2002
MPH, Public Health

Stonehill College   1993 — 1997
BA, Health Care Administration

Experience
Commonwealth Care Alliance  May 2015 - Present
Accountable Care Associates  August 2013 - March 2015
BMC HealthNet Plan   November 2005 - August 2013
BMC HealthNet Plan   November 2005 - 2013
BMC HealthNet Plan   November 2005 - 2013

Skills
Nursing, Utilization Management, Managed Care, Medical Billing, Healthcare, Healthcare Management, Clinical Research, Medicare, Disease Management, Medicaid, Case Managment, Care Management, Clinical Reimbursement..., Medical Coding, HIPAA, Medicine, Informatics, Inpatient, Hospitals, Utilization Review, Healthcare Industry, Wound Care, Medical/Surgical, Medical Terminology, Meditech, Healthcare Information..., Acute Care, Surgery, Provider Relations, Patient Advocacy, Critical Care, Pediatrics, Home Care, Epic Systems, Health Insurance, Case Management

Education
Holyoke Community College   1992 — 1996
Associate of Arts and Sciences (AAS), Liberal Arts and Sciences/Liberal Studies

Holyoke Community College
Associate of Science (A.S.), Registered Nursing/Registered Nurse

Experience
Tufts Health Plan – Network Health  July 2008 - Present
Network Health  October 2010 - July 2013
Network Health  July 2008 - October 2010
BMC HealthNet Plan   April 2004 - June 2008
Tufts Health Plan  1998 - 2003

Skills
Data Analysis, Healthcare Information..., HIPAA, Healthcare, Software Documentation, Health Insurance

Education
Gibbs College   2000 — 2002
Associates, Multimedia and Visual Communications

Gibbs College-Boston   2000 — 2002
Associate of Arts (AA), Design and Visual Communications, General

Experience
Fallon Health  March 2015 - Present
Accountable Care Associates  September 2013 - February 2015
BMC HealthNet Plan   September 2012 - September 2013
Holyoke Visiting Nurses Association   May 2011 - September 2012
Institute of Integrative Nutrition  May 2011 - May 2012
Holyoke Visiting Nurses Association   2007 - 2011

Skills
Healthcare, Managed Care, Wellness, Wellness Coaching, Disease Management, Nursing, Case Management, Medicaid, Medicare

Education
College of Our Lady of the Elms   1995 — 1999
BSN, Nursing

Experience
BMC HealthNet Plan/Well Sense Health Plan  November 2014 - Present
Center for Living & Working, inc.   September 2014 - Present
BMC HealthNet Plan   July 2014 - November 2014
Network Health  November 2012 - June 2014
Witness Victim Service Center   September 2011 - August 2012
Boston Medical Center  December 2008 - July 2011
Emmaus Inc.   September 2007 - May 2008

Skills
Non-profit Board..., Non-profit Leadership, Non-profit Fund..., Non-profit Consulting, SPSS, Microsoft Office, Non-profit Program..., Program Evaluation, Strategic Planning, Public Speaking, Program Management, Research, Training, Community Outreach, Clinical Research, Grant Writing, Program Development, Healthcare, Case Management, Nonprofits, Grants, Management

Education
Case Western Reserve University   2011 — 2012
Master of Science in Social Administration, Community and Social Development Social Work

Bridgewater State College   2004 — 2008
Bachelor of Science, Social Work and Sociology

Experience
U.S. Department of State   April 2012 - Present
United States Department of Defense  July 2011 - April 2012
Steven Douglas Associates  September 2010 - April 2012
US Army  June 2009 - July 2010
NeighborWorks America  July 2007 - August 2008
Neighborhood Health Plan  February 2007 - July 2007
Sabre Corporation  November 2004 - February 2007
BMC HealthNet Plan   September 2000 - November 2004

Skills
Management, Disaster Recovery, Databases, Microsoft SQL Server, Business Intelligence, SharePoint, Database Administration, T-SQL, Data Warehousing, Windows, SQL, Virtualization, SSIS, Enterprise Architecture, SSRS, Performance Tuning, HTML, Windows Server, SQL Tuning, C++, VMware ESX, Data Center, Servers, Data Warehouse..., SDLC, PowerPoint, F5 BigIP, Windows Server 2008 R2, Java, Microsoft SQL Server..., Strategic Planning, .NET C#, SQL Server DBA, Microsoft SQL Server..., High Availability..., EMC Storage Solutions, Negotiation, BMC Remedy, Capacity Planning, Data Modeling, Active Directory, Data Migration, Team Leadership, Security, Enterprise Software, Budgets, ETL, Testing, Integration, .NET

Education
Northeastern University   2003 — 2005
Master of Science (MS), Information Technology

Atlantic Union College   1992 — 1996
Bachelor of Arts (BA), History

Atlantic Union College   1992 — 1996
Bachelor's degree, History, 3.0

Experience
BMC HealthNet Plan/Well Sense Health Plan  December 2013 - Present
BMC HealthNet Plan   February 2007 - February 2012
Harvard Pilgrim Health Care  1998 - 2007
Commonwealth Automobile Reinsurers  1995 - 1998

Skills
Health Insurance, Healthcare, Medicaid, Medicare, Managed Care, Process Improvement, HIPAA, Insurance, Financial Analysis, Provider Network..., Trend Analysis, Leadership, Project Management, Contract Negotiation

Education
Babson College - Franklin W. Olin Graduate School of Business   1998 — 2001
MBA, Finance

Fairfield University   1990 — 1994
BS, Math major, Biology minor

Experience
UnitedHealth  July 2015 - Present
Blue Cross Blue Shield of Massachusetts  March 2015 - July 2015
Blue Cross Blue Shield of Massachusetts  September 2013 - March 2015
Genworth Financial/CareScout   October 2011 - December 2012
On Time Cleaning Services   December 2008 - June 2012
BMC HealthNet Plan   July 2007 - August 2009
BMC HealthNet Plan   July 2005 - July 2007

Skills
Provider Relations, Medicare, Medicaid, Healthcare, Credentialing, Claims Resolution, Customer Service, Team Building, Recruiting, Contract Management, Microsoft Office, Microsoft Word, Management, Claim, Leadership

Education
Dean College   2001 — 2005
Associates, Business

Experience
Boston Medical Center Health Net Plan  July 2010 - Present
Boston Medical Center Health Net Plan  July 2003 - Present
BMC HealthNet Plan   January 2006 - January 2012
Provider Relations   March 2008 - July 2010

Skills
Business Analysis, Medical Billing, SDLC, Revenue Cycle, ICD-9, Data Entry, Microsoft Excel, Cognos, Project Management, Microsoft Office, Customer Service, SharePoint, Crystal Reports, Healthcare Industry, EHR, HIPAA, Auditing, Healthcare Information...

Education
Laboure College   2008 — 2010
CCS-P, Health Care

UMass Boston   1991 — 1993
Management in Human Services

Experience
BMC HealthNet Plan   November 2004 - Present
Southcoast Hospitals Group  June 1981 - May 2004
Southcoast Health System & Southcoast Hospitals Group  1981 - May 2004

Skills
Nursing, Medical/Surgical, Disease Management, Medicaid, Case Management, Case Managment, Healthcare Management, Hospitals, Managed Care, Psychiatry

Education
BCC. Bridgewater   1979 — 1981
Associate of Science (AS), Registered Nursing/Registered Nurse

Bridgewater State University

Experience
BMC HealthNet Plan   May 2012 - Present
Tufts Health Plan  June 2002 - May 2012

Skills
Health Insurance, Insurance, HIPAA, Managed Care, Medicaid, Health Policy, Process Improvement, Network Development, Public Speaking, Training, Healthcare, Healthcare Industry, Customer Service, Microsoft Excel, Microsoft Word, PowerPoint, Microsoft Office, Data Entry, Lotus Notes, Outlook, Call Centers, Claim, Call Center, Healthcare Management, HMO, Claims Resolution, Claim Investigation, Medical Terminology, Call Center Development, PPO, E-Learning, Instructor-led Training, Instructional Design, Camtasia

Education
Lesley University   2008 — 2012
Bachelor of Arts (B.A.), American Studies

Experience
BMC HealthNet Plan   April 2002 - Present
Open Market  1998 - 2001
Digital Equipment Corporation  1983 - 1998

Skills
Data Warehousing, Healthcare Analytics, cognos, Microsoft SQL Server

Education
Bentley College   1984 — 1990
Bachelor of Science (B.S.), Computer Information Systems

Experience
Well Sense Health Plan  May 2015 - Present
Well Sense Health Plan  February 2014 - May 2015
Xerox  November 2013 - January 2014
BMC HealthNet Plan   May 2013 - November 2013
NH Healthy Kids Corp.   April 2003 - July 2012

Skills
Customer Service, Nonprofits, Medicaid, Managed Care, Team Building, Healthcare

Education
Loyola University of Chicago   1999 — 2000

University of NH   1995 — 1999
Bachelor of Arts (B.A.), Classics and Classical Languages, Literatures, and Linguistics

Experience
BMC HealthNet Plan   September 2007 - Present

Education
Jefferson State Community College   1982 — 1984
Associate's degree, Registered Nursing/Registered Nurse, B