Horizon Blue Cross Blue Shield of New Jersey
Industry: Company
DescriptionHorizon Blue Cross Blue Shield of New Jersey, headquartered in Newark, New Jersey is the only licensed Blue Cross and Blue Shield Association plan in New Jersey, providing health insurance coverage to over 3.2 million people throughout all of New Jersey. Location: 3 Penn Plaza East; Newark, New Jersey Headquarters: Newark, New Jersey, United States CEO: Kevin P. Conlin (1 Jan 2018–) General counsel: Linda A. Willett Founded: 1932 Subsidiaries: Horizon NJ Health,
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Horizon Blue Cross Blue Shield of New Jersey Employees
GSK April 2015 - Present
GSK October 2013 - April 2015
GSK October 2011 - October 2013
GSK November 2009 - October 2011
GSK March 2006 - November 2009
Johnson & Johnson August 2004 - March 2006
Johnson & Johnson August 2002 - August 2004
Horizon Blue Cross Blue Shield of New Jersey February 2002 - July 2002
Horizon Blue Cross Blue Shield of New Jersey August 2000 - February 2002
Horizon Blue Cross Blue Shield of New Jersey November 1994 - July 2000
Education
Rutgers, The State University of New Jersey-Newark 1990 — 1994
Bachelor's Degree, Accounting, 3.0/4.0
HealthFirst October 2014 - Present
Horizon Blue Cross Blue Shield of NJ May 2007 - September 2014
Horizon Blue Cross Blue Shield of New Jersey September 2005 - May 2007
ACS, a Xerox Company May 2004 - September 2005
ACS, a Xerox Company April 2003 - July 2004
International Institute of New Jersey March 2001 - April 2003
Skills
PMP, SDLC, Vendor Management, Business Analysis, PMO, Project Portfolio..., Project Management, Requirements Gathering, Business Requirements, Process Improvement, Visio, Healthcare, Software Project..., Process Reengineering, Budget and Financial..., Requirements Analysis, Quality Assurance, Release and Change..., Program Management, System Testing, Regression Testing, Project Planning, Full project lifecycle..., Project Estimation, Project Finance, Business Process...
Education
Stevens Institute of Technology 2004 — 2006
Master of Science (MS), Management Information Systems, General, 3.9
Rutgers, The State University of New Jersey-Newark 1998 — 2001
Bachelor's degree, Management Information Systems, General, 3.9
Horizon Blue Cross Blue Shield of New Jersey January 2004 - Present
Skills
PeopleSoft, Financial Reporting, Sarbanes-Oxley Act, Corporate Finance, Outlook, Financial Analysis, PMO, Mergers, Health Insurance, Analysis, Access, Portfolio Management, QuickBooks, Change Management, Essbase, Strategic Financial..., Customer Service, Risk Management, Forecasting, Accounting, Microsoft Word, Process Improvement, Visio, Requirements Analysis, Budgets, Business Analysis, Financial Services, Peachtree, Healthcare
Education
Saint Peter's University 2005 — 2007
MBA, MSA, Finance, Accountancy
Berkeley College 1999 — 2003
BS, Accounting
Benchmark Realty January 2015 - Present
Franklin/Cool Springs Office of Crye-Leike Realtors November 2013 - December 2014
Galderma 2003 - 2006
CollaGenex Pharmaceuticals 2000 - 2003
Horizon Blue Cross Blue Shield of New Jersey 1999 - 2000
Skills
Real Estate, Sales, Contract Negotiation, Marketing, Selling, Sellers, Seller Representation, Listings, Listing Homes, Multiple Listing Service, Buyers, First Time Home Buyers, Buyer Representation, Relocation, Corporate Relocation, Single Family Homes, Townhomes, Condos, Investment Properties, Social Media Marketing, Social Networking, Pharmaceutical Sales, Healthcare, Health Insurance, Managed Care
Education
University of Medicine and Dentistry of New Jersey 1997 — 2001
MPH, Health Systems and Policy
University of Delaware 1994 — 1996
BA, Psychology
Saint Joseph's University 1992 — 1994
Psychology
Skone Cosmetics March 2010 - Present
Horizon Blue Cross Blue Shield of New Jersey January 1999 - August 2007
Skills
Fashion, Cosmetics, Social Media Marketing, Blogging, Beauty Industry, Coaching, Strategy, Marketing, Social Media, Entrepreneurship, Small Business, Video
Education
Saint Peter's University 2005 — 2007
MBA, Business Management
Center for Vein Restoration August 2015 - Present
Robert Wood Johnson University Hospital July 2013 - Present
Nigel Frank International October 2014 - August 2015
Dr. Jeffrey Hofman OBGYN June 2013 - August 2013
Robert Wood Johnson University Hospital February 2012 - July 2013
JFK Medical Center February 2013 - May 2013
Horizon Blue Cross Blue Shield of New Jersey May 2011 - August 2011
Skills
CPR Certified, Healthcare, Hospitals, BLS, Medical Terminology, Patient Safety, HIPAA, Cpr Certified, ACLS, Clinical Research, EMR, Critical Care, Healthcare Management, Healthcare Information..., Public Speaking, Microsoft Word, PowerPoint, Social Networking, Time Management, Social Media, Leadership, Microsoft Excel, Research, Event Planning, Customer Service
Education
Rutgers University-New Brunswick 2010 — 2013
Bachelor of Science (BS), Exercise Science, Psychology
North Carolina State University 2009 — 2010
Steinert High School 2005 — 2009
Elderplan Inc October 2014 - Present
Visiting Nurse Service of New York November 2013 - October 2014
Horizon Blue Cross Blue Shield of New Jersey February 2013 - October 2013
Horizon Blue Cross Blue Shield of New Jersey June 2010 - February 2013
Horizon Blue Cross Blue Shield of New Jersey September 2006 - June 2010
Horizon Blue Cross Blue Shield of New Jersey January 2000 - August 2003
PNC BANK January 1998 - January 2000
Skills
Medicare, Insurance, Compliance, Healthcare, Customer Service, HIPAA, SOX, Auditing, Managed Care, Mentoring, Process Improvement, Inventory Management, Supervisory Skills
Education
St. Peter's College 2009 — 2011
Rutgers, The State University of New Jersey-Newark 2003 — 2006
Horizon Blue Cross Blue Shield of New Jersey March 2013 - Present
Skills
Microsoft Office, Management, Microsoft Excel, Leadership, PowerPoint, Public Speaking, Customer Service, Project Management, Business Analysis, Process Improvement, SDLC, Team Building, Strategic Planning, Visio, Microsoft Word, Research, Requirements Analysis, Vendor Management, Team Leadership, Data Analysis, Time Management, Analysis, Software Documentation, Sales, Access, Outlook, SharePoint, Project Planning
Education
Rutgers, The State University of New Jersey-Newark
Economics
Horizon Blue Cross Blue Shield of New Jersey August 2012 - Present
Horizon Blue Cross Blue Shield of New Jersey April 2005 - July 2012
Horizon Blue Cross Blue Shield of New Jersey February 2001 - March 2005
Horizon Blue Cross Blue Shield of New Jersey May 1999 - January 2001
Horizon Blue Cross Blue Shield of New Jersey May 1997 - December 1999
Skills
Health Insurance
Education
Saint Peter's University 2009 — 2011
MBA, Risk Management
Kean University 2005 — 2008
B.S., Business Management
Horizon Blue Cross Blue Shield of New Jersey May 2004 - May 2014
Horizon Blue Cross Blue Shield of New Jersey May 2004 - May 2014
Horizon Blue Cross Blue Shield of New Jersey October 2004 - April 2010
Horizon Blue Cross Blue Shield of New Jersey January 2000 - October 2004
Horizon Blue Cross Blue Shield of New Jersey July 1992 - December 2000
Prudential Financial/Insurance October 1985 - May 1992
Skills
Visio, Business Analysis, SharePoint, Software Documentation, SQL, Process Improvement, Healthcare Information..., Microsoft SQL Server, Business Intelligence, Project Management, Systems Analysis, Integration, Data Warehousing, Data Analysis, HIPAA
Education
Saint Peter's University 2010 — 2011
Credits, Business Administration and Management, General
Union County College 2001 — 2003
Credits, Business Administration and Management, General
Garfunkel Wild, PC August 2015 - Present
Garfunkel Wild, PC September 2014 - August 2015
Novartis May 2014 - August 2014
Superior Court of New Jersey August 2013 - March 2014
Horizon Blue Cross Blue Shield of New Jersey May 2013 - July 2013
Saint Michael's Medical Center September 2012 - April 2013
State of New Jersey Office of the Attorney General June 2012 - August 2012
Parallax LSC May 2008 - August 2011
GlaxoSmithKline August 2007 - December 2007
Mawenzi Primary School August 2007 - August 2007
Skills
Pharmaceutical Industry, Research
Education
Seton Hall University School of Law 2011 — 2015
Juris Doctor (J.D.)
Saint Joseph's University 2004 — 2008
Bachelor's Degree
Healthfirst November 2011 - Present
Horizon Blue Cross Blue Shield of New Jersey January 2004 - December 2011
Horizon Blue Cross Blue Shield of New Jersey April 2008 - November 2011
Skills
Visio, SDLC, Change Management, PMP, Process Improvement, PMO, Business Analysis, Vendor Management, Requirements Gathering, HIPAA, Business Requirements, MS Project, Procurement, Risk Analysis, Six Sigma, CSM
Education
Rutgers, The State University of New Jersey-Newark 1992 — 1995
Bachelor of Science (BS), Management Information Systems, General
Catalyst 360 / AARP August 2014 - Present
Q vision for equality February 2014 - Present
Party Lite March 2014 - July 2014
Viacom-VH1 February 2014 - February 2014
Ross Stores Inc. July 2013 - September 2013
The New York Public Library August 2012 - February 2013
Celgene March 2012 - June 2012
Journey To Wellness June 2011 - February 2012
Ogletree Deankins August 2011 - September 2011
Horizon Blue Cross Blue Shield of New Jersey July 2010 - April 2011
Skills
Legal Research, Litigation, Legal Writing, Westlaw, Document Review, Civil Litigation, Courts, Litigation Support, Bankruptcy, Lexis, Commercial Litigation, Corporate Law, Intellectual Property, Legal Assistance, Mediation, Employment Law, Dispute Resolution, Family Law, Criminal Law, E-Document Review, eDocs DM, Pennsylvania Producer's...
Education
Rutgers, The State University of New Jersey-Newark 2009 — 2011
Master of Public Administration (M.P.A.), Public Administration, B+
Rutgers, The State University of New Jersey-Newark 2006 — 2009
Bachelor's degree, Political Science and Government, B+
Union County College 2004 — 2006
Associate of Arts and Sciences (A.A.S.), Paralegal Studies, B
Horizon Blue Cross Blue Shield of New Jersey August 1999 - Present
Skills
Process Improvement, Business Analysis, Microsoft Excel, PowerPoint, Management, Leadership, Training, Microsoft Word, Event Planning, Databases, Access, Visio, Public Speaking, Strategic Planning, Nonprofits
Education
Saint Peter's University 2009 — 2011
BA, Buisness Management
Saint Peter's University 2009 — 2011
MBA, Healthcare Administration
Ashley Furniture HomeStores of Metro New York & New Jersey September 2015 - Present
(C) Systems, LLC March 2014 - August 2015
Prudential Financial December 2009 - February 2014
Prudential Financial October 2007 - December 2009
Horizon Blue Cross Blue Shield of New Jersey June 2007 - October 2007
Horizon Blue Cross Blue Shield of New Jersey April 2006 - June 2007
Horizon Blue Cross Blue Shield of New Jersey November 2005 - April 2006
Horizon Blue Cross Blue Shield of New Jersey October 2003 - November 2005
IDT Corporation April 2003 - August 2003
Metro One Telecommunications May 2002 - April 2003
Skills
Financial Reporting, Accounts Receivable, Account Reconciliation, General Ledger, Financial Accounting, Microsoft Excel, Financial Analysis, Customer Service, Journal Entries, Lotus Notes, Accounting, Oracle Applications, Monthly Close Process, PeopleSoft, Transaction Management, Discrepancy Resolution, PAM for Securities, BlackRock Aladdin, Internal Audit, External Audit, Customer Support, Accruals, Investment Management, Asset Management, Oracle General Ledger, Portfolio Management, Portfolio Performance..., Issue Resolution, Team Leadership, Employee Training, Project Coordination, Journal Entries Approval, New Asset Value..., Trade Reconciliation, Cash Management, Supervisory Experience, Quick Study, Versatility, Financial Impairment..., Financial Security..., Financial Security Moves, Cognos, Bloomberg Terminal
Education
American InterContinental University Online 2011 — 2013
Master of Business Administration (MBA), Finance, 4.0
Saint Peter's University 1999 — 2003
Bachelor of Science (B.S.), Accounting
Horizon Blue Cross Blue Shield of NJ May 2008 - Present
Horizon Blue Cross Blue Shield of New Jersey March 2002 - June 2005
Horizon Blue Cross Blue Shield of New Jersey March 1998 - March 2002
Skills
Requirements Gathering, Requirements Analysis, Process Improvement, Business Process, Insurance, Health Insurance, Call Centers, Business Analysis, Business Process..., User Acceptance Testing, Business Process Design, Healthcare Information..., Medicaid
Education
Rutgers, The State University of New Jersey-Newark 1986 — 1990
BS, Accounting
Horizon Blue Cross Blue Shield of New Jersey
Skills
Vendor Management, Health Insurance, Business Analysis, Program Management, Healthcare, Medicare, Managed Care, Process Improvement, Insurance, Call Centers, Visio, HIPAA, PMP
Education
Saint Peter's University
Bachelor's Degree
East Side High School 1978 — 1982
INTEGRITY HEALTH July 2012 - Present
The Loomis Company February 2010 - June 2012
Barnabas Health February 2004 - September 2009
Horizon Blue Cross Blue Shield of New Jersey January 1997 - February 2003
Skills
Utilization Management, Healthcare, Medicare, Nursing, Hospitals, Case Managment, Acute Care, Inpatient, Disease Management, Clinical Research, Utilization Review, Health Policy, Managed Care, Medicaid, Healthcare Management, Process Improvement
Education
St. Francis Scool of Nursing 1983 — 1986
RN, Nursing
St. Peter's College 1983 — 1986
BS,MBA, Business Administration, HealthCare Management
Horizon Blue Cross Blue Shield of New Jersey September 2010 - Present
NIP Group, Inc 2007 - 2010
Everest National Insurance Company 2003 - 2007
Prudential Financial 2000 - 2002
Prudential Financial 1999 - 2000
Prudential Financial 1997 - 1999
Prudential Financial 1995 - 1997
Prudential Financial 1991 - 1995
Nabisco Brands - Cookie and Cracker Division 1989 - 1991
Singer Kearfott 1986 - 1989
Skills
Agile Project Management, Budgets, Web Development, International Exposure, Information Technology, Strategy, SDLC, PMO, PMP, IT Strategy, Business Process..., Business Intelligence, Project Management, ITIL, Data Center, Leadership, Process Improvement, Requirements Analysis, Enterprise Software, Change Management, Business Analysis, Management, Vendor Management
Education
Saint Peter's University 1996 — 1998
MBA, MIS/International Business
St. Peter's College 1981 — 1985
Bachelor of Science, Computer Science
Horizon Blue Cross Blue Shield of New Jersey April 2007 - Present
St. Philip's Academy, Newark October 1991 - June 2004
Skills
Managed Care
Education
Rutgers, The State University of New Jersey-Newark
Saint Peter's University
Horizon Blue Cross Blue Shield of New Jersey
Skills
Medicare, Employee Benefits, Health Insurance, Insurance, Claim, Brokers, HIPAA, Workers Compensation, Health Savings Accounts, Claims Management, Long-term Care, Risk Management, Process Improvement, Vendor Management, Business Analysis, SDLC, Leadership, Healthcare
Education
Rutgers, The State University of New Jersey-Newark
MBA
Rutgers, The State University of New Jersey-Newark
Bachelor of Science (BS), Finance, General
Horizon Blue Cross Blue Shield of New Jersey December 2009 - February 2015
Kessler Institute for Rehabilitation October 2005 - September 2006
Concentra May 1995 - October 2005
Skills
Case Management, Claim, Claims Management, Customer Service, Disease Management, Employee Benefits, HIPAA, Health Insurance, Healthcare, Insurance, Managed Care, Management, Nursing, Workers Compensation
Education
Rutgers, The State University of New Jersey-Newark 1991 — 1995
Masters of Science, Community Health Nursing
21st Century Oncology June 2009 - Present
Anchor Health Centers June 2007 - June 2009
University of Miami June 2006 - June 2007
Cleveland Clinic July 1999 - May 2006
HCA Physician Services October 1996 - June 1999
Horizon Blue Cross Blue Shield of New Jersey October 1988 - October 1996
Skills
Revenue Cycle, Healthcare, Process Improvement, Financial Reporting, Managerial Finance, Accounting, KPI Dashboards, Team Building, Data Analysis, Managed Care, Revenue Cycle Management, Healthcare Management, Healthcare Information..., Budgets, Financial Analysis, Physician Relations, Practice Management, Payroll, Accounts Receivable, EMR, Accounts Payable, Physicians, Hospitals, Invoicing, Insurance, Healthcare Consulting, Medical Billing, HIPAA, EHR, Medicare, Medicaid, Medical Coding, Credentialing, Healthcare Industry, Provider Relations, Healthcare Reimbursement, Forecasting
Education
Rutgers, The State University of New Jersey-Newark 1983 — 1988
BA, Business Administration/Finance
Purchasing Power April 2013 - Present
Affinion Group July 2007 - February 2013
Toys R Us August 2005 - July 2007
Horizon Blue Cross Blue Shield Of New Jersey July 2001 - August 2005
Aluminium.com October 2000 - February 2001
Net2Phone September 1999 - October 2000
Genesis Direct / Proteam.com 1997 - 1999
Skills
Vendor Management, Leadership, Avaya, Team Leadership, Telecommunications, Human Resources, Customer Service, Strategic Planning, Lead Generation, Management, Process Improvement, Project Management, Call Centers, Outsourcing, Customer Satisfaction, Project Planning, Analytics, Analysis, Forecasting, Business Analysis, Customer Experience, Customer Retention, CRM, Cross-functional Team..., Workforce Management, Operations Management, Strategy, Account Management, Contact Centers, Performance Management, Program Management, Team Management, Business Development, Business Process..., Product Management, BPO
Education
Rutgers, The State University of New Jersey-Newark 1995 — 2000
BS, Management
Essex Catholic
Sisters of the Good Shepherd October 2010 - January 2011
Sears June 2008 - January 2010
Horizon Blue Cross Blue Shield of New Jersey July 2008 - August 2008
Horizon Blue Cross Blue Shield July 2008 - August 2008
Hollister June 2008 - August 2008
Hudson County Democratic Organization June 2006 - August 2006
Skills
Psychology
Education
Saint John's University 2007 — 2011
B.A., Psychology
2005 - 2007Saint Dominic Academy High School
Saint John's University
Degree: BA, Psychology; Adult English Teacher
PSEG January 2013 - Present
Horizon Blue Cross Blue Shield of New Jersey May 2011 - January 2013
WebMD May 2007 - July 2011
WebMD October 2006 - October 2007
WebMD August 2005 - October 2006
Goodrich Corporation March 1999 - August 2005
Landmark Communications June 1994 - March 1999
SOUTHLAND CORPORATION January 1990 - January 1994
Skills
Compensation, Employee Relations, Compliance, Mergers, Internal Communications, Contract Negotiation
Education
Saint Leo University 1994 — 1999
Bachelor of Arts, Human Resources Administration
monroe township high school 1980 — 1983
Boonton Board of Education September 1990 - June 2014
Lakeview Learning Center September 1989 - June 1990
Horizon Blue Cross Blue Shield of New Jersey September 1971 - November 1977
Skills
Classroom, Lesson Planning, Curriculum Development, Curriculum..., Classroom Management, Guidance Program..., Staff Development, Peer Mentoring, Standardized Testing..., Standardized Testing..., Public Speaking, Time Management, Interventions, Social Studies, Training, Editing, Leadership, Microsoft Office, Strategic Planning, Social Media, Fundraising
Education
MA William Paterson University 1999 — 2003
Master of Education (M.Ed), Student Counseling and Personnel Services
Rutgers, The State University of New Jersey-Newark 1967 — 1971
Bachelor of Arts (B.A.), History
Value Options February 2014 - Present
InVentiv Health, Inc. June 2012 - November 2013
Horizon Blue Cross Blue Shield of New Jersey March 2008 - May 2012
University of Phoenix-Jersey City Campus March 2006 - February 2008
ADP March 2005 - March 2006
Paychex November 2003 - March 2005
Skills
Managed Care, Product Launch, Coordination of Benefits, ADP Payroll, Payroll Taxes, Etime, Microsoft Office, Visio, Microsoft Excel, Microsoft Word, Salesforce.com, Paychex Preview, Pharmaceutical Sales, Cardiology, Neurology, Sales Effectiveness, Pharmaceutical Industry, Paychex, Leadership, Training
Education
Saint Peter's University 2012 — 2016
Business Administration and Management, General
Piscataway High School 1993 — 1997
Diploma, High School/Secondary Diplomas and Certificates
Dell July 2012 - February 2014
A and A consulting July 2009 - July 2012
Horizon Blue Cross Blue Shield of New Jersey January 2009 - July 2009
Manhattan's Physician Group January 2007 - September 2008
Skills
Call Center Development, Health Care..., Medical Practice..., Call center start-up, Leading Development..., Design Teams, English & Spanish..., Tactical Implementations, Emergency Medical..., Customer Satisfaction, Emergency Medical, CRM, Process Improvement, Call Centers, Leadership, Performance Management, Management, Program Management, Recruiting, Team Building, Customer Experience, Customer Retention, Analysis, Contact Centers, Budgets, Quality Assurance, Sales, Business Development, Strategic Planning, Insurance, Managed Care, Vendor Management, Employee Benefits, Physicians, BPO, HIPAA, Integration, Health Insurance, Operations Management, Client Services, Outsourcing, Workforce Planning, Healthcare Management, Employee Relations, Training, Workforce Management, Customer Acquisition, Personnel Management, Change Management, Revenue Cycle Management
Education
St. Peter's College 1998 — 2003
Bachelor's degree, International Business
St. Peter's Prep 1992 — 1996
High School
Horizon Blue Cross Blue Shield of New Jersey February 1999 - Present
Skills
Bilingual-English/Spanis..., Microsoft Office, Microsoft Excel, Microsoft Word, Microsoft SQL Server, ClearQuest, Outlook, Lotus Notes, Siebel, PowerPoint, Technical Writing, System Testing, Regression Testing, Test Case Generation, Business Analysis, Business Requirements, Peer Mentoring, Technical Subject Matter
Education
St. Peter's College
Business Administration, Management and Operations, 4.0
Imperial Frozen Foods Co May 2015 - Present
Independent Contractor May 2005 - Present
Sony Electronics January 1999 - April 2005
Sony Electronics March 1992 - January 1999
Horizon Blue Cross Blue Shield of New Jersey October 1986 - March 1992
Skills
Cross-functional Team..., Web Applications, User Experience, Integration, IT Strategy, Project Management, Management, Content Management, Information Architecture, Vendor Management, SDLC, IT Management, Portals, SharePoint, Web Project Management, B2B, Web 2.0, Technology Needs..., Technology Evaluation, Cloud Computing, Visio, Pre-sales, Portal Applications, Technical Presales
Education
Saint Peter's University
BS, Computer Science
Truven Health Analytics May 2013 - Present
Board of Pensions of the Presbyterian Church January 2012 - May 2013
OptumHealth 2001 - 2011
CareScience (Quovadx) 1997 - 2001
McKesson (Per-Se Technologies) 1994 - 1997
Horizon Blue Cross Blue Shield of New Jersey 1991 - 1994
Skills
Key Account Management, Healthcare Information..., Data Warehousing, Employee Benefits, Data Analysis, Employee Wellness, Disease Management, Vendor Management, Health Insurance, Healthcare Industry, Informatics, Provider Relations, Process Improvement, Strategic Planning, Management Consulting, Salesforce.com, CRM, Microsoft Office, Client Presentation
Education
Saint Joseph's University
MBA, Health Administration
Onco360 Oncology Pharmacy Solutions January 2012 - Present
Medco March 2011 - January 2012
Horizon Blue Cross Blue Shield of New Jersey March 2005 - February 2011
Skills
Medicare, Medicaid, PeopleSoft, Access, Business Objects, Pivot Tables, Data Analysis, Healthcare, Visio
Education
St. Peter's College 2009 — 2011
Master of Business Administration (MBA), Business Administration, Management and Operations
HMS November 2014 - Present
Fidelis Care March 2014 - October 2014
Horizon Blue Cross Blue Shield of New Jersey March 2005 - March 2014
Horizon Blue Cross Blue Shield of New Jersey March 2005 - March 2014
Horizon Blue Cross Blue Shield of New Jersey March 2005 - March 2014
Horizon Blue Cross Blue Shield of New Jersey November 2002 - May 2003
Skills
Data Analysis, Managed Care, Health Insurance, Analysis, Training, Process Improvement, Leadership, Business Analysis, Business Process..., Provider Relations, Medicare, HIPAA, Management, Visio, Claim, Healthcare, Business Requirements, Requirements Gathering, Lotus Notes, SharePoint, Requirements Analysis, PPO, HMO, Databases, Health Policy, User Acceptance Testing, Employee Benefits, Medicaid, Call Centers, Healthcare Industry, SDLC, Microsoft Excel, Requirements Management, Policy, Vendor Management, Healthcare Management, Gap Analysis, Outlook, Business Process, Access, Business Objects, Business Intelligence, Program Management
Education
Saint Peter's University
Bachelor of Science (B.S.), Business Administration and Management, Healthcare
ActiveHealth Management January 2015 - Present
MetLife November 2013 - January 2015
ActiveHealth Management May 2013 - November 2013
Medco Health Solutions (now Express Scripts) March 2010 - August 2012
Medco Health Solutions March 2004 - March 2010
Medco Health Solutions December 2002 - March 2004
Medco Health Solutions October 1995 - December 2002
Medco Health Solutions May 1991 - October 1995
Horizon Blue Cross Blue Shield of New Jersey May 1986 - February 1991
Skills
Operational Excellence, Cross-functional Team..., Process Improvement, Strategic Planning, Microsoft Office, Access, Pharmacy Benefit..., Healthcare, Managed Care, Data Analysis, Proposal Writing, Team Building, Budget Process, Oral & Written..., Program Management, Project Management, Employee Benefits, Management, Pharmacy, Strategy, Leadership, Training
Education
Rutgers, The State University of New Jersey-Newark 1981 — 1986
BA, Business Administration: Marketing Concentration
Belleville High School 1977 — 1981
High School Diploma, College/University Preparatory and Advanced High School/Secondary Diploma Program
Stop & Shop August 2010 - Present
Hackensack University Medical Center April 2015 - May 2015
Indian Health Services February 2015 - March 2015
St. Peter's University Hospital January 2015 - February 2015
Rite Aid November 2014 - December 2014
St. Peter's University Hospital October 2014 - November 2014
Horizon Blue Cross Blue Shield of New Jersey September 2013 - October 2014
Princeton House Behavioral Health June 2014 - July 2014
Robert Wood Johnson University Hospital May 2014 - June 2014
Bristol-Myers Squibb June 2013 - August 2013
Skills
Registered Pharmacy..., Cell Culture, Cytotoxicity, DNA extraction, PCR, Immunocytochemistry, Western Blotting, HPLC, GPC, Electrospinning, Fluorescence Microscopy, Scanning Electron..., Cancer, Pharmacists, Research, Community Pharmacy, Medication Therapy..., Pharmacy
Education
Rutgers, The State University of New Jersey-New Brunswick 2009 — 2015
Doctor of Pharmacy, Pharmacy
Horizon Blue Cross Blue Shield of New Jersey June 2014 - Present
Rutgers University - Office of Veterans Affairs May 2013 - May 2014
United States Marine Corps September 2006 - November 2010
Skills
Troubleshooting, Leadership, Maintenance & Repair, Information Assurance, Security Clearance, Process Improvement, Business Systems..., Change Management, Customer Service, SharePoint, Project Coordination, Event Planning, Project Management, ClearQuest, Avionics, Military Operations, Veterans Benefits, Electronics, Aircraft Maintenance, Security+, Military Experience, Military, Lotus Notes, Microsoft Office, Microsoft Excel, Professional Audio, Stage Lighting, Windows 7, DoD, Social Networking, Business Requirements, Networking, Requirements Gathering
Education
Rutgers, The State University of New Jersey-Camden 2011 — 2017
Bachelor of Science (BS), Computer Science
Rutgers, The State University of New Jersey-Newark 2014 — 2015
Certificate in Information Technology, IT Project Management
Center for Naval Avitation Techinical Training 2007 — 2008
Certificate, Avionics Maintenance Technology/Technician
Brown & Brown Benefit Advisors March 2001 - Present
Horizon Blue Cross Blue Shield of New Jersey March 1993 - February 2001
Horizon Blue Cross Blue Shield of New Jersey March 1991 - February 1993
Skills
Health Insurance, Brokers, Account Management, Employee Benefits, Insurance, Managed Care, Health Savings Accounts, Life Insurance, Medicare, Marketing, Claim, Training
Education
Rutgers, The State University of New Jersey-New Brunswick 1985 — 1989
Bachelor of Arts, Communication
Oxford Healthcare IT April 2014 - Present
Rady Children's Hospital-San Diego February 2014 - April 2014
Tenet Healthcare May 2011 - January 2014
SSM Cardinal Glennon Childrens Hospital 2010 - October 2012
Saint Louis University Hospital 2003 - 2011
Saint Louis University Hospital 2007 - 2010
Horizon Blue Cross Blue Shield of New Jersey 2001 - 2003
Horizon Blue Cross Blue Shield of New Jersey 1999 - 2001
Skills
Healthcare IT, Clinical, Nursing, Transplantation, Pediatrics, Epic Clinical..., Management, Informatics, Healthcare Information..., Transplant, Clinical Research, EMR, Hospitals, Inpatient, Epic Systems, CPOE, EHR, Case Managment, Critical Care, Physicians, Ambulatory, Patient Safety, ICU, Meditech, Healthcare Management, BLS
Education
Saint Louis University 2011 — 2014
Masters in Healthcare Informatics
Saint Louis University 1991 — 1995
BSN, Nursing
Lancer Hospitality November 2014 - Present
BSC March 2014 - July 2014
The Law Office of Patrick M. Sutton October 2011 - February 2014
Champps December 2012 - June 2013
Horizon Blue Cross Blue Shield of New Jersey June 2006 - June 2007
Skills
Office Management, Office Administration, Administrative..., Travel Arrangements, Calendaring, Spreadsheets, Confidentiality, Data Entry, Calendars, Executive Support, Outlook, Office Equipment, Fax, Executive..., File Management, Telephone Skills, Legal Writing, Training, Filing, Receptionist Duties, Business Correspondence, Executive Level..., Notary Public, 10 Key, Internet Explorer, Customer Service, Telephone Reception, Bookkeeping, Copying, Microsoft Office, Administrative Work, Administration, High Level Of..., Phone Etiquette, Meeting Scheduling, Multi-line Phone, Administrative Office..., Microsoft Publisher, Electronic Filing, Calendar Planning, Handle Confidential..., Executive Administrative, Personal Support, Discretion
Education
Normandale Community College 2014 — 2016
Bachelor of Applied Science (BASc), Environmental Engineering Technology/Environmental Technology, Freshman
Saint Paul College-A Community and Technical College 2011 — 2011
Trinitas Regional Medical Center 2015 - Present
Horizon Blue Cross Blue Shield of New Jersey May 2006 - March 2014
Skills
Healthcare, Healthcare Information..., Strategic Planning, Leadership, Health Insurance, Microsoft Word, HIPAA, PowerPoint, Research
Education
Saint Peter's University 2011 — 2015
Healthcare Management, Health/Health Care Administration/Management
CIGNA May 2013 - Present
Horizon Blue Cross Blue Shield of New Jersey May 2012 - May 2013
Horizon Healthcare Innovations, LLC July 2010 - May 2012
Horizon Blue Cross Blue Shield of New Jersey May 2007 - July 2010
Skills
Analytics, Data Analysis, SAS/SQL, Statistical Modeling, Research, Healthcare, Informatics, Data Manipulation, SAS, Statistics, SAS programming, PROMETHEUS, ETG, Databases, SQL, Analysis, Data Warehousing, Leadership, Data Mining, Business Intelligence, Data Management, SAS Programming
Education
St. Peter's College 2008 — 2011
Master of Business Administration, Risk Management
St. Peter's College 2003 — 2007
Bachelor of Science, Mathematics
WellPoint March 2013 - Present
Horizon Blue Cross Blue Shield of New Jersey November 2012 - February 2013
Group Health Incorporated July 2012 - November 2012
EmblemHealth October 2011 - June 2012
Trinissoft Tirana, Albania July 2005 - December 2008
Skills
Software Quality..., Agile & Waterfall..., Mentoring, Solutions Provider, Functional Testing, SQL DB2, SoapUI, RQM, ClearQuest, ClearCase, Team Leadership, Quality Center, Lean IT, RUP Methodologies, Test Management, HIPAA, ICD-9, ICD-10, Test Planning, System Integration..., User Acceptance Testing, Web Services, IBM Mainframe, Business Requirements, SDLC, Business Analysis, Databases, Quality Assurance, HP Quality Center
Education
Sacred Heart University 2014 — 2016
Master's degree
University of Northern Virginia
Bachelor's degree
Agricultural University of Tirana 2001 — 2007
Bachelor's degree
Hasan Tahsini 1997 — 2001
High Scool
Horizon Blue Cross Blue Shield of New Jersey May 2015 - Present
Horizon Blue Cross Blue Shield of New Jersey March 2008 - May 2015
Horizon Blue Cross Blue Shield of New Jersey October 2005 - March 2008
AIG October 2003 - October 2005
AIG October 2001 - October 2003
Levine Jacobs & Company November 2000 - September 2001
KPMG US November 1999 - November 2000
Wilson Marketing December 1998 - November 1999
Skills
SOX 404, Model Audit Rule, Risk Analysis, Internal Controls, Auditing, Program Management, Governance, Financial Reporting, Risk Management, Insurance, Enterprise Risk..., General Ledger, Risk Assessment
Education
Saint Peter's University 2011 — 2013
Master of Business Administration (MBA), Risk Management
William Paterson University of New Jersey 1994 — 1998
Bachelor of Science (BS), Accounting
Horizon Blue Cross Blue Shield of New Jersey June 2013 - Present
Skills
Lotus Notes, Managed Care, Employee Benefits, Insurance, Health Insurance, Claim, Disability Insurance
Education
Saint Peter's University
Bachelor of Science (BS), Business Administration, Management
Horizon Blue Cross Blue Shield of New Jersey May 2015 - Present
Facility Solutions Group June 2010 - June 2014
EY August 2007 - January 2010
Burgoyne Sales June 2000 - August 2007
Skills
Energy Management, Facilities Management, Contract Management, Energy Efficiency, Construction Management, Electricians, Value Engineering, Construction, Building Services, HVAC, Process Scheduler, Contract Negotiation, Contractors, Procurement, LEED, Green Building, Energy, Sustainability
Education
DeVry University
Bachelor of Applied Science (B.A.Sc.), Business Administration
Saint Peter's University
CarePoint Health June 2014 - August 2015
CarePoint Health System Bayonne Medical System January 2009 - June 2014
Clara Maass Medical Center November 2007 - January 2009
Horizon Blue Cross Blue Shield of New Jersey March 2002 - December 2007
Skills
InterQual Criteria, Milliman Care Guidelines, RAC Readiness, Compliance, Policy, Audit, Appeals Management, Case Management, Utilization Management, Managed Care, Medicare, Management, Case Managment, Healthcare Management, Auditing
Education
Seton Hall University 2013 — 2016
MSN, Health Administration/Case Mgmt
Rutgers, The State University of New Jersey-Newark
BSN, Nursing
UnitedHealthcare Global March 2015 - Present
UnitedHealth Group November 2013 - March 2015
Horizon Blue Cross Blue Shield of New Jersey July 2010 - October 2013
Horizon Blue Cross Blue Shield of New Jersey January 2002 - July 2010
Horizon Blue Cross Blue Shield of New Jersey January 1999 - January 2002
Horizon Blue Cross Blue Shield of New Jersey January 1996 - January 1999
Skills
SDLC, PMO, PMP, Project Portfolio..., Business Analysis, Vendor Management, Software Project..., MS Project, Visio, Requirements Analysis, Requirements Gathering, Process Improvement, Program Management, Project Management, Business Requirements, Analysis
Education
St. Peter's College 2007 — 2009
Master of Business Administration (M.B.A.), Marketing
Richard Stockton College of New Jersey 1990 — 1995
Bachelor of Arts (B.A.), English Language and Literature/Letters
Positive Impact Partners May 2015 - Present
Saint Joseph's University January 2015 - Present
Horizon Blue Cross Blue Shield of New Jersey 2015 - Present
Skills
News Writing, Press Releases, Creative Writing, Editing, Microsoft Office, Social Media, Social Media Marketing, Customer Service
Education
Saint Joseph's University 2012 — 2016
English Language and Literature, Communication Studies
Horizon Blue Cross Blue Shield of New Jersey January 2013 - Present
Horizon Blue Cross Blue Shield of New Jersey September 2011 - Present
Horizon Blue Cross Blue Shield of NJ September 2001 - September 2011
Skills
Investigations, Security, Business Continuity, Corporate Security, Emergency Management, Fraud, Information Security, Disaster Recovery, Surveillance, Program Management, HIPAA, Security Awareness, Vulnerability Assessment, Leadership, Computer Security, Business Continuity..., Information Security..., Enterprise Risk..., Facilities Management, Security Management, Security Audits, Risk Assessment, Computer Forensics, PCI DSS, Vulnerability Management, Penetration Testing, Security Policy, Private Investigations, Investigation
Education
Saint Peter's University 1982 — 1986
BS, Business Management
Seton Hall University
MPA, Criminal Justice
Horizon Blue Cross Blue Shield July 2008 - Present
Horizon Blue Cross Blue Shield of New Jersey January 2004 - July 2008
Horizon Blue Cross Blue Shield of NJ January 2004 - July 2008
Education
Saint Peter's University 2010 — 2014
Masters Business Administration, Management, 3.975
St. Peter's College 2005 — 2009
BSA, Business
IIL 2006 — 2007
PMP, Project Management
Wyndham Worldwide July 2005 - Present
Horizon Blue Cross Blue Shield of New Jersey September 1999 - July 2005
Horizon Blue Cross Blue Shield of New Jersey September 1999 - July 2005
Saint Barnabas Medical Center October 1992 - September 1999
Skills
Strategy, Marketing Communications, Marketing, Analytics, Leadership, Management, Public Relations, Training, Creative Direction, Revenue Analysis, Loyalty Programs, Hotels, Hospitality Industry, Hospitality, Hospitality Management, Loyalty Marketing, Hotel Management, Event Management, Food & Beverage, Marketing Strategy, Project Management, Direct Marketing, Social Media Marketing, Online Advertising, E-commerce, Cross-functional Team..., Integrated Marketing, Team Leadership, Email Marketing, Data Analysis, Multi-channel Marketing, Customer Retention, Online Marketing, CRM, Competitive Analysis, Database Marketing, Marketing Management, Segmentation, Customer Acquisition, Market Planning
Education
Rutgers, The State University of New Jersey-Newark 1987 — 1992
Bachelor of Science (B.S.), Accounting
Horizon Blue Cross Blue Shield of New Jersey August 2014 - Present
Horizon Blue Cross Blue Shield of New Jersey September 2010 - Present
Horizon Blue Cross Blue Shield of New Jersey June 2008 - September 2010
Horizon Blue Cross Blue Shield of NJ November 2004 - June 2008
Horizon Blue Cross Blue Shield of New Jersey January 2002 - October 2004
Horizon Blue Cross Blue Shield of New Jersey November 1999 - January 2002
Horizon Blue Cross Blue Shield of New Jersey April 1998 - November 1999
Education
Saint Peter's University 2014 — 2017
Master of Business Administration (MBA), Healthcare Administration and Risk Management
Rutgers, The State University of New Jersey-Newark 2002 — 2008
Bachelor of Science (BS), Management and Global Business
Horizon Blue Cross Blue Shield of NJ October 1999 - October 2010
Horizon Blue Cross Blue Shield of New Jersey October 1999 - October 2010
Skills
Team Building, Marketing, Public Relations, Advocate, Americans with...
Education
Saint Peter's University 1995 — 1998
Horizon Blue Cross Blue Shield of New Jersey January 2009 - Present
Horizon Blue Cross Blue Shield 2000 - 2009
Skills
Bilingual, Health Producer License, Healthcare, Microsoft Excel, Budgets, Close Attention to..., Process Improvement, Customer Service, Microsoft Office, Account Management, Marketing, Access, Employee Benefits, Leadership, Business Analysis, Management
Education
St. Peter's College 1988 — 1992
Bachelor of Science (B.S.), Business Management
Horizon Blue Cross Blue Shield of New Jersey November 2010 - Present
Horizon Blue Cross Blue Shield of NJ January 2007 - November 2010
Horizon BCBSNJ 1995 - 2007
Skills
SQL, Informatics, Health Insurance, Project Management, Healthcare, Unix, Management, SAS Programming, Health Care Reform, Statistical Data..., Data Analysis, Vendor Management, Process Improvement
Education
Saint Peter's University 2004 — 2007
MBA, Finance
Rutgers, The State University of New Jersey-Newark 1995 — 1999
BS, Management
Horizon Blue Cross Blue Shield of New Jersey January 2013 - Present
Wedgewood Communications November 2005 - January 2013
Wedgewood Communications November 2005 - April 2010
CCCC of Union County 1990 - 2006
Saint Barnabas Medical Center 1985 - 1989
Skills
Press Releases, Brochures, Writing, Copywriting, Special Events, Public Relations, Community Building, Advertising, Event Management, Proofreading, Content Management, Newsletters, Fundraising, Creative Direction, Marketing Communications, Editorial
Education
Rutgers, The State University of New Jersey-Newark 1977 — 1981
Bachelor of Arts (BA), Political Science/ English (Journalism)
Piassek Benefit Advisors, LLC April 2006 - Present
Hobbs Group/Hilb, Rogal, & Hobbs January 1998 - May 2006
Horizon Blue Cross Blue Shield of New Jersey January 1989 - November 1998
Skills
Health Savings Accounts, Employee Benefits, Insurance, Benefits Administration, Umbrella Insurance, Professional Liability, Account Management, Consulting, Buy-sell Agreements, Training, Customer Service, Strategic Planning
Education
Rutgers, The State University of New Jersey-Newark 1980 — 1985
Bachelor of Science (B.S.), Business Administration and Management, General
Horizon Blue Cross Blue Shield of New Jersey December 2014 - Present
Horizon Blue Cross Blue Shield of NJ February 2008 - Present
WMC Mortgage October 2003 - February 2008
Skills
Customer Service, Insurance, Access, Business Analysis, Employee Benefits, Management, Microsoft Office, New Business Development, Process Improvement, Risk Management, Vendor Management
Education
Saint Peter's University
Business Management
Horizon Blue Cross Blue Shield of New Jersey 2011 - 2014
Horizon Blue Cross Blue Shield of New Jersey 2009 - 2011
American International Group 2006 - 2009
AIG 2005 - 2006
American International Group 2004 - 2005
AIG 2000 - 2004
AIG 1998 - 2000
Chubb Insurance 1997 - 1998
Chubb Insurance 1994 - 1997
Skills
Cross-functional Team..., Change Management, Process Improvement, Business Process, Six Sigma, Strategy, Operations Management, Leadership, Strategic Planning, Project Management, Management Consulting, Insurance, Business Analysis, Performance Management, Management, Business Process...
Education
Rutgers, The State University of New Jersey-Newark
BS, Accounting
Horizon BCBSNJ January 2000 - Present
Horizon Blue Cross Blue Shield of New Jersey June 1996 - October 2000
Horizon Blue Cross Blue Shield of New Jersey March 1995 - June 1996
Skills
Managed Care
Education
Rutgers, The State University of New Jersey-Newark 1987 — 1991
BA, Economics, Finance
CVS Caremark Corporation August 2013 - Present
MediGuard.org October 2010 - Present
Horizon Blue Cross Blue Shield of New Jersey June 2011 - August 2013
Horizon Blue Cross Blue Shield of New Jersey July 2010 - June 2011
Walgreens Pharmacy July 2009 - July 2010
iGuard May 2007 - May 2009
Skills
Pharmacy, Medicare, Managed Care, Pharmacists, Clinical Research
Education
Rutgers University-New Brunswick 2003 — 2009
Pharm.D., Pharmacy
Horizon Blue Cross Blue Shield of New Jersey July 2007 - Present
OAO Technology Solutions February 1994 - July 2007
Skills
Business Analysis, Integration, ITIL, PMP, Customer Service, IT Strategy, Management, PMO, Vendor Management
Education
Rutgers University 1998 — 2002
Computer Science, Computers, Math
Societe Generale Corporate and Investment Banking - SGCIB July 2015 - Present
Barclays September 2014 - Present
Barclays December 2010 - Present
Horizon Blue Cross Blue Shield of New Jersey November 2010 - December 2010
UBS Wealth Management August 2006 - March 2010
Skills
Accounts Payable, Finance, SAP, Equities, IFRS, Account Reconciliation, Analysis, General Ledger, Accounting, Capital Markets, Financial Analysis, Fixed Income, Internal Controls, Management, Variance Analysis
Education
Saint Peter's University 2004 — 2008
Bachelor's degree in Accounting, Minor in Finance
Saint Peter's University
Atlantic Valley Volleyball Club January 2002 - Present
NASCO October 2000 - Present
NASCO October 2000 - Present
Horizon Blue Cross Blue Shield of NJ June 1988 - October 2000
Horizon Blue Cross Blue Shield of New Jersey June 1988 - October 2000
Skills
Insurance, Health Insurance, Account Management, Process Improvement, Sales, Business Analysis, Team Building, Workshop Facilitation, Strategic Planning, Customer Service, Networking, Leadership, Project Management, Change Management, Training, Vendor Management, Management, Customer Satisfaction, Coaching, Strategy, Program Management, Analysis, Business Process..., Team Leadership, Cross-functional Team..., PMO, Visio
Education
Rutgers, The State University of New Jersey-Newark 1976 — 1980
bs, business administration
Seton Hall Preparatory School 1972 — 1976
HS Diploma, College Prep
Horizon Blue Cross Blue Shield of New Jersey September 2015 - Present
Physicians Care Surgical Hospital August 2013 - August 2015
Physicians Care Surgical Hospital August 2012 - August 2013
Proven Healthcare April 2012 - April 2013
ProgenyHealth November 2007 - August 2012
Chester County Hospital 1998 - 2008
Phoenixville Hospital 2003 - 2007
Main Line Health August 2000 - December 2001
Hahnemann University Hospital 1990 - 1998
Skills
Utilization Management, Quality Improvement, Managed Care, Healthcare Management, Nursing, Healthcare Consulting, Disease Management, Medicare, Hospitals, Nursing Education, Healthcare, Medicaid, Case Management, Case Managment, Clinical Research, Critical Care, EHR, EMR, Healthcare Information..., Patient Safety, Inpatient, NICU, Quality Management, Informatics, Utilization Review, Healthcare Industry, Milliman criteria, InterQual criteria, Health Policy, Accreditation, CPOE, Performance Improvement, Meaningful Use, PreAdmission Testing
Education
Saint Joseph's University 1994 — 1997
MHA, Health Administration
West Virginia University 1984 — 1990
BSN, Nursing
Susquehanna Township High School
Horizon Blue Cross Blue Shield of New Jersey May 2015 - Present
Horizon Blue Cross Blue Shield of New Jersey August 2013 - Present
Horizon Blue Cross Blue Shield of New Jersey October 2011 - August 2013
Horizon Blue Cross Blue Shield of New Jersey March 2010 - October 2011
Fox Asset Management (an Eaton Vance company) 2005 - 2009
Prudential Investment Management August 2002 - November 2005
Skills
Corporate Finance, Budgeting, Sales Management, Strategic Planning, Portfolio Management, Investments, Strategic Financial..., Forecasting, Business Analysis, Finance, Risk Management, Financial Analysis, Marketing Strategy, Valuation, Budgets, Equities, Project Finance, Economics, Financial Reporting, Compliance
Education
Rutgers, The State University of New Jersey-Newark 2010 — 2014
MBA, Concentration: Management and Business Strategy
The University of Chicago - Booth School of Business 2012 — 2012
Executive Program, Corporate Strategy, Completed
Seton Hall University 1998 — 2002
BS, Finance, 3.8
Elderplan August 2015 - Present
Horizon Blue Cross Blue Shield of New Jersey April 2010 - Present
Horizon Blue Cross Blue Shield of New Jersey December 2009 - November 2010
Horizon Blue Cross Blue Shield of NJ July 2007 - November 2009
Fidelis Care June 2006 - July 2007
Education
Saint Peter's University 2008 — 2010
MBA, Management/Risk Management
Stonehill College 2002 — 2006
BA, Health Care Administration
Horizon Blue Cross Blue Shield of New Jersey June 2015 - Present
Horizon Blue Cross Blue Shield of New Jersey November 2012 - June 2015
WellPoint October 2011 - November 2012
Horizon Blue Cross Blue Shield of New Jersey August 2010 - October 2011
Horizon Blue Cross Blue Shield of New Jersey January 2006 - August 2010
Horizon Blue Cross Blue Shield of New Jersey June 2000 - December 2005
Horizon Blue Cross Blue Shield of New Jersey April 1997 - May 2000
Skills
Process Improvement, Management, Analytics, Health Insurance, Healthcare, Medicare, Informatics, Financial Analysis, SAS, Claim, Managed Care, Insurance, SDLC, Leadership, Vendor Management, Access, HIPAA, Medicaid, Visio, Data Analysis, Requirements Gathering, Healthcare Information..., Healthcare Industry, Medicare Part D
Education
Saint Peter's University 2004 — 2008
MBA, Management
The College of New Jersey 1989 — 1993
BS, Business Management
Ebix 2010 - Present
Scotch Plains Rescue Squad June 2008 - Present
Peak Performance Solutions 2006 - 2011
Mayfare Software Solutions 2003 - 2006
JVC America Inc. 1997 - 2002
Horizon Blue Cross Blue Shield of New Jersey 1990 - 1996
Medigroup - NJ 1986 - 1990
Skills
Program Management, Process Improvement, Vendor Management, Strategic Planning, Team Building, Cross-functional Team..., Management, New Business Development, Project Planning, Customer Service, Analysis, Change Management, Marketing Strategy, Healthcare, Microsoft Office, Microsoft Excel, Budgets, Negotiation, Microsoft Word, PowerPoint
Education
Università degli Studi di Siena / University of Siena 1980 — 1982
Medicine
Rutgers, The State University of New Jersey-Newark 1976 — 1980
Bachelor of Arts (BA), Chemistry
Horizon Blue Cross Blue Shield of New Jersey September 2014 - Present
Horizon Blue Cross Blue Shield of New Jersey June 2013 - September 2014
The Zellman Group, LLC May 2011 - June 2013
Lowe's Home Improvement November 2005 - May 2011
J.C. Penney Inc July 2005 - November 2005
CompUSA September 2004 - July 2005
Saint Joseph's University September 2001 - May 2004
Skills
Surveillance, Interrogation, Loss Prevention, Security, Criminal Justice, CCTV, Compliance, Internal Investigations, Private Investigations, Auditing, Management, Fraud, Inventory Control, Asset Protection, Shrinkage, Interrogation Techniques, Security Management, Physical Security, Organized Retail Crime, Background Checks, Exception Based..., Security Operations, Criminal Investigations
Education
Utica College 2009 — 2011
MS, Economic Crime Management
Saint Joseph's University 2000 — 2004
Bachelor of Science, Criminal Justice
Horizon Blue Cross Blue Shield of NJ May 1995 - Present
Horizon Blue Cross Blue Shield of New Jersey 1995 - Present
Skills
Employee Benefits, Health Insurance, Managed Care, Medicare, Brokers, Account Management, Health Savings Accounts, Insurance, Strategic Planning, Claim, Sales, Term Life Insurance, Disability Insurance, Selling, Workers Compensation, Underwriting, Marketing, Life Insurance, Customer Service, Management, Business Analysis, Property & Casualty..., Salesforce.com, Healthcare, Sales Management, Team Building, Vendor Management, Leadership, Long-term Care, Process Improvement, Commercial Insurance, New Business Development
Education
Rutgers, The State University of New Jersey-Newark
SMART Pain Management, LLC 2013 - Present
CVS Caremark / Universal American 2009 - 2013
Coventry Health Care, an Aetna Company 2008 - 2009
CareFirst BlueCross BlueShield 2003 - 2008
Great-West Life 2000 - 2002
Horizon Blue Cross Blue Shield of New Jersey 1990 - 1996
Skills
Managed Care, Process Improvement, Vendor Management, Cross-functional Team..., Strategic Planning, Healthcare, Medicare, Medicaid, Team Building, Business Analysis, Pharmacy Benefit..., Healthcare Industry, Healthcare Management, Insurance, Healthcare Information..., Executive Management, Call Centers, Strategy, Medicare Part D, Disease Management, Leadership, Health Insurance, HIPAA, Provider Relations, Employee Benefits, Business Process..., Performance Improvement, Healthcare Consulting, Software Documentation
Education
Rutgers, The State University of New Jersey-Newark 1981 — 1986
B.A. Business Administration, marketing, finance
Horizon Blue Cross Blue Shield of New Jersey June 2011 - Present
Citco Fund Services September 2007 - June 2011
Macy's November 2004 - September 2007
Cendant January 2002 - November 2004
Skills
Financial Reporting, Financial Analysis, Budgeting, Excel, Accounting, Access, Forecasting, General Ledger, Outlook, Word, Analysis, Microsoft Office, Pricing, Accounts Receivable, Accounts Payable, Corporate Finance, Essbase, Auditing, Financial Modeling, Finance, Account Reconciliation, Process Improvement, Cash Management, Insurance, Budgets, PeopleSoft, Variance Analysis, Microsoft Excel, Microsoft Word
Education
Rutgers, The State University of New Jersey-Newark 1998 — 2002
Economics, Finance
Magellan Health Services February 2011 - Present
Magellan Health Services February 2011 - December 2012
BCBSNC September 2008 - January 2011
Horizon Blue Cross Blue Shield of New Jersey July 1999 - November 2007
Skills
Customer Service, Cross-functional Team..., Business Process..., Telecommunications..., Microsoft Word, Access, Avaya IP Telephony, Witness, Microsoft Office, Microsoft Excel, Strategic Planning, Virtualization, Leadership, Software Documentation, Training, Insurance, Health Insurance, Healthcare, Employee Benefits, Process Improvement
Education
Saint Augustine’s University 2009 — 2012
Bachelor of Science (BS), Organizational Leadership
Horizon Blue Cross Blue Shield of New Jersey November 2012 - Present
Horizon Blue Cross Blue Shield of New Jersey January 2002 - October 2012
Horizon Blue Cross Blue Shield of New Jersey January 2001 - December 2001
Horizon Blue Cross Blue Shield of New Jersey September 1995 - December 2000
Skills
SAS programming, SQL, Cognos, Unix, Microsoft Office, Microsoft Excel, Microsoft Word, Customer Service, PowerPoint, English, Research, Windows, Outlook, Photoshop, Teaching, HTML
Education
Rutgers, The State University of New Jersey-Newark
Bachelor of Science (BS), Business Administration and Management, General
St. Peter's College
Master of Business Administration (MBA), Finance, General
Regeneron Pharmaceutical Inc. October 2014 - Present
Regeneron Pharmaceuticals July 2013 - Present
Horizon Blue Cross Blue Shield of New Jersey December 2011 - June 2013
Roche Pharmaceuticals April 2002 - April 2010
Hoffmann-La Roche Inc., Nutley, NJ October 1999 - April 2002
Skills
Informatics, PMP, Pharmaceutical Industry, Process Improvement, ITIL, Software Documentation, Visio, Project Portfolio..., Project Management, Quality Assurance, PMO, MS Project, Vendor Management, Change Management, SDLC, Business Process..., Customer Support, SAP, Project Coordination, SharePoint, Software Development, Testing, 21 CFR Part 11, Business Analysis, Cross-functional Team..., Disaster Recovery, Software Project..., Healthcare, Requirements Analysis, Resource Management, IT Management, IT Strategy, Business Process, Integration
Education
Kaizen Technologies 2012 — 2012
Rutgers Graduate School of Business
MBA, Finance
Rutgers, The State University of New Jersey-Newark
BA, MBA, Economics, Finance
Horizon Blue Cross Blue Shield of New Jersey 1993 - Present
Education
Rutgers, The State University of New Jersey-Newark 1989 — 1993
Bachelor of Science, Biology
Healthfirst January 2015 - Present
Healthfirst June 2013 - January 2015
Healthfirst March 2012 - June 2013
Horizon Blue Cross Blue Shield of New Jersey October 2009 - March 2012
Horizon Blue Cross Blue Shield April 2008 - October 2009
Horizon Blue Cross Blue Shield of New Jersey October 2006 - April 2008
EmblemHealth May 2004 - August 2005
Skills
Critical Thinking, advanced analytics, desktop applications, Medicare, Data Analysis, Access, Healthcare, Business Intelligence, Excel, Business Analysis, Microsoft Office, Analytics, Medicaid, Applications, Microsoft Excel, Healthcare Information..., HIPAA, Project Management, Visio, Management, Process Improvement, Insurance, SDLC, Software Documentation, Requirements Gathering, Salesforce.com, SAS, Business Requirements, SharePoint, Vendor Management, Pharmacy, Managed Care, Healthcare Industry, Analysis, Health Insurance, Program Management, Leadership, Strategic Planning, Cross-functional Team...
Education
Saint Peter's University 2009 — 2011
MBA, Information Systems
Marsh August 2014 - Present
Healthcare Industry June 2014 - July 2014
Terumo April 2014 - May 2014
Horizon Blue Cross Blue Shield of New Jersey November 2012 - December 2013
Horizon Blue Cross Blue Shield of New Jersey August 2007 - November 2012
Verizon Wireless 2004 - 2007
Skills
Management, Strategy, Leadership, Proposal Writing, Marketing Communications, Project Management, Sales, Analysis, Marketing Strategy, Strategic Planning, Healthcare, Product Development, Business Strategy, Integrated Marketing, Product Marketing, Vendor Management, Microsoft Office, Microsoft Excel, Brand Communication, Cross-functional Team..., Data Analysis, Thrive in..., Market Analysis, New Business Development, Insurance, Risk Management, Health Insurance, Marketing, Business Analysis, Account Management, B2B, Salesforce.com, Market Planning, Process Improvement, Training, Business Development, Employee Benefits, Managed Care, CRM, Business Process..., Research, Social Media, Public Speaking, Customer Service, Program Management, Sales Management, Financial Analysis, Finance, Negotiation, Team Building
Education
St. Peter's College 2008 — 2010
MBA, International Business, Marketing, Finance
University of Virginia Hispanic Studies 2005 — 2005
Minor, Spanish
Villanova University 2002 — 2005
Bachelor of Arts, Political Science
FHS
High School
Horizon Blue Cross Blue Shield of New Jersey January 2003 - Present
Horizon Blue Cross Blue Shield of NJ 2003 - Present
Skills
Medicare, Insurance, Health Insurance, Contract Negotiation
Education
Rutgers, The State University of New Jersey-New Brunswick
Horizon Blue Cross Blue Shield of New Jersey December 2013 - Present
Compliance Implementation Services CIS January 2012 - May 2012
Temple Small Business Development Center January 2012 - April 2012
Shire Pharmaceuticals June 2011 - August 2011
Pennsylvania Superior Court January 2011 - April 2011
New Jersey Tax Court June 2010 - July 2010
Porzio Bromberg & Newman P.C. September 2007 - July 2009
Skills
Legal Research, Trials, LexisNexis, Corporate Law, Litigation Support, Policy, Litigation, Civil Litigation, Westlaw, Courts, Intellectual Property, Legal Assistance, Criminal Law, Trademarks, Privacy Law, Motions, Arbitration, Legal Writing, Research, Analysis, Customer Service
Education
Temple University 2009 — 2012
J.D., Law
Saint Joseph's University 2003 — 2007
B.A., Political Science
Chatham High School
Horizon Blue Cross Blue Shield of New Jersey 2006 - Present
IBM February 1999 - May 2012
AT&T 1982 - 1999
Skills
Business Analysis, SDLC, Requirements Gathering, Business Requirements, Visio, User Acceptance Testing, Requirements Analysis, Systems Analysis, Business Process, PMO, Data Warehousing, Leadership, Gap Analysis, Business Process..., Vendor Management, Software Documentation, Business Intelligence
Education
Saint Michael's College
Bachelor of Arts (BA), Biology/Biological Sciences, General
JPMorgan Chase & Co. October 2013 - Present
Horizon Blue Cross Blue Shield of New Jersey July 2012 - October 2013
Horizon Blue Cross Blue Shield of New Jersey October 2010 - July 2012
The College of New Jersey September 2008 - May 2010
First Investors Corporation 2009 - 2009
Skills
Health Insurance, Bloomberg Terminal, Data Analysis, VBA, SAS programming, Insurance, Portfolio Management, SAS/SQL, Microsoft Office, Data Management, Executive Reporting, Insurance Claims, Fundamental Research, Value Investing, Security Analysis, Basics of Unix, Performance Dashboards, PeopleSoft, Finance, Statistics, SAS Programming, Research
Education
Rutgers, The State University of New Jersey-Newark 2011 — 2015
Master of Business Administration (M.B.A.)
The College of New Jersey 2006 — 2010
Bachelor of Science (B.S.)
SAS Training
Certificate
Horizon Blue Cross Blue Shield of New Jersey May 1999 - March 2013
Skills
Insurance, Medicare, Managed Care, SDLC, Employee Benefits, Business Analysis, Process Improvement, HIPAA, Underwriting, Vendor Management, Visio, Healthcare, Risk Management, Medicaid, Property & Casualty..., Brokers, Access, Requirements Gathering, Provider Relations, Claims Resolution, NCQA, Credentialing, Dentistry, PPO, HMO, Call Centers
Education
Rutgers, The State University of New Jersey-Newark
Peace Corps September 2006 - November 2008
Paine College September 2004 - May 2006
Horizon Blue Cross Blue Shield of New Jersey August 1995 - August 2003
Education
The University of Kent
Master of Laws (LL.M.), International Law and International Relations
Rutgers, The State University of New Jersey-Newark
Master of Science (M.S.), Global Affairs
Spelman College
Bachelor of Arts (B.A.), Spanish Language and Literature
Ultimate Gaming December 2013 - September 2014
Adecco Group April 2011 - November 2013
BAYADA Home Health Care April 2011 - March 2012
Horizon Blue Cross Blue Shield of New Jersey December 2005 - February 2010
Rutgers University May 2004 - July 2004
Rutgers University September 1999 - August 2002
Skills
Online Gaming, Payments, Online Poker, Online Casino, Poker, Data Entry, Spreadsheets, Telephone Skills, Filing, Claims Handling, Claim Investigation, Customer Service, Claims Resolution, Microsoft Word, Microsoft Excel, Fax, Management, Medicare, Health Insurance, Sales, Gaming Industry, Microsoft Office, Employee Benefits
Education
Rutgers, The State University of New Jersey-Newark 1999 — 2005
Bachelor of Arts (B.A.), Journalism, 3.0
Horizon Blue Cross Blue Shield of New Jersey
Skills
Internal Audit, Internal Controls, Enterprise Risk..., Sarbanes-Oxley Act
Education
Rutgers University-Newark
Bachelor of Science (BS), Accounting
Horizon BCBSNJ June 2013 - Present
Horizon Blue Cross Blue Shield of New Jersey May 2007 - May 2015
Horizon Blue Cross Blue Shield of New Jersey August 2010 - December 2011
Horizon Blue Cross Blue Shield of New Jersey May 2008 - August 2010
Skills
Testing, Management, Business Analysis, Claim, Technical Architecture, Data Migration, Infrastructure, IT Strategy, Requirements Gathering, Technical Systems, Business Requirements, Systems Analysis, PMP, Requirements Analysis, Process Automation, Vendor Management, Project Portfolio..., Visio, Enterprise Architecture, SharePoint, PMO, Data Warehousing, Software Project..., Business Intelligence, Integration, Business Process, Business Process..., Solution Architecture, Resource Management, Process Improvement, Information Technology, Program Management, Software Documentation
Education
Rutgers University 1985 — 1990
Bachelor of Science (B.S.), Political Science and Government
Horizon Blue Cross Blue Shield of New Jersey January 2000 - Present
Skills
Managed Care, Medicare, Health Insurance, Medicaid, Provider Relations, HIPAA, Utilization Management, Disease Management, HMO, Healthcare, PPO, Healthcare Management, Network Development, Medicare Part D, Credentialing, Health Policy, Claim, Insurance, ICD-9, Healthcare Information...
Education
St.Peter's College 2011 — 2012
Master's degree, Marketing/Marketing Management, General
Rutgers, The State University of New Jersey-Newark 1996 — 2000
Bachelor of Arts (BA), Psychology
Horizon Blue Cross Blue Shield of New Jersey April 2014 - Present
Horizon Blue Cross Blue Shield of New Jersey July 2011 - April 2014
PNC Bank April 2007 - November 2010
Moose Mountain Marketing February 2006 - April 2007
AnySystem.com April 2003 - March 2005
Archive Systems April 1999 - April 2003
Skills
Customer Service, Management, Leadership, Sales, Training, Process Improvement, PowerPoint, Marketing, Business Analysis, Project Management, Insurance
Education
Saint Peter's University 2012 — 2016
Master of Business Administration (M.B.A.), Health/Health Care Administration/Management
Centenary College 2003 — 2005
Bachelor of Business Administration (B.B.A.), Business Administration and Management, General
Pine Forge Academy 1993 — 1997
High School Diploma
Mars February 2014 - Present
Merck December 2011 - February 2013
Merck June 2009 - December 2011
Merck July 2007 - June 2009
PwC January 2006 - July 2007
Horizon Blue Cross Blue Shield of New Jersey June 2005 - December 2005
Skills
Sarbanes-Oxley Act, Pharmaceutical Industry, Financial Analysis, Forecasting, Hyperion Enterprise, Microsoft Office, Spotfire, SAP BPC, SAP R/3, SAP BW, HFM, System Architecture, Accounting, Year-end Close, Month End Close, Microsoft Excel, Networking, SAP ERP, Process Improvement
Education
Rutgers, The State University of New Jersey-Newark 2003 — 2005
Bachelor's degree, Accounting and Finance
University of Mumbai 1999 — 2002
Bachelor's degree, Business Administration, Management and Operations