Experience
Caked Up Inc   January 2000 - Present
Horizon NJ Health   January 2012 - October 2012
Johnson & Johnson Healthcare Systems  February 2008 - February 2011
UNISYS-NJ Medicaid   April 2006 - February 2008
True Servant Community Development Corporation   June 2002 - June 2005

Skills
Medicaid, Managed Care, Medicare, Healthcare, Healthcare Management, Case Managment, Health Insurance, HIPAA, Credentialing, Healthcare Information..., PowerPoint, Public Speaking, Insurance, Data Analysis, Microsoft Excel, Microsoft Office

Education
Morgan State University   1999 — 2001
Communications

Experience
Horizon NJ Health of Blue Cross/Blue Shield   August 2012 - Present
Horizon NJ Health   August 2010 - August 2012
Horizon Blue Cross Blue Shield of New Jersey  August 2003 - August 2010
Robert Wood Johnson University Hospital Hamilton  1995 - 2003
Interim HealthCare  1995 - 1995

Skills
Managed Care, Medicaid, Utilization Management, Healthcare Management, Healthcare, Medicare, Process Improvement, Medicare Part D, Medicaid Managed Care, Microsoft Office, Budgets, Nursing, Analysis, Healthcare Industry, HMO, Software Documentation, Data Analysis, Case Management, Disease Management, Medicine, PPO, EMR, Provider Relations, Healthcare Consulting, Case Managment, HIPAA, Clinical Research, Health Insurance, Healthcare Information..., Physicians, Home Care, Health Policy, JCAHO, Program Management, IV, Revenue Cycle, Credentialing, Network Development, Claim, Acute Care, EHR, NCQA, Insurance, Hospitals, Community Outreach, Provider Network..., HEDIS, Quality Improvement, Provider Networks

Education
Rider University   2004 — 2008
Master of Arts (MA), Human Service Administration

Seton Hall University   1993 — 1995
BSN, Nursing

Experience
Horizon NJ Health   August 2013 - Present
Horizon BSBSNJ   October 2011 - August 2013
Horizon BCBSNJ  October 2005 - October 2011
Horizon Blue Cross Blue Shield  March 2008 - July 2009

Skills
Healthcare Information..., Learning Management, Mental Health, Vendor Management, Program Management, Team Building, Public Speaking, Visio, Provider Relations, Policy, Adult Learning Theory, Health Policy, Managed Care, Medicaid, Team Leadership, Project Management, Health Care Reform, Customer Satisfaction, NCQA, ICD-10, Medicaid Managed Care, Self-funded, Medical Coding, Gap Analysis, Revenue Cycle, ICD-9, Claims Handling, Medical Billing, Process Improvement, Training, Medicare, HIPAA, PPO, Insurance, Healthcare, Claim, Health Insurance, Customer Service, SharePoint, Call Centers, Claims Resolution, Cross-functional Team..., Leadership, Business Analysis, Employee Relations, Change Management, Staff Development, Coaching, Project Planning, Call Center Development

Education
Capella University   2015 — 2017
Bachelor of Business Administration (BBA), Information Technology

Thomas Edison State College   2015 — 2017
Bachelor of Business Adminstration, Information Technology

Southern New Hampshire University   2014 — 2015
Bachelor of Business Administration (B.B.A.), Health/Health Care Administration/Management

Brookdale Community College   1996 — 1997
Certification, Architectural Engineering

Kearny High School   1991 — 1995
High School Diploma, English Literature (British and Commonwealth)

Experience
Saba and Associates, LLC   May 2015 - Present
Anthem, Inc.   June 2005 - April 2015
Horizon NJ Health   December 1997 - June 2005
PSCNY   June 1995 - November 1997
NCS Healthcare (LTC)   March 1993 - June 1995
Express Scripts  June 1986 - November 1992
CVS Pharmacy  April 1985 - June 1986

Skills
Managed care, Leadership, Medicaid, Medicare Part D, Strategic Planning, Medicaid Managed Care, Management, High Performance Teams, Medicare, Pharmacy Benefit..., Healthcare Management, Healthcare, Utilization Management, Healthcare Information..., Disease Management, Health Policy, Healthcare Industry, Managed Care, Pharmacy, Team Building, EMR, Pharmacists, Pharmacy Automation, Oncology, Provider Relations, Health Insurance, Credentialing, Diabetes, Physicians, Network Development, Healthcare Consulting, HMO, Physician Relations, Revenue Cycle, HIPAA, Informatics, Quality Improvement, Process Improvement, Executive Management, Program Management, Cross-functional Team..., Strategy, Project Management, Data Analysis, Pharmaceutical Industry, Contract Negotiation, Change Management, Consulting, Long-term Care

Education
University of Pennsylvania - The Wharton School   2000 — 2000
Certificate, Executive Management

Union College   1992 — 1996
MS, Healthcare Administration

Albany College of Pharmacy of Union University   1979 — 1984
BS, Pharmacy

Experience
Optum  July 2014 - Present
United Healthcare  September 2010 - July 2014
United Healthcare  March 2008 - September 2010
United Healthcare  November 2005 - March 2008
United Healthcare Community Plan  September 2002 - November 2005
Horizon NJ Health   September 1995 - July 2002

Skills
Healthcare, Medicare, Data Analysis, Strategic Planning, Outlook, Research, Microsoft Excel, Public Speaking, PowerPoint, Microsoft Word, Teaching, Managed Care, Customer Service, Leadership, Health Insurance, Microsoft Office, Windows, Grassroots Fundraising, Creative Problem Solving, Great Motivator, HIPAA, Medicaid, Healthcare Management, Political Campaigns, Politics, Community Organizing, Board of Directors, Nonprofits, Marketing Strategy, Sports Coaching, Job Coaching, Employee Training, Management, Insurance, Healthcare Industry, Process Improvement, Healthcare Information...

Education
Rutgers, The State University of New Jersey-New Brunswick   1989 — 1993
Bachelor's of Science, Industrial Engineering

Fairleigh Dickinson University-Metropolitan Campus   1987 — 1989
Industrial Engineering

Dr. Bonilla's Leadership Tomorrow

Experience
Cigna-HealthSpring  August 2007 - Present
Horizon NJ Health   2001 - 2007
OakTree Health Plan   1998 - 2001
Principal Health Care of Delaware   1997 - 1998
Care Advantage  1997 - 1997
Garden State Medical Group   1991 - 1996
WILLIAM E. HOOPER, Jr., M.D., P.A.   1989 - 1991

Skills
Managed Care, Medicare, Utilization Management, Healthcare Management, Medicaid, Disease Management, Case Managment, Hospitals, Health Policy, Credentialing, Medicine, Inpatient, Healthcare Information..., Quality Improvement, Health Insurance, NCQA, Physicians, HIPAA, Case Management, HEDIS, Informatics, Pharmacy, Clinical, Medicare Advantage, Healthcare, Clinical Research

Education
Temple University, The Fox School of Business and Management   2002 — 2004
Master of Business Administration Degree, Healthcare Management

University Hospital, State University of New York, Stony Brook   1986 — 1989
Internist, Internal Medical Residency

Columbia University College of Physicians and Surgeons   1982 — 1986
Doctor of Medicine, Medicine

University of Pennsylvania   1978 — 1982
Bachelor of Arts, Biology

North Bergen High School   1974 — 1978
High School Diploma

Experience
Horizon NJ Health   May 2012 - Present
Hawaii Medical Service Association  October 2007 - January 2012
Community News Network   September 2004 - September 2007

Skills
Writing, Editing, Proofreading, Communications, Public Relations, Advertising

Education
The College of New Jersey   2000 — 2004
Bachelor of Arts, English & Journalism/Professional Writing

Experience
AmeriHealth Caritas/ PerformRx   June 2014 - Present
Horizon NJ Health   May 2012 - January 2014
Horizon Blue Cross Blue Shield of New Jersey  March 2011 - May 2012
PerformRx  January 2010 - March 2011
PerformRx  December 2006 - January 2010
PerformRx  October 2006 - December 2006
AmeriHealth Administrators  November 2003 - October 2006
Keystone Mercy Health Plan  June 2002 - November 2003
RITE AID  August 1989 - June 2002

Skills
Microsoft Office, Management, Microsoft Word, Microsoft Excel, Research, PowerPoint, Training, Leadership, English, Process Improvement, Windows, Outlook, HTML, Recruiting, SQL, Java, Interviews

Education
University of Phoenix   2008 — 2010
Master of Business Administration (MBA), Health Care Management

University of Phoenix   2005 — 2008
Bachelor of Science (B.S.), Business Management

Temple University College of Liberal Arts   2003 — 2005
Organizational Leadership

Temple University College of Liberal Arts   1992 — 1994
Pre-Pharmacy Studies

Experience
Horizon NJ Health   May 2015 - Present
NYU Langone Medical Center  August 2013 - Present
NYU Langone Medical Center  October 2013 - January 2015
McKeever Dental Care   July 2006 - January 2013
Wayne Dental Arts   April 2003 - July 2006

Skills
Change Management, Patient Education, Periodontics, Dentistry, Local Anesthesia, Digital Radiography, Dentrix, Teeth Whitening, Nitrous Oxide, Oral Care, Health Education, Radiography, Eaglesoft, Dental Care, Cosmetic Dentistry, Pediatric Dentistry, Cpr Certified, Restorative Dentistry, Dental Software, Healthcare, Cancer Screening

Education
Ashford University July 2011   2010 — 2011
Masters of Arts, Organizational Management; Health Care Administration

Ashford University   2008 — 2010
Bachelor of Arts (BA) in Organizational Management

Bergen Community College   1995 — 1998
Associate of Science (AS) in Applied Science, Dental Hygiene

Memorial High School,

Experience
Horizon NJ Health   August 2014 - Present
St. Joseph's Regional Medical Center   November 2010 - August 2014
Lincoln Park Care Center  March 2010 - September 2010
Center For Family Support  September 2009 - February 2010
Center For Family Support  September 2006 - August 2009
St. Clare's Hospital   September 2008 - April 2009
Big Brothers Big Sisters  September 2007 - June 2008

Skills
Inpatient, Hospitals, Adolescents, Community Health, Healthcare, Medicaid, Psychotherapy, Treatment, Psychology, Medicare, Group Therapy, Case Managment, Social Services, Mental Health, Substance Abuse..., Developmental..., Medical Social Work, Psychosocial, Mental Health Counseling, Family Therapy, Crisis Intervention, Healthcare Management, Chemical Dependency, Elder Care, Art, Behavioral Health, Marketing, Managed Care, Child Welfare, Foster Care, Case Management, Motivational..., Biopsychosocial..., DSM-IV, School Social Work

Education
Rutgers University-New Brunswick   2007 — 2009
Master of Social Work (MSW), Social Work

Montclair State University   2004 — 2006
Bachelor of Arts, Psychology

Experience
Aetna  November 2014 - Present
Horizon NJ Health   September 2012 - October 2014
Hamilton Area YMCA  April 2007 - February 2013
LPL Financial - Wealth Management Partners   October 2011 - August 2012

Skills
Customer Service, Public Speaking, Event Planning, PowerPoint, Data Entry, Microsoft Office, Outlook, Microsoft Excel, Administration, Administrative..., Access, Coaching, Community Outreach, Event Management, Insurance, Marketing, Nonprofits, Operations Management, Organizational..., Program Management, Public Relations, Social Media, Social Networking, Supervisory Skills, Teaching, Team Building, Training, Volunteer Management

Education
Saint John's University   2009 — 2011
Bachelor of Arts, Psychology

Mercer County Community College   2007 — 2009
Business Administration, Psychology

Hamilton High School West   2003 — 2007

Experience
Horizon NJ Health   November 2006 - December 2007
Horizon NJ Health   July 2003 - November 2006
Vista Research, Inc  November 2001 - February 2003
Vista Research, Inc  April 1999 - November 2001
ChartOne  1998 - 1999
Thomas Cook Foreign Exchange   January 1994 - April 1998

Skills
Budgeting, Administrative Support, Scheduling, Troubleshooting, Customer Service, Microsoft Office, Excel, Outlook, Word, PowerPoint, Accounts Payable, Administration, Accounts Receivable, Accounting, Data Entry, Writing, Research, Problem Solving, Purchasing, Event Planning, Data Analysis, Lotus Notes, Planning, Coordination, Inventory Management, Financial Reporting, Payroll, Process Improvement, Windows, Documentation, Analysis, Software Documentation, Budgets, Microsoft Excel, System Administration, Project Planning, Human Resources, Leadership, Marketing, Team Building, Management, Healthcare, Public Speaking, Process Scheduler, Access, Visio, Provider Relations, Credentialing, Administrative..., Microsoft Word

Education
Bethany SchoolGuatemala, Central America

De Anza College

Experience
SmithBucklin  September 2011 - Present
Georgetown University Hospital  September 2010 - September 2011
Loudon Medical Group, Loudon Pediatric Associates   June 2010 - August 2010
Horizon NJ Health   June 2009 - August 2009
Bristol-Myers Squibb  June 2007 - January 2009

Education
New York University   2014 — 2016
Master's Degree, Organizational Behavior

James Madison University   2006 — 2010
Bachelor of Science (B.Sc.), Health Services Administration, Business Minor

Pennsbury High School   2002 — 2006

Experience
Horizon NJ Health   July 2012 - Present
Football Playbook Online   2009 - Present
Agile Technologies  May 2010 - July 2012
NOBEL Systems, Inc.   November 2009 - March 2010
Global Aerospace, Inc.   January 2008 - October 2009
Fuel7, Inc.   March 2006 - December 2007
New Jersey Property Liability Guaranty Association   September 2004 - March 2006
NIA Group  August 2001 - September 2004
Evolving Edge Communications   May 2000 - July 2001

Skills
Software Project..., Business Analysis, Vendor Management, Legacy Modernization, Integration, Application Development, Process Improvement, Staff Management, Start-ups, Insurance, Insurance Claims, Management Consulting, Project Management, Strategic Planning, Software Documentation, Leadership, PMP, SDLC, IT Strategy, Business Process..., Requirements Analysis, IT Management, MS Project, Change Management, Requirements Gathering, Visio, Business Process, Team Leadership, Resource Management, Project Planning, Professional Services, SQL, Business Requirements, PMI, Databases, Management, Healthcare, Data Governance, Healthcare Information..., Property & Casualty..., Master Data Management, Consulting, Data Integration, Enterprise Software, Governance, Business Process..., Performance Management, Information Technology, Business Objects, Business Intelligence

Education
University of Massachusetts at Amherst - Isenberg School of Management   2012 — 2015
MBA, Health/Health Care Administration/Management

Rutgers University-New Brunswick   2001 — 2004
BA, Computer Science

Experience
Horizon NJ Health   2011 - Present
ACS Healthcare Provider Solutions  January 2005 - January 2011

Skills
Type WPM 80, Microsoft Office, Microsoft Excel, Microsoft Word, Microsoft Applications, Managed Care, Medicaid Managed Care, HMO, Medicare, Utilization Management, Enrollment Management

Education
Mercer County Community College   1994 — 1995

Trenton Central High School   1990 — 1994
Diploma

Experience
Horizon NJ Health   January 2006 - Present
Horizon NJ Health   August 2002 - June 2006

Skills
Project Coordination, Event Management, Team Leadership, Event Planning, Coordination, Community Outreach, Administration, Mentoring, Public Speaking, Editing, Project Planning, Project Implementation, Training, Strategic Planning, Medicaid, Research, System Administration, Health Insurance, Microsoft Word, PowerPoint, Marketing, Microsoft Office, Customer Service, Leadership, Healthcare, Nonprofits, Team Building, Medicaid Managed Care, Process Improvement, Medicare, Project Management, Managed Care

Education
Southern Illinois University, Carbondale   2008 — 2011
Bachelor’s Degree, Workforce Education and Development, Cum Laude

Wilmington University
MBA, Healthcare and Marketing

Experience
Horizon Blue Cross Blue Shield of New Jersey  April 2013 - Present
Horizon Blue Cross Blue Shield of NJ  December 2011 - April 2013
Horizon Blue Cross Blue Shield of NJ  October 2007 - December 2011
Horizon NJ Health   September 2005 - September 2007
Baker and Taylor  2004 - 2005
R. R. Bowker LLC   2002 - 2005
RR Bowker  2002 - 2004
AT&T  January 1990 - November 2001
AT&T  1993 - 1994

Skills
Troubleshooting, Cross-functional Team..., Visio, SDLC, Marketing, Quality Assurance, Leadership, SharePoint, Requirements Analysis, Process Improvement, Access, Customer Service, Vendor Management, Analysis, Oracle, Business Analysis, Management, Budgets, Business Requirements, Business Intelligence, Software Documentation, Program Management, Team Building

Education
Raritan Valley Community College   1987 — 1991

Manville High School   1983 — 1987
General

Experience
Horizon NJ Health / Horizon Blue Cross/Blue Shield of New Jersey   March 2008 - Present
Horizon NJ Health   April 2007 - March 2008
Commerce Bank  September 2006 - March 2007
Wayport  2004 - 2005
Elan Pharmaceuticals  2002 - 2004
Lockheed Martin  1997 - 2001

Skills
Access, SQL, Software Documentation, Troubleshooting, Process Improvement, Windows 7, Visio, MS Project, Help Desk Support, Analysis, SharePoint, Business Analysis, Requirements Analysis, Requirements Gathering, Healthcare Information..., Active Directory, XP, Windows, casetrakker, Agile Methodologies

Education
Drexel University   2001 — 2009
BA, Information Systems

Rancocas Valley Regional High School

Experience
Horizon NJ Health   May 2014 - Present
Horizon NJ Health   June 1999 - May 2014
New Jersey Department of Environmental Protection  1990 - June 1999
New Jersey Department of Environmental Protection  June 1987 - December 1990

Skills
Medicaid, Managed Care, Medicaid Managed Care, Health Policy, Medicare, Healthcare, HIPAA, Health Insurance, Policy, Legislative Relations, Credentialing, Healthcare Industry, Legislation, Healthcare Management, PPO, Health Care Reform, Health Law, Healthcare Reimbursement, Strategic Planning, Insurance, Network Development, Medicare Part D, Contract Negotiation, Claim, NCQA, Utilization Management, Corporate Governance, Government Contracting, Environmental Policy, Government, Compliance, Environmental Compliance, Contract Management, Administrative Law, Special Needs..., Policy Analysis, Public Policy, Leadership, Lobbying, Process Improvement, Long-term Care, Public Speaking, Developmental..., Medicare/Medicaid..., Provider Relations, Membership Growth, Board Governance, Employee Training

Education
Rutgers, The State University of New Jersey-New Brunswick   1983 — 1987
BS, Environmental Planning and Design;Plant Science;Animal Science

Experience
Hackensack University Medical Center  February 2014 - Present
Berkadia  August 2012 - February 2014
Hackensack University Medical Center  April 2011 - September 2012
Horizon NJ Health   June 2010 - April 2011
Horizon Blue Cross Blue Shield of New Jersey  1998 - November 2010
Merck  February 2001 - September 2002
Honeywell International Inc.  September 1999 - February 2001
Advanta  January 1998 - January 1998
Thomas Jefferson University  January 1998 - January 1998
Hoffman La Roche  January 1998 - January 1998

Skills
Crystal Reports, MS Office Suite, Informatica, Unix Shell Scripting, PeopleSoft, HRIS, Access, Payroll, Production Support, Financials, SQR, SQL, Business Analysis, Documentation, SQL Server, Requirements Analysis, Benefits, PeopleTools, PeopleCode, Excel, Integration, Microsoft Office, Word, Analysis, Databases, HTML, Data Warehousing, Windows, PL/SQL, Unix, XML, Troubleshooting, Oracle SQL, COBOL, Outlook, Application Development, Systems Analysis, Process Improvement, Operating Systems

Education
Mercer County Community College   1987 — 1989
AAS

Informatica Training   2005 — 2005

Chubb Training Center   2005 — 2005
Certificate

Experience
Horizon NJ Health   July 2014 - Present
Coordinated Family Care  January 2012 - July 2014
Caring Family Community Services  February 2011 - December 2011
BUF: Health & Human Services   August 2009 - February 2011

Skills
Social Services, Counseling, Crisis Intervention, Case Management, Adolescents, Parents, Mental Health, Adults, Psychology, Case Managment

Education
Rutgers University-New Brunswick   2003 — 2008
BA, Psychology & Sociology

Piscataway High School   1999 — 2003

Experience
Southern Jersey Family Medical Centers, Inc.   January 2011 - Present
Southern Jersey Family Medical Centers, Inc.   October 2008 - January 2011
Southern Jersey Family Medical Centers, Inc.   June 2003 - October 2008
Horizon NJ Health   March 2001 - June 2003

Skills
Process Improvement, Strategic Planning, Project Management, Financial Analysis, Business Analysis, Customer Service, Management, Risk Management, Leadership, Healthcare Management, Insurance, Change Management

Education
Temple University - Fox School of Business and Management   1989 — 1996
Master of Business Administration (M.B.A.), Health/Health Care Administration/Management

Experience
Reiser Legal Nurse Consulting, LLC   January 2013 - Present
Horizon NJ Health   May 2013 - Present
HCCC  November 2009 - February 2012
Robert Wood Johnson University Hospital Hamilton  May 2006 - October 2009

Skills
Product Liability, Wrongful Death, Litigation, Legal Research, Personal Injury..., Automobile Accidents, Attorneys, Case Managment, Nursing, Professional Malpractice, Criminal Defense, Medical/Surgical, Healthcare, Workers Compensation, Research

Education
Mercer County Community College   2004 — 2007
Associate of Science (A.S.), Registered Nursing/Registered Nurse

Saint Joseph's University   2002 — 2003

Experience
Horizon NJ Health   July 2011 - Present
Horizon NJ Health   March 2003 - July 2011
Great-West Financial  July 1997 - December 2002
Great-West Financial  June 1993 - July 1997

Skills
Medicare, Medicaid, Health Insurance, Access, Claims Handling, Claims Resolution, Claims Management, Long-term Care, Compliance, Fraud Detection, UAT coordination, Business Requirements, Training, HMO, Vendor Management, Vendor Relationships, Vendor Contracts, HIPAA, Affordable Care Act, Utilization Management, Health Care Reform, PPO, POS, EPO, Customer Service

Education
Southern New Hampshire University   2014 — 2017
Master of Business Administration (M.B.A.), Health/Health Care Administration/Management

Monmouth University   1984 — 1989
Bachelor of Science (B.S.), Business Administration and Management, General

Experience
Pratt & Whitney  May 2015 - Present
Michigan Legal Help   October 2013 - May 2015
Office of the Public Defender  June 2014 - August 2014
Horizon Blue Cross Blue Shield of New Jersey  June 2012 - August 2013
INROADS  June 2011 - August 2013
University of Connecticut  August 2011 - May 2013
SolAmor Hospice  August 2011 - August 2012
Horizon NJ Health   June 2011 - August 2011
CentraState Medical Center  June 2005 - August 2007

Skills
Healthcare Management, PowerPoint, Microsoft Excel, Microsoft Word, Access, Microsoft Office, Claim, Customer Service, Marketing, Teamwork, Medicaid, Windows, Insurance, Data Analysis

Education
Michigan State University - The Eli Broad Graduate School of Management   2014 — 2017
Master of Business Administration (MBA), Finance

Michigan State University College of Law   2013 — 2017
Juris Doctor, Health Law

The University of Connecticut   2009 — 2013
Bachelor of Science, Healthcare Management, Gerontology

Manalapan High School   2005 — 2009
High School Diploma

Experience
AmeriHealth Caritas  January 2001 - Present
Keystone Mercy Health Plan  2001 - Present
Horizon NJ Health   2004 - 2005
Coventry Health Care  January 1999 - June 2000
Prudential AARP  August 1986 - January 1999
AARP HealthCare Options   1986 - 1999

Skills
Medicaid, Managed Care, Medicare, Process Improvement, Healthcare, HIPAA, Insurance, Health Insurance, Auditing, Training, Corporate Communications

Education
Wissahickon Sr. High   1982 — 1986

Temple University

Experience
Horizon NJ Health   August 2015 - Present
Horizon NJ Health   May 2014 - August 2015
Horizon NJ Health   June 2012 - May 2014
Bracoloni Memorials   April 2007 - January 2011
CVS Pharmacy  June 2001 - February 2007

Skills
Customer Service, Management, Strategic Planning, Microsoft Office, Sales, Team Building, Leadership, Project Management, Microsoft Excel, Training, Microsoft Visio, Apple iWork

Education
Temple University - Fox School of Business and Management   2015 — 2019
Master of Business Administration (M.B.A.), Business Administration and Management, General

Rider University   2006 — 2011
Master of Arts (M.A.), Counseling Psychology

Rider University   2000 — 2004
Bachelor of Arts (BA), Psychology

Experience
Horizon NJ Health   April 2009 - Present
University Health Plans, Inc.   March 2008 - April 2009
Multiplan  August 2003 - February 2007

Skills
Contract Negotiation, HIPAA, Health Insurance, Healthcare, Healthcare Industry, Healthcare Information..., Hospitals, Managed Care, Medicaid, Medicare, Network Development

Education
Kutztown University of Pennsylvania   1993 — 1997
B.S., Telecommunications

Experience
Saint Michael’s Medical Center 2010 – present   February 2010 - Present
Saint Barnabas Health Care System  2008 - 2010
Dover Business College  2006 - 2007
Horizon NJ Health   2000 - 2006
CIGNA Healthcare  1998 - 2000
HealthSource  1995 - 1997
ChubbHealth   1993 - 1995
Chubb LifeAmerica  1990 - 1993

Skills
Hospitals, Physicians, Health Insurance, Managed Care, Medicaid, Medicare, Healthcare, HIPAA, Healthcare Management, Healthcare Information..., Utilization Management, Provider Relations, Medicaid Managed Care, PPO, HMO

Education
Montclair State University   1999 — 2002
MA, Administration & Supervision - Concentration in Adult Education & Training, 3.99 GPA

Montclair State University
BA, Psychology

Experience
TD  March 2015 - Present
Merrill Lynch  March 2013 - February 2015
Horizon NJ Health   October 2011 - February 2013
Opvantek, Inc.   October 2010 - September 2011
VNSNY  June 2009 - September 2010
Citigroup  May 2003 - May 2009
New York City Housing Authority (NYCHA)   May 2002 - April 2003
TMP Worldwide  September 2001 - April 2002
McCann Erickson  April 2000 - August 2001
Oregon State University  June 1998 - December 1999

Skills
Cloudera, Pig, Hadoop, Hive, NoSQL, R, Python, Mahout, Flume, Sqoop, Oozie, Oracle E-Business Suite, Data Management, Business Analysis, Requirements Analysis, Business Intelligence, SDLC, Data Warehousing, Visio, SQL, Software Project..., Microsoft SQL Server, Process Improvement

Education
Oregon State University   1998 — 2000
Master's degree

Experience
Med-Metrix  June 2014 - Present
UnitedHealthcare  August 2003 - June 2014
Horizon NJ Health   1996 - 2003
Prudential Insurance  1989 - 1996

Skills
Network Development, Managed Care, Health Insurance, Medicaid, Provider Relations, PPO, HMO, Medicare, Health Policy, Healthcare Industry, Healthcare, Healthcare Management, Hospitals, Physicians, Home Care, Process Improvement, HIPAA, Quality Improvement

Education
La Salle University   1985 — 1989
Bachelor of Science (BS), Business Administration, Management and Operations / Health Care Operations

Archbishop Wood High School   1981 — 1984

Experience
University of Massachusetts Lowell  April 2013 - Present
Elise William Enterprise, LLC   November 2007 - December 2011
Ingersoll Rand  March 2005 - December 2005
Merrill Lynch  September 2004 - March 2005
Somerset County Council  December 2003 - September 2004
Horizon NJ Health   February 1997 - July 2002

Skills
Employee Performance..., Microsoft Word, Excel, PowerPoint, PeopleSoft, Publisher, Access, Lotus Notes, Outlook, HRIS, Oracle, Employee Relations, FMLA, HR Consulting, Onboarding, Personnel Management, Team Building, College Recruiting, Payroll, Process Improvement, Vendor Management, Microsoft Office, Career Development, Customer Service, Employee Engagement, Employee Benefits, Public Speaking, Microsoft Excel, Human Resources, New Hire Orientations, Recruiting, Temporary Placement, Training, ADP Payroll, Workforce Planning, HR Policies, Interviews, Leadership, Microsoft Publisher, Performance Management, Talent Management, Deferred Compensation, Talent Acquisition, Benefits Administration, Organizational..., Change Management, Performance Appraisal, Applicant Tracking..., Coaching, Succession Planning

Education
Rider University   1996 — 1999
Masters, Human Services

University of Delaware   1987 — 1992
BS, Human Resources

Experience
Horizon NJ Health   January 2008 - Present
Health Partners  March 2005 - December 2007
Health Partners  July 2001 - March 2005
OakTree Health Plan   June 2000 - July 2001
Benova, Inc.   October 1996 - June 2000

Skills
Policy, Program Management, Healthcare, Vendor Management, Managed Care, Medicaid, Medicare, Contract Negotiation, Auditing, Contract Management, Utilization Management, Claim, Health Insurance, Process Improvement, HIPAA, Healthcare Information..., Healthcare Management

Education
Widener University School of Law   2004 — 2006
Master of Jurisprudence (MJ), Health Care Law

Temple University   1992 — 1996
Bachelor of Arts (BA), Communications: Radio, TV & Film

Delaware County Community College   1989 — 1992
Associates Degree, Liberal Arts

Experience
Horizon NJ Health   September 2008 - Present
Horizon NJ Health   April 2000 - September 2008

Skills
Medicaid, Managed Care, Health Insurance, Healthcare, HIPAA, Pharmacy, Healthcare Management, Health Policy, Claim, Process Improvement, Insurance, Data Analysis, Lotus Notes, Medicare, Team Building

Education
Rider University   1998 — 1999
Bachelor's, Business Administration--Mgt and Org Behavior

Hamilton HIgh School East, Steinert   1989 — 1993

Experience
Horizon NJ Health   April 2013 - Present
Horizon NJ Health   September 2011 - Present
Temple University  2004 - 2013
United Behavioral Health  February 2008 - September 2011
Independence Blue Cross  January 1998 - July 2007

Skills
Medicaid, Medicare, Healthcare, Health Insurance, Claim, Customer Service, Outlook, Microsoft Office, Microsoft Excel, Microsoft Word, Credentialing, PowerPoint, Research, Medicaid Managed Care, Medical Compliance, Contract Negotiation, Provider Relations, Managed Care, Insurance, HIPAA, Disease Management, Network Development, Hospitals, Software Documentation, Healthcare Management, Clinical Research, Policy, Utilization Management, Healthcare Industry, Health Policy, HMO, Leadership, Training, Team Building, Medical Terminology, Quality Improvement, Revenue Cycle, Access, Healthcare Information..., Medicare Part D, Physicians, Process Improvement, Management, Data Analysis

Education
Rosemont College   1991 — 1995
BA, English

Experience
UnitedHealth Group  April 2015 - Present
UnitedHealth Group  March 2010 - April 2015
Horizon NJ Health   May 2000 - March 2010

Skills
Medicaid, Managed Care, Network Development, Health Insurance, Credentialing, HIPAA, Healthcare Management, Healthcare, Claim, Provider Relations, HMO, PPO, Healthcare Industry, Medicaid Managed Care, Data Analysis, Disease Management, Health Policy, Claims Resolution, Medical Billing, Physician Relations, Practice Management, Quality Improvement, Healthcare Reimbursement

Education
Lock Haven University of Pennsylvania

Experience
Horizon NJ Health   April 2011 - Present
Horizon NJ Health   January 2009 - April 2011
Kennedy Health System  2000 - 2007

Skills
Healthcare Management, Managed Care, Medicare, Healthcare, Medicaid, Healthcare Information..., Healthcare Industry, HIPAA, Provider Relations, Insurance, Hospitals, Health Insurance, Data Analysis, Access, Process Improvement

Education
Saint Joseph's University   1998 — 2002
M.S., Health Administration

Fairleigh Dickinson University-Florham Campus   1987 — 1991
B.S., Marine Biology

Experience
Humana At Home  October 2014 - Present
Horizon NJ Health   May 2011 - August 2014
Auto Injury Solutions  January 2009 - August 2009
Hospital for Special Surgery  November 2007 - June 2008
Royal London Hospital Trust   September 2003 - June 2006

Skills
Healthcare, Hospitals, Healthcare Management, Nursing, Medical Case Management, Health Assessment, Evidence-based Medicine, Patient Safety, Community Health, Medical Terminology, BLS, EMR, Clinical Research, HIPAA, Healthcare Information..., Home Care, Cpr Certified, Inpatient, ACLS, Medical/Surgical, Radiology Nursing, Patient Advocacy, Mentoring, Time Management, Problem Solving, Dependable Team Player, Compassion, Interpersonal..., Analytical Skills, Therapeutic Listening, Medical-Surgical, CPR Certified, Case Management, Nursing Care, Registered Nurses, Managed Care, Medicare, Orthopedics, Quality Improvement, Acute Care, Treatment, Management

Education
Chamberlain College of Nursing   2009 — 2012
Bachelor of Science (B.S.), Registered Nursing/Registered Nurse, President's Honor Roll.

Princess Alexandra College of Nursing
Nursing, Registered Nursing/Registered Nurse

Experience
Florman Tannen, LLC   April 2008 - Present
Florman Tannen, LLC   2008 - Present
Tannen Healthcare Consulting, LTD.   2006 - 2008
Horizon NJ Health   2004 - 2006
Aetna  January 1997 - December 2005
Long Island College Hospital  1987 - 1997
Long Island Jewish Medical Center  1982 - 1987
Nassua Suffolk HSA   1979 - 1982
Rogatz and Meyers   1977 - 1978

Skills
HIPAA, Managed Care, Leadership, Healthcare, Hospitals, Medicare, Healthcare Information..., Strategic Planning, Healthcare Consulting, Contract Negotiation, Healthcare Management, Medicaid, Health Insurance, EMR, Provider Relations, Start-ups, Insurance, Practice Management, Policy, Physicians, Health Policy, Healthcare Industry, EHR, Revenue Cycle, Business Development, Long-term Care, Informatics, Performance Improvement, Medical Billing, Medicine, Medical Coding, Executive Management, Radiology, Internal Medicine

Education
LIU Brooklyn   1961 — 1965
BA, History

Long Island University
BS

Experience
Fidelity Investments  June 2015 - Present
Delta Air Lines  September 2014 - May 2015
Mercury Insurance  November 2009 - August 2014
IPC Information System   February 2008 - October 2009
Horizon NJ Health   March 2007 - January 2008

Skills
Java Enterprise Edition, WebSphere Application..., Struts, Web Services, Hibernate, JDBC, Spring Framework, XML, Agile Methodologies, SOA, SQL, Tomcat, JBoss Application Server, JMS, Oracle, Ant, Maven, DB2, Servlets, JSP, JavaScript, Java, WebSphere MQ, Shell Scripting, UML Tools, ClearCase, SDLC, Software Development, CSS, WebSphere

Education
Jawaharlal Nehru Technological University

Experience
Horizon NJ Health   November 2012 - September 2014
Horizon Blue Cross Blue Shield of New Jersey  February 2012 - November 2012
Rabobank  June 2005 - July 2010
Israel Discount Bank  July 2001 - August 2004
Intesa Sanpaolo  January 1998 - May 2001
Intesa Sanpaolo  June 1994 - January 1998
Bank of New Zealand  January 1991 - June 1994
Bank of New Zealand  January 1989 - January 1991
Commerzbank  January 1986 - January 1989

Skills
Freehold, Banking, Software Documentation, Management, Security, PMO, Leadership, Project Management, Customer Service, Healthcare, Business Analysis, Training, Process Improvement, SharePoint, HIPAA, Documentation, Healthcare Information..., Consulting

Education
Brookdale Community College   2011 — 2011
Certification, Electronic Health Record Management Program

Brookdale Community College   2005 — 2005
Certification, Business Application Computer Specialist

New Utrecht High School   1975 — 1979
Academic

Regina Pacis   1967 — 1975

Experience
HorizonNJHealth   September 2001 - Present
Horizon NJ Health   September 2003 - September 2008
Lower Bucks Hospital  January 1990 - January 2001

Skills
Medicaid, Case Managment, Medicare, Home Care, Utilization Management, Managed Care, Rehab, Inpatient, Healthcare Management, Case Management, Nursing, Medical Case Management, Quality Improvement

Education
Holy Family University   2003 — 2011
MSN, Nursing

William Paterson University of New Jersey   1977 — 1982
BSN, Nursing

Experience
Presscott Associates   2010 - Present
Medical Practice Management Associates, Inc.   2007 - 2009
Horizon NJ Health   2002 - 2006

Skills
Medicare, Medicaid, Provider Relations, Healthcare Consulting, HIPAA, Managed Care, Healthcare Management, Health Policy, Healthcare Industry, Health Insurance, Physicians

Education
Temple University

Experience
Horizon NJ Health   2013 - Present
Horizon NJ Health   2010 - 2013
Horizon NJ Health   2007 - 2009
Horizon NJ Health   2005 - 2007
University Health Plans (UHP) / Centene   2004 - 2005
University Health Plans (UHP) / Centene   2002 - 2004
University Health Plans (UHP) / Centene   2001 - 2002

Skills
Medicaid, Healthcare, SQL, Data Analysis, Business Analysis, Access, Analysis, Process Improvement, Microsoft Excel, Managed Care, Healthcare Management, Public Speaking, Software Documentation, Leadership, Hospitals, PowerPoint, SAS, Trend Analysis, Financial Analysis, Financial Reporting, Cross-functional Team..., Healthcare Industry, Medicare, HIPAA

Education
New Jersey Institute of Technology   1997 — 2001
Bachelor's degree, Information Systems

Experience
Coulter & Associates  October 2010 - Present
The Affinitee Group   2009 - 2010
Dynamic Commerce Applications   2007 - 2008
American Insurance Management Group, Inc. (AIM)   2004 - 2007
Horizon BCBS - Horizon NJ Health   2003 - 2004
American Insurance Management Group, Inc. (AIM)   2000 - 2003
AmeriChoice  1996 - 2000
Horizon NJ Health   1994 - 1996

Skills
Insurance, Employee Benefits, Risk, Healthcare, Strategic Planning, Project Management, Leadership, Strategy, Claim, CRM, Managed Care, Sales, Financial Risk, Reinsurance, Management, Negotiation, Healthcare Industry

Education
Camden County College

West Catholic Girls High School

Experience
Horizon NJ Health   July 2011 - October 2012
Cure Auto Insurance  November 2007 - September 2009

Skills
Medicaid, Managed Care

Education
Ashford University   2009 — 2012
Bachelor's degree, Organizational Management

Mercer County Community College   2004 — 2007
Associates, Business Management

Experience
Bristol-Myers Squibb Company  January 2014 - Present
Robert Wood Johnson Foundation  December 2012 - Present
Bristol-Myers Squibb Company  June 2005 - January 2010
Horizon NJ Health   2004 - 2005

Skills
Administrative..., Concur, Lotus Notes, Travel Arrangements, Outlook, Calendaring, Calendars, Access, Data Entry, PowerPoint, Microsoft Excel, Confidentiality, Software Documentation, Microsoft Word, PeopleSoft, Administrative...

Education
Health Choices School of Holistic Massage   2004 — 2006
Certificate, Modalities of Massage include Shiatsu, Swedish, Polarity, Reflexology, Spa Treatments, Energy Work

Katharine Gibbs School   1988 — 1989
Certificate, Secretarial Sciences

Experience
Horizon NJ Health   March 2007 - Present
Horizon NJ Health   March 2007 - Present
Horizon NJ Health   November 2004 - March 2007
Horizon NJ Health   2004 - 2007
AmeriGroup  January 2003 - January 2004
United Healthcare/ AmeriChoice   January 2001 - January 2003
United Healthcare/ AmeriChoice   January 2000 - January 2001
United Healthcare/ AmeriChoice   January 1998 - January 2000

Skills
Managed Care, Medicaid, Healthcare, Medicare

Education
Seton Hall University   1990 — 1996
B.A., Psychology

Seton Hall UniversitySouth
B.A, Psychology

Seton Hall University
Graduate Certificate Program, Healthcare Administration and Management

Experience
Horizon NJ Health   January 2004 - Present
Horizon NJ Health, Trenton NJ   January 2004 - Present
Express Scripts  January 2005 - January 2007

Skills
HIPAA, Managed Care, Pharmacy Benefit..., Medicare Part D, Medicaid, Medicare, Pharmacists, Health Insurance, Healthcare, Health Policy, Data Analysis, Utilization Management, Leadership, Healthcare Management, Pharmaceutical Industry, Pharmacy, Hospitals, Medicaid Managed Care, Claim, Healthcare Information...

Education
City University of New York-Brooklyn College   1982 — 1984
AAS, Medicinal and Pharmaceutical Chemistry, B

Experience
Horizon NJ Health   October 2012 - Present
UnitedHealth Group  May 1996 - April 2011
AmeriChoice of New Jersey, a UnitedHealth Group Company   January 2006 - February 2010
UnitedHealth Group  August 2001 - January 2006

Education
Northcentral University   2013 — 2015
Ed.D., Organizational Leadership

University of Phoenix   2011 — 2013
Masters, Public Administration

University of Phoenix   2008 — 2011
Bachelors of Science, Business

Temple University

Experience
Horizon NJ Health   November 2011 - Present
Horizon NJ Health   April 2007 - November 2011
excelleRx  April 2008 - April 2010
William B. Kessler Memorial Hospital   March 2007 - March 2009
excelleRx  July 2004 - March 2007
CVS Caremark Corporation  August 2004 - December 2004

Skills
Managed Care, Pharmacists, Medicaid, Medication Therapy..., Formulary, Medication Adherence, Pharmacy Benefit..., Pharmacy, Clinical Pharmacy, Immunization, Pharmacy Practice, Healthcare, Medicaid Managed Care, Hospital Pharmacy, Certified Immunizer, Pharmacotherapy, Prior Authorization

Education
Rutgers, The State University of New Jersey-New Brunswick   1998 — 2004
Doctor of Pharmacy, Pharmacy

Experience
Horizon NJ Health   April 2008 - Present

Education
Rutgers University – Camden   2014 — 2016
Master's Degree, Clinical/Medical Social Work

Thomas Edison State College   2012 — 2013
Bachelor's Degree, Psychology with Concentration in Behavior Science, 3.5

Burlington County College   2007 — 2011
AAS Dual Degree, Human Services/Sociology

Experience
Capital Health  December 2013 - Present
Golden Living Center  December 2012 - December 2013
Horizon NJ Health   September 2012 - November 2012
Cybergistics LLC   July 2012 - August 2012
Community Medical Center  June 2012 - July 2012
Healthsouth Rehabilitation Hospital  January 2003 - January 2011

Skills
DRG & APC Assignments, HIPAA Regulations, Insurance Reimbursement, Medicare/Medicaid..., Hospital Information..., Medical, Pharmacology..., Managed Care..., Current HIM Technology, ICD-10 Conversion..., Clinical Data Management

Education
Raritan Valley Community College   2010 — 2012
Associate of Science, Health Information Technology

Saint Petersburg Junior College   1979 — 1982
Associate of Science, Physical Therapist Assistant

point pleasant

Experience
Horizon NJ Health   June 2012 - December 2012
Benedict College  January 2011 - May 2012
Horizon NJ Health   2009 - 2011

Education
Strayer University-Pennsylvania   2012 — 2014
Master of Public Administration (M.P.A.)

Benedict College   2009 — 2012
B.A.

Mercer County Community College   2005 — 2008

Experience
Horizon NJ Health   May 2014 - Present
Horizon NJ Health   May 2005 - May 2014

Skills
Case Management, Customer Service, Healthcare, Process Improvement, Medicaid, Microsoft Office, Health Insurance, Managed Care

Education
Monmouth University   2005 — 2006
Master of Social Work (M.S.W.), children and Family Practice

Kean University   2001 — 2005
Bachelor's Degree in Social Work

Experience
United Healthcare  September 2002 - Present
Horizon NJ Health   September 1995 - July 2002

Education
Rutgers, The State University of New Jersey-New Brunswick   1989 — 1993
Bachelor of Science (BS), Industrial Engineering

Fairleigh Dickinson University

Experience
Briggs Auction/Ellason Antiques   January 2008 - Present
Horizon NJ Health   April 2005 - October 2008

Skills
Antique and Estate..., Antiques, Appraisals, Art History, Auctions, Managed Care, Museums, Home Staging, Fine Art, Curating, Contemporary Art

Education
American University   1979 — 1980
Masters in Public Admin., Urban Affairs, 3.4

Union College   1973 — 1976
B.A., Political Science, 3.25

Experience
TIAA-CREF  April 2005 - Present
Horizon NJ Health   September 2000 - April 2005
CentraState Healthcare System  September 1997 - September 2000

Education
Monmouth University   2000 — 2002
Master of Business Administration (M.B.A.), Business Administration and Management, General

Slippery Rock University of Pennsylvania   1994 — 1997
Bachelor of Science (BS), Health Services Administration

Experience
St. Clares Health System Dover   January 2015 - Present
Horizon NJ Health   April 2014 - November 2014
Horizon NJ Health   April 2013 - April 2014
Nursing Care Inc.   August 2012 - April 2013
Warren Hospital  April 2009 - August 2009
Mount Sinai Beth Israel  September 2007 - February 2008

Skills
Microsoft Office, Microsoft Excel, Customer Service, Leadership, Microsoft Word, Public Speaking, Training, Insurance, PowerPoint, Team Building, Nursing, Cardiac Care, Telemetry, Case Management, Patient Education, Direct Patient Care, Patient Advocacy, Cultural Sensitivity, Nursing Care, Home Care, Private Duty, Managed Care, Pediatrics, Phlebotomy, Healthcare

Education
Phillips Beth Israel School of Nursing   2005 — 2007
Associate's degree, Registered Nursing/Registered Nurse

Experience
Horizon NJ Health   November 2014 - Present

Education
Mercer County Community College
Associate of Science (AS), Registered Nursing/Registered Nurse