At Centene Corporation, I directed provider data and operations supporting Florida Medicaid and Marketplace products, overseeing a 205-person organization and a $7M departmental budget. I implemented an enterprise data validation and control program that reduced provider data errors below 2%.
I also strengthened inventory management and reduced backlogs, preventing more than $600K in potential AHCA regulatory fines. I served as executive liaison for AHCA audits and corrective action plans, using SQL, Excel, and KPI reporting to identify issues and support remediation.
Earlier, at CVS HEALTH / AETNA, I managed provider relations and claims escalations, configured QNXT provider data tables, and implemented CAQH ProView for Groups. At APWU HEALTH PLAN, I reduced pended claim inventory by 33% and spearheaded a nine-month QNXT core administration system implementation.
