5500 Columbia Pike* Arlington, Virginia 22204 * (312) 237-0179
SUMMARY: * Successful management of cross functional teams exceeding organizational objec tives * Exceptional experience using analytical techniques in response to operational issues * Extensive background in managing, monitoring, implementing short and long term action items, and strategic plans involving organizational activities * Strong interpersonal skills interfacing with senior level executives and key s takeholders to complete projects * Competent liaison/ subject matter expert for complex project initiatives and p rograms * Highly proficient at identifying areas for improvement, recommending needed re solutions, and preparing comprehensive reports on findings * Proven ability using diverse analysis: monitoring, auditing, surveys, and data collection to meet key management and administrative objectives * Excellent ability to understand, interpret, and summarize complex business or legislative/regulatory requirements EDUCATION: Troy University- Master of Science in Management (July 2010) University of Illinois at Chicago- Bachelor of Arts Degree, 2000 EXPERIENCE: Consultant, Contract Specialist Glenridge Healthcare Solutions. Elkridge, Maryland June 2009-present Responsible for implementing programs to build and nurture positive relationship s between the health plan, providers, and practice managers. Identify gaps in ne twork, negotiate fee schedules, and assist with contracting needs based on colle cting and analyzing aggregate data. * Maintain and monitor monthly client list of 85 providers with a contractual c onversion rate of 83%. Average team conversion 75% State Relations Manager, Regulatory Affairs WellCare Health Plans, Inc., Tampa, Florida March 2008- May 2009 Facilitated policy regulation awareness program for Managed Care Plans and Presc ription Drugs Plans; interacting with market leadership and community/national o rganizations. Coordinated with key matrix partners (Provider Relations, Client S ervices, Business Development, Compliance, etc.) to develop key messages and act ion plans related to state advocacy and congressional feedback. Coordinated and managed state regulatory meeting itineraries, approach, and presentation: influe ncing outcomes. * Identified and developed over 150 viable partnering opportunities to ensure a wareness and training of beneficiary enrollment/satisfaction programs * Developed current education and regulation focused presentations, training ma terials, and dashboard reports for internal employees, regulatory officials, and congressional staffs * Researched and successfully mitigated over 25 complex consumer escalated issu es a month from state officials including congressional agency staff and insuran ce regulators. 95% resolution rate. * Established effective internal policies and procedures to ensure compliance w ith state contracts, financial, data/ record management, and legal standards for programs representing over 10% of member enrollment Nicole Ball Page Two Senior Manager, Compliance and Operations Kaplan Professional, Chicago, Illinois October 2002- March 2008 Promoted to Senior Manager. Managed Kaplan Professional online educational produ ct inventory including instructional materials, courses, and compliance services for B to B and B to C markets. Prepared financial reports and managed P&L. Ensu red electronic and print programs meet state compliance requirements. Supervised staff in audits, research, student admissions, operations, program accreditatio n, and policy administration. Oversaw compliance system integrations to automate and streamline information access . Traveled to agencies and regulatory boards to present course material and content for approval. Worked with cross functiona l teams to identify needs, determine feasibility of projects and make recommenda tions. * Served as Administrator for the compliance implementation of a 1 million doll ar platform initiative * Provided product development and IT with required business requirements recei ving 95% accreditation rating * Supported 200 online data management programs while increasing program capaci ty by 50% within third year, accounting for 75% of department's 30 million dolla r annual revenue * Facilitated and supported an increase in enrollment of B to C market by 45% Compliance Manager ( Kaplan Professional, 2003-2006 ) Promoted to Compliance Manager. Supervised compliance staff in the management of more than 200 education lines. Reviewed projects, made assignments, and monitor ed work through completion. Served as company representative at state commission meetings and industry events to gain a thorough understanding of policy changes to ensure compliance of company's products. * Received annual Outstanding Achievement Awards Senior Compliance Analyst ( Kaplan Professional, 2002-2003 ) Identified customer needs, completed research and gained regulatory approval res ulting in the addition of 75 new programs in 2003 Research Analyst Bacon's Information, Chicago, Illinois 2001-2002 Identified sources of information and integrated sources into existing source pr ofiles. Created and edited calendar profiles for advertising clients. Created da tabases of more than 1,000 media sources. Contract Data Researcher Northwestern University, Chicago, Illinois 1999- 2001 Conducted healthcare improvement study, collected personal, dietary and anthropo metrical information through interviews and compiled data for nutritional study. TECHNICAL: Excel, Word, PowerPoint, Clientele, State Net, LexisNexis, Oracle CERTIFICATIONS: Project Management Professional (PMP) Certification ( September 2010 ) American Management Association - Leadership Training TRAVEL: Very willing to relocate and travel