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DEBRA L. WHITE6221 Turpin St – Murray, UT 84107
801-889-7364 – [email protected]
PROCESS IMPROVEMENT, INNOVATION & COST SAVINGSConsistently Successful in Driving Process Improvement, Analyzing, Project Implementation, Innovation and Cost Savings
Director Experience and Qualifications — 12-year career demonstrates steady, upward progression and success in maintaining robust cost stewardship measurements and implementing world class activities in Claims Cost Stewardship. Proven to be effective in analyzing, modeling, financial discipline, and project implementation. Driven performer with excellent problem solving skills, idea generation, innovation and process improvement. Successful in sourcing, contracting and implementation of new vendors.
QUALIFICATIONS & EXPERTISE
Data Analytics and validationData modeling
Advanced Knowledge in Microsoft Word, Excel, Access, Outlook, PowerPoint, etc.
Advanced Project Management Business Process Reengineering & ImprovementTraining Material Development Regional Team LeadershipAuditing Methodologies EDI management
SQL
PROFESSIONAL EXPERIENCE & REPRESENTATIVE CONTRIBUTIONS
The Regence Group • Salt Lake City, UT September 2002 – PresentManager – Resource and Development 2013 – PresentLead a team to see multiple projects through from inception to completion. Identify corporate costs / savings through analyzing health care data. Implement regular audits and offer refresher and new hire training. Provide backup, support and input to Director of Claims Cost Stewardship and Vice President of Claims as needed. Create, maintain and present Claims Cost Stewardship performance reporting status at various departmental and executive level meetings.
Identify, Establish and Maintain Claim Cost Stewardship Savings. Identify savings opportunities, establish savings ROIs and maintain/see to the projects implementation and completion. Coordinated with Corporate Strategic Finance to develop and maintain value added AIP result tracking measures.
• Result: Provided Leadership to drive a 5X return on Tier I AIP goal. My team was the largest single contributor to Tier I success, driving more than one third of Tier I savings/recoveries ($9.5M)
Increased Capacity. Partnered with IT to analyze data flows for MSP and non-MSP to increase capacity for unstaffed work.• Result: Increased capacity and reduced the non-value added work being reviewed by 50%
Analyze Vendor Findings for Cost Savings Opportunities. Created and implemented ongoing reports to capture identified areas of weaknesses and gaps.• Result: Lead prevention and control team to a realized savings of $1.2M today and still identifying and implementing more reports on
an ongoing basis. Working towards automation of the current reports.
Implement Departmental Audits and Trainings. Lead my team in creating and implementing a quality assurance function and trainings to drive baseline improvement.• Result: Improved baseline by 1.5% overall
Strategic Consultant – Claims Cost Stewardship 2013 – 2013See multiple projects through from inception to completion. Identify corporate costs / savings through analyzing health care data. Duties remained the same as the Quality Analyst, but reporting change to Claims from Finance.Quality Analyst – Cost Stewardship 2011 – 2013 See multiple projects through from inception to completion. Identify corporate costs / savings through analyzing health care data.
DEBRA L. WHITE [email protected] 801-309-8760 Analyze Claims Data for Cost Savings Opportunities. Improved COB identification process and uncovered around ~$8M of lost opportunities.• Result: Lead COB teams to a realized savings of $1.1M to date and still in the process of recovering more
Improved Monthly Operations Reporting. Took a manual process and automated it, reducing the process time from ~40 hours per month to ~2 hours per month• Result: Saving ~468 hours and ~$13K annually
Business Consultant II 2009 – 2011 See multiple projects through from inception to completion. Key member of Provider Services reporting to the manager of Health Care Services. Identify corporate and local state costs savings through analyzing health care data.
Analyze Claims Data for Cost Savings Opportunities. Modeled claims data for various employer groups against Regence’s different networks• Result: Indentified cost savings opportunities for various employer groups and Regence totaling $1.5 million.
Review and Research issues. Identify and created remediation plans to resolve root causes of major issues• Result: Identified the root causes of EDI issues saving over $500K a year
Analyze Claims Data Submitted by Third Party Vendors. Reviewed current cost of using a third party vendor to contract with our chiropractor providers instead of contracting with the chiropractors directly• Result: Terminated contract with third party vendor and contracted directly with Chiropractors, saving Regence over $300K in
administrative costs and over $360K is claims cost
Performance Integrity Analyst III 2005 – 2009 Develop auditing methodologies and pull statistically valid audit samples. Audit the quality control of business and individual setup for health insurance information entered into the system. Involved in quality improvement processes.
Create Quality Improvement Processes by analyzing and identifying current areas of high audit findings• Result: Identified areas for improvement and individually work with the Membership department on these areas. This increased
Regence’s Member Touchpoint Measure (MTM) scores for Utah by 50%.
Membership Administrator II March 2004 – December 2005 Reconciled and maintained eligibility of large and small group accounts with additional coordination through electronic medium. Developed great customer account relationships. Balanced cash transmittals with Finance monthly.
Develop Distinquished Customer Relationships by working one on one with our larger group accounts reconciling their monthly premium bills, eligibility maintenance, and assisting them with various other needs on request.• Result: Retention rate of larger group accounts improved by 25% thus maintaining good company revenue.
FEP Claims Analyst 2002 – 2004 Identify areas for process improvement. Process and adjust various types of claims
Improved Operations by creating a mail merge file for overpayment and credit letters• Result: Reduced the amount of administrator hours by 13% that was spent on sending overpayment and credit letters to
patients and providers all while tracking who the letters were sent to.
EDUCATION
Bachelor of Science (BS), Accounting – University of Phoenix, Salt Lake City, UT 2011Project Management Excellence Certificate – University of Utah, Salt Lake City, UT 2011Leadership and Management Certificate – University of Utah, Salt Lake City, UT 2011
