1/18/12
To Whom It May Concern:
I am writing to express my interest for Public Administration positions. I am very interested in positions with an organization.
I have recently completed my Masters of Public Administration (MPA): Health Service Administrator. I am currently a Managed Care Coordinator in the Department of Chronic Care Program under the Division of Health Care Management for Horizon Blue Cross Blue Shield of New Jersey. I believe my strong academic background, personal initiative and work experience would be an asset.
I am attracted to because it is a fast growing innovative organization that directly relates to my career objectives, which are to provide quality service and to support the mission of a growing organization. I am particularly familiar with the strategic goals and objectives that your organization is undertaking. I am prepared to work diligently to achieve and excel corporation expectations.
I appreciate your time and consideration. I look forward to speaking with you. Enclosed is my resume for your review.
Sincerely,
Enjoli T. Davis
To obtain a stimulating position in the Health Service Administration sector where skills from my academic and work experience will be challenged daily.
Summary of Qualifications:
10 years of Community/ Public Health Service
10 years of exceptional Customer Service and telephonic skills
10 years Presentation skills i.e. PowerPoint
10 years research and analytical skills
10 years office/ administrative experience
5 years experience working with Managed Care Products i.e. Medicare, HMO, PPO/ Direct Access, POS
Computer Proficient in Microsoft Word, Excel, Access, Visio, Lotus Notes
Proficient in Strategic Plans and Grant Proposals
Hard working, able to multi- task efficiently and make sound decisions.
Project Management skills
Strong interpersonal skills with both adults and youth,
Excellent communication, training and leadership skills.
Education
Kean University, Union, NJ (2011)
Masters of Public Administration (MPA): Health Services Administrator
Delaware State University Dover, DE (2007)
Bachelor of Science-Community Health
Professional Experience
Managed Care Coordinator- Medicare, Fully Insured
Horizon Blue Cross Blue Shield NJ, Newark, NJ 9/2007-Present
• Act as a liaison between Registered Nurses and Horizon Chronic Care Program members enforcing behavioral modifications to decrease fluctuations in hospitalizations and emergency room visits
• Handle Chronic Care Program members with any of the nine chronic conditions; ESRD/ CKD, MS, Hepatitis C, COPD, Heart Failure, Diabetes, CAD, Asthma, Weight Management
• Promote & encourage Chronic Care Program to members to make behavioral modifications of their overall health
• Assist staff in developing their decision making skills, and provide guidance when staff are faced with complex issues
• Generate Clear Quest Requests for Care Planner Web additions required for the CCP (i.e. Requesting Signatures of newly hired employees, generating requests for access of CPW system for newly hired employees in Chronic Care Program
• Generate CMS Guidelines, submissions for the approval of BCBSNJ Medicare population of Chronic Care Program (i.e. modifications and updates of letters, brochures, postcards) to be distributed via mail to Horizon BCBSNJ Chronic Care Program Medicare members
• Generate Encoda requests for Horizon BCBSNJ members of the Chronic Care Program(i.e. mailings of postcards, brochures) to receive on a quarterly basis about CCP
• Generate Communication Database request for Horizon BCBSNJ members and physicians of Chronic Care Program (i.e. mass mailing of letters, postcards, flyers)
• Ascertain clinical data for HEDIS Measures of all members in Chronic Care Program from doctors/ patients which determines how efficient the program is with decreasing percentage of hospitalizations
• Generate Case Issues for Chronic Care Program referrals for current CCP members referred to Registered Dieticians from Registered Nurses, Case Managers
• Allocate VRI Hometelemonitoring alerts received from prior dates of patients currently in Chronic Care Program among Registered Nurses
• Communicate with providers/ facilities to obtain patient/members of Chronic Care Program medical records
• Enter Health Risk Assessments received from Chronic Care Program members of Medicare, Fully Insured, SHBP, National accounts into case within Care Planner Web
• Handle and administer Fully Insured, Medicare case records of Chronic Care Program members among Nursing/ Case Managers
• Daily conforming with HIPAA Policies & Procedures, Members Rights & Regulations, Healthcare fraud
Participated in Special Projects:
• SNP (Special Needs Program) Medicare Program: Generate Case Issues for Chronic Care Program referrals for current Horizon Blue Cross Blue Shield members referred to Registered Nurses, Case Managers to enforce behavioral modifications to decrease fluctuations in hospitalizations and emergency room visits
• Designed, developed and executed workflows for newly hired Managed Care Coordinators (MCC’s) working in Chronic Care Program and its Mail Center.
• VRI Home Telemonitoring Project: engaged and administered members in Chronic Ca...
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