Brooke Ozee
Bourbonnais
Summary
Achieved seamless coordination between network operations and health plans, enhancing overall service quality. Drove strategic engagement with directors, managers, and analysts to streamline health plan network processes. Delivered impactful support to ensure effective operations across multiple teams.
Overview
6
6
years of professional experience
Work History
Provider Data Services, SR Analyst, Project Manager
Aetna/CVS Health
09.2024 - Current
- Provider Data Services, SR Analyst, Project Manager
- - Increase focus on improving provider data accuracy which will improve Directories
- - Meet established Production and Quality Metrics for function and/or business unit
- - Lead Multi-touch reduction and Rework Initiatives
- - Reduce rework volume by improving initial quality
- - Put into effect/action HeartAtWork behaviors in daily activities.
- - Reduce rework cases/issues
- - Improve revised One Touch Resolution 92-93% (QNXT, end to end processes, Shared Mailboxes, etc.)
- - Put into effect/action HeartAtWork behaviors in daily activities
- - Continue to remove silos and roadblocks to create an end-to-end processes that obsesses on the Provider Experience and promotes development
- - Evaluate opportunities to further align roles and reduce handoffs within Cred, Provider Data and Contract Ops
- - Focus on development utilizing Learning Center, mentorship, shadowing, Lunch and Learn sessions, etc.
- - Colleague engagement in survey participation
- - Cross-functional engagement
- - Participation and engagement in team huddles, townhalls and workgroups.
- - Participate in cross training activities across functions and teams.
- - Increased HAW engagement by liking and sending recognitions.
- Utilize current tools such as member look-up tool, drill tool, term drill tool etc.
- - Support system enhancements and automation workgroups
- - BLERG Tool ran for reworks- created Coaching Records for Analysts to rework errors and coaching completed by Managers.
- - PCR Template-revamp for Standardization
- - Support L&P with new hire training.
- - Onboarding of new vendor, Sutherland
- Performing daily Audits on Completed Cases- providing feedback to Sutherland Trainers
- - SKIP level interview September 2025 with Jen Cross.
Provider Data Services Admin- MPOS -Market Liaison (VA, NJ, MD & NY)
Aetna/CVS Health
10.2022 - Current
- Identify issues and communicate with all impacted to provide resolution.
- Work collectively with Network Ops and Health Plans
- Identify/address any internal performance issues / educational opportunities internally, prior to Network Ops and Health Plan involvement
- Partners with Health Plan, builds a repour and confidence.
- Shortens turn-around-time related to issue resolution (not waiting on HP response)
- Prevents rework
- Market liaisons do not currently have a production requirement but are responsible for timely engagement and resolution of escalated issues. And are also monitored on their ability to handle assignments promptly.
- Attend regular meetings for the State/Health Plan they are assigned to.
- Conduct regular meetings with network and/or state health plan team.
- Compiling and sharing state specific Inventory reports by state and region for the entire MPOS team
- Intaking and reviewing escalated requests for entire MPOS org, ensuring issue resolution, and communicating outcomes in a timely manner. Prioritizing issues as required.
- Support and maintain state market rules for all MPOS and communicate changes to all MPOS teams.
- Be the SME and POC for provider data clean-up for assigned states
- Cascade any issues or trends occurring within their regions and/or states and report those back to MPOS management.
- If any state specific requirements are not captured within the PCR and repeated issues occur, the Liaison will be the point of contact for engagement with Network Ops and Health Plan for overall resolution
- Any state specific needs for Pends the Pend Lead will work closely with the Liaison to gain accurate data required, while the Liaison takes the lead in identifying root cause and engages Network Ops and Health Plan if needed.
- Upkeep Market Lead and Manager Teams Q&A Assignment (monthly)
- Very detail Oriented
- Provide thorough research and extensive analytical skills.
Provider Data Services Admin- Market Lead (VA, NJ & MD)
Aetna/CVS Health
08.2021 - 10.2022
Claims research Specialist, G&A Contracting
Aetna/CVS Health
02.2020 - 08.2021
Timeline
Provider Data Services, SR Analyst, Project Manager
Aetna/CVS Health
09.2024 - Current
Provider Data Services Admin- MPOS -Market Liaison (VA, NJ, MD & NY)
Aetna/CVS Health
10.2022 - Current
Provider Data Services Admin- Market Lead (VA, NJ & MD)
Aetna/CVS Health
08.2021 - 10.2022
Claims research Specialist, G&A Contracting
Aetna/CVS Health
02.2020 - 08.2021