Joann Peck

About Joann Peck

Dedicated, effective leader with extensive experience in the health care environment and expertise in operations management, provider relations management, provider communications and education management, member and account services management, project/program management and vendor management/contracting. Proven success in relationship management, leading and developing staff, and collaborating with organizational senior leaders, providers, customers and internal/external business partners to achieve defined departmental and corporate goals that exceed performance expectations.

Experience

1. Senior Manager, Medicare Advantage Operations

   Harvard Pilgrim Health Care

   May 2018 — Present · Canton, MA, US

   Manage team of Operations Specialists, Claims and Provider Appeals Analysts, with oversight responsibility for escalated provider claims issue resolution, provider appeals management, vendor management and internal, cross-functional operational projects- Oversee the daily management of other Operations Support functions such as Ika claims system role management, high dollar claim reviews, provider termination notices to members, Corrective Action Plan (CAP) tasks and other operations support activities- Manage cross functional Claims Issues Resolution Workteam and the Harvard Pilgrim/Beacon Claims Configuration Workgroup, and provide management support for the Beacon Joint Operating Committee and the Medicare Advantage Operations Committee- Provide technical support, direction and guidance to ensure delivery of compliant operations, with a focus on continuous improvement, efficiency and constituent satisfaction- Lead implementation of new product, regulatory and process improvement initiatives in accordance with budget and target time frames- Investigate and facilitate resolution of broad, high impact claims issues identified by internal and external stakeholders- Plan and prioritize work plans to ensure completion of Medicare Advantage Operations business processes and reporting.

Education

• University of Connecticut

  BS, Psychology

  1986 — 1989

• Boston College

  Graduate Program Certificate, "Leadership for Change"; Sociology and Business

  2000 — 2001

• University of Pennsylvania

  Mathematics

  1984 — 1986

Skills

• Leadership
• Employee Benefits
• External Communication
• Management
• Team Building
• Program Management
• Hipaa
• Budgets
• Healthcare Industry
• Provider Relations
• Health Insurance
• Project Planning
• Managed Care
• Communication Strategy
• Process Improvement
• Policy
• Healthcare
• Business Analysis
• Project Management
• Social Networking
• Business Process Improvement
• Customer Service
• Vendor Management
• Insurance
• Communication
• Cross-Functional Team Leadership
• Public Relations
• Strategy
• Editing Newsletters
• Healthcare Management
• Strategic Communications
• Training
• Newsletters
• Performance Management
• Software Documentation