Paula Sumner-Walker, MBA, MS

Experience

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  University of Phoenix

  Jan 2004 - Jan 2006

  Enrollment Counselor/Trainer and Mentor

  Enrolled students for MBA/HCM, MHA, MSN, BSN, and BSHA degrees. Provided advisement and support services to students. Ensured retention of students through accurate and quality support. Resolved student conflicts and defused problems by handling situations using exceptional interpersonal communication skills. Trained and developed new and existing students including physicians, clinicians, physician assistants, and nurses for advanced educational studies.

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  UnitedHealthcare

  Apr 2006 - May 2010

  Managed all risk adjustment activity under the direction of Arizona Physicians IPA Medicare Operations and Compliance, ensuring target goals for Health Plan’s risk score impacting Medicare’s revenue by 3,000,000.00 to 4,000,000,00 million in 2008, and 4,000,000.00 million in 2009. Monitored coding and documentation procedures through physician offices, annual chart review audits of PCP and Specialist offices and ongoing risk/adjustment/coding education to our Health plan provider network. Improved and enhanced documentation ad coding, monitoring risk adjustment projects and processes, risk adjustment increased APIPA and Medicare revenue. Managed Compliance activities and projects under the direction of the APIPA Compliance Manager including monitoring and resolving Medicare provider escalated issues, Pharmacy Focus Group for Part D Coverage compliance gap, End-stage renal disease monthly monitoring for reconciliation, and Appeals and Grievances. As a result of these Compliance activities Medicare remained consistent and compliant as a Health plan and with CMS the Center of Medicare and Medicaid Services. Supported Medicare Sales and Marketing department with lead assignments and Medicare new member applications while ensuring timely submission. Medicare Sales and Marketing increased membership through new leads and referrals an average of 600 members a month and ensured applications were timely submitted. Appointed to the APIPA AHCCCS plan Policy Committee to review and format policies for APIPA, Medicare and all other departments. Managed the administration of Medicare PHI data release and supported internal data requests. Worked to maintain HIPPA compliance. Treated every managed care contact with dignity, respect, taking the time to personally build relationships of trust through professional interpersonal communication. Responded to providers within a timely manner and kept them well informed while providing excellence in customer service. Show less Friend of Sahuarita AwardIssued by Sahuarita/Amado School District · Jan 2013I received the Friend of Sahuarita Award for the creation and implementation of the 1st ever Health Fair in Amado, Arizona. This was an extremely successful event in an very small rural community that brought local and community leaders and organizations together including the elementary school and school district, the health center, police and fire department and the company that hosted it under my direction: UnitedHealthCare along with a partnership with Sopori Elementary School. .It was a well attended event and had a recurring event in years that succeeded since it was first implemented by me and the support of Amado, Arizona.Oversaw and managed all community relations activities for two counties: East Maricopa county and Pima County for the healthplan.Oversaw and implemented health presentations throughout East Maricopa county and Pima county.Developed 1st outreach rural event in Amado, Arizona for the healthplan. Show less

  • Risk Adjustment Administrator/Medicare Trainer

    Apr 2008 - May 2010

  • Provider Services Supervisor

    Feb 2008 - Apr 2008

  • Community Relations Territory Manager

    Apr 2006 - Feb 2008
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  Career Success Schools

  Jun 2010 - Jun 2011

  High School Science Teacher and Curriculum Developer

  Developed curriculum for three subject matters: Environmental Science, Earth Science and Green Technology. Instructed High School students, grades 9th through 12th, in Environmental Science, Earth Science and Green Technology. Attended trainings and staff meetings necessary for professional and student development. Organized in-school presentations and field trips for high school students.

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  Avesis

  Aug 2011 - Oct 2011

  Provider Services-Network Management

  Responsible for the delivery of 100% accurate information to AVESIS providers and the communication of detailed information regarding all Avesis lines of business to Avesis providers, perspective providers and Avesis team members. Participated in educational sessions for targeted providers regarding coding, compliance standards, and regulatory changes as needed Participated in the development and implementation of provider retention programs and education tools Assisted in the development of provider web portal materials Assisted with the development of internal department Policies & Procedures to support educational sessions with providers Incoming and outgoing calls as needed for position. Acted as liaison between contracted providers and various departments within Avesis. Quickly and efficiently resolved provider issues communicate seeking assistance from Provider Services Team Lead and Director, Network Management where needed Show less

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  Walden University

  Nov 2011 - now

  Director Choice award recipient, Feb 2025Manager Award: The Mover & Shaker Award recipient, Feb 2024Pillar of Excellent Award nominee in 2024 and 2025Consistently high metric performer across the College of Nursing department and SSA department. Highest registration rate, and cohort early contact rate, reaching all of my students quarter by quarter.I was promoted to Senior Student Success Advisor effective September 18, 2023. I am an Academic Advisor for our master-level nursing students pursuing nurse practitioner degrees and post-master's certificate degree program. I advise new students and existing students on completing degree requirements. I work consistently with over 600 students to inform, support, and assist students with academic and university policies and procedures, while also advising, registering, and supporting students from other advisors as well..Back up manager support when the manager is out of office for our team.Point of contact for our team for answering questions, concerns, assisting with students appointments.Appointed Change Champion and point of expertise for our Salesforce Consolidation product launch for our teamPeer mentor and trainer for our new Student Success Advisors and employees under the direction of the Global Operations and Training department. Support our product development manager on feedback and recommendations on the online university portal revampment.Writer and contributor for our Walden University Student Success Advising newsletter. Show less 2022 Pillar of Excellent Award Nominee Recipient Feb 2022I am an Academic Advisor for our master, doctoral, and Ph.D. nursing students and advise new students and existing students on completing degree requirements. I regularly work closely with over 600 students to inform, support, and assist students with academic and university policies and procedures.I have been awarded the Student Success Advising Cap Puzzle Award for achieving five of the five total pillar employee recognition awards and categories for my role as an academic advisor and my professional impact on the student experience.I am appointed to the Walden University PASS Lab Student Services operations committee under the direction of the Director of Operations, Student Success Advising.I was appointed to be on the Walden University Solutions Center, an inter-department department consisting of Financial Aid, Financial Account Management, and Student Success Advising to review and provide academic and financial implications for any student course and university withdrawal.I am currently working or have worked on the following university committees: Rapid Response Onboarding as the College of Nursing Lead, Social Events committee as a social co-chair, Diversity and Inclusion committee as a committee member appointed by VP, Dr. Denise Boston, and the scholarly review committee as a scholarship committee reviewer.I am a new hire trainer and curriculum developer under the direction of the Global Operations and Training department. I work daily with all university departments for students' success and experience at Walden University. Including the customer care support team, financial aid, finance, field experience, residency, alumni services, career services department.I am a contributing writer for our Walden University Student Success Advising newsletter. Show less

  • Senior Student Success Advisor

    Sept 2023 - now

  • Student Success Advisor

    Nov 2011 - Sept 2023