Brooke Radebach, MBA

Experience

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  Community Care Plan

  Jan 2001 - Jan 2003

  Member Eligibility Specialist

  Process monthly eligibility and remittance files received from the State of Michigan.Reconcile monthly remittance files received from the State of Michigan.Investigate and resolve complex member related issues as they arise.Creation and maintenance of all policies and procedures related to member eligibility.Attend meetings in Lansing to gain insight and knowledge about the upcoming changes in Medicaid. Work to have improvements for plan updated at the state level.Creation of tools to be used by the team in order to help them understand and apply eligibility processes and procedures.Act as an expert on member eligibility and the Medicaid system. Show less

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  Spectrum Health

  May 2003 - Dec 2003

  Strategic Regulatory Specialist

  Compile necessary documentation required for submission of Certificate of Need (CON) applications.Following CON regulations, complete CON applications and file with the State of Michigan in a timely manner.Organize and lead meetings with internal and external customers. Lead discussion focused on the items needed for the submission of CON applications.Attend meetings in Lansing concerning CON regulations and policy.Become an expert for Spectrum Health on CON regulations and CON policies and procedures. Educate other departments on the CON regulations and how it is applied to projects subject to CON approval.Gather and maintain financial information received for CON projects and maintain as project evolves. Show less

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  Priority Health

  Dec 2003 - Jun 2022

  Provides operational supervision over assigned wellness staff and wellness programs and services delivered to Priority Health Employer groups. Working with staff, the position will oversee, supervise and assist in services targeted to employer groups and Priority Health members as a part of our wellness product line to ensure products are standardized, processes are documented and adhered to, assist in addressing customer service issues, and prioritize client needs and department workload. This position also serves as an active member of Priority Health's Wellness Team by participating as appropriate in strategy sessions, department planning, project management and new product development. Will support the efforts of Priority Health in reaching its accreditation goals and quality standards through participation on internal work teams and other duties as assigned. Show less Develop HTML prototypes and work with the wellness team to ensure they are usable and functional. Work with the wellness team to productionalize HTML prototypes and online applications. Act as a liaison between Priority Health and health risk appraisal vendor to create and refine employer groups’ and/or individual wellness web experience. Create wellness portals for employer groups/individual. Identify and resolve problems and issues.Create and maintain file uploads. Develop reports and ad hoc queries. Assist with the development and maintenance of ad hoc applications.Process weekly override requests for physical exams and condition management. Update and close Facets inquires working closely Customer Service and Wellness Account Representatives to ensure members receive credit.Create policies, procedures, timelines and process flows to assist with product implementation and conduct training on these tools as needed. Helps define, build and implement new wellness service line and related PH products. Act as liaison between the sales team, wellness team and customer service. Assist with defining product/project scope needs, identifying resources needed and coordinating key stakeholders.Provides technical assistance to wellness and other Priority Health departments on wellness web tools and functionality. Communicate and work well with external customers, alone with Wellness staff and Sales partners. Show less Ensure successful implementation of wellness products and services.Support the delivery of and increase the participation in wellness products and services with employer groups and members resulting in an exceptional customer service.Serve as the internal point person to capture wellness related operational issues, conduct investigation and provide resolution.Assist with defining product/project scope needs, identifying resources needed and coordinating key stakeholders.Draft and approve business requirements conduct testing and act as liaison between wellness and IT.Assist with developing sales and marketing materials.Develop reports and perform ad hoc queries. Define, build and support new product development, wellness operational processes, operational/CRM tracking tools and turn-key report generation. Lead and coordinate all internal Priority Health functions regarding employer launch Act as a liaison between various internal Priority Health departments.Provide technical support/coordination of wellness client/member communications.Leads integration of wellness with Priority Health systems, including 2009 launch of new Wellness Web Experience with Web MD.Lead and coordinate all third party relationships to ensure a success product implementation.Provide oversight and guidance for Wellness Web Implementation Assistant. Show less Efficiently and accurately respond to telephone inquiries from agents, employer groups, members and other departments.Efficiently and accurately respond to billing and eligibility questions and concerns as presented from walk-in customers.Become and expert on and provide education to customers on eligibility requirements, COBRA, HIPAA regulations, premium billing and payment inquiries.Assist agents, employer groups and other departments with administrative issues, such as submitting enrollments, enrollment record changes, providing access to necessary services, receiving payments and submitting group and member level terminations.Quote group rates to employer groups when necessary.Process enrollment and change forms received from employer groups within a timely fashion.Account Representative responsible for maintaining enrollment information for employer groups offering HRA and HSA accounts. Show less

  • Manager, Wellness Analytics and Operations

    May 2014 - Jun 2022

  • Supervisor, Wellness Analytics & Operations

    May 2013 - May 2014

  • Lead, Wellness Operations Specialist

    Oct 2012 - May 2013

  • Wellness Implementation Specialist

    Oct 2007 - Sept 2012

  • Enrollment Specialist/Billing and Enrollment Phone Representative

    Dec 2003 - Oct 2007
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  Spring Health

  Jun 2022 - May 2024

  Customer Success Operations Manager
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  Ferris State University

  Oct 2024 - now

  Clinic Operations Manager