Allen Buice

Experience

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  Capital One

  Jun 2005 - Aug 2006

  Business Analyst

  I led teams within the Capital One Corporate Risk Office to identify operational and IT related business risks. I led collaborative endeavors to develop and implement risk mitigation strategies for corporate technology, internal procedures and other areas. Worked with a team of business and data analysts in auditing and managing internal and external vendor contracts for the Corporate Technology Office.

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  Lovelace Health Plan

  Jan 2006 - Jun 2009

  Provider Contract Manager

  I managed and audited provider contract data and rate schedules for commercial, Medicare/Medicaid, and other health insurance lines of business. I did training for incoming claims and provider relations staff members. I worked daily with provider representatives, claims specialists, provider credentialing staff, finance, and other business processes and owners throughout the organization to resolve issues and conflicts.

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  HealthInsight

  Jul 2009 - May 2018

  Project Manager

  I led full-scale quality of care and regulatory compliance audits of Medicaid Managed Care organizations and providers in New Mexico and Oregon. I developed extensive procedures for reporting complex health data and analysis to these respective states on data and audit findings. I worked collaboratively with counterparts at MCOs to do quality improvement efforts. Attend state and federal level advisory meetings for the Medicaid program. I wrote reports for public consumption on audit findings and recommendations. Show less

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  Presbyterian Health Plan

  May 2018 - now

  Senior Program Manager

  I am responsible for overseeing implementations of health insurance related programs across multiple lines of business. I am an expert in provider network operations, health plan operations, regulatory and contractual compliance, and health plan governance. I work with staff from front line employees to C-suite executives to successfully manage projects' scope, schedule, and budget.