Susan Holladay

Experience

• 

  BlueCross BlueShield of SC

  Jul 1992 - Nov 2012

  I was responsible for the effective and efficient control of claims processing and customer service related functions. I developed and executed strategic and operational plans for the department. I directed and managed 125-150 exempt and non-exempt employees. I supported and developed operations management by establishing performance objectives and developing plans designed to strengthen management skills. I reviewed and analyzed business and contract directives to ensure a clear understanding of the requirements. I ensured compliance with all applicable laws, regulations, and contract requirements while meeting performance expectations through the establishment and implementation of effective management controls. I tracked, monitored and analyzed productivity and quality reports to ensure adherence to established contract requirements and to identify areas for continuous improvement. As the project lead for a major federal contract proposal that we won, I wrote and edited strong proposal content and evaluated responses from SMEs to ensure compliance with requirements and mitigate proposal risk. Show less I managed the daily activities of a multi-functional area. I directed and supervised 20-30 FTEs to ensure claims, correspondence and telephone inquiries to maintain contract compliance standards. I was responsible for monitoring productivity, attendance and the quality of work produced. I researched problems and participated as project leader on system changes to reduce payment errors. I managed multiples projects for policy changes, quality improvement initiatives, and system change efforts while ensuring contract policies and procedures were administered timely, consistently and accurately. I assisted with budget preparation and monitored expenses related to the budget. I participated in the design of a multi-million dollar web site that provided self-service for members and providers. I led and participated in multiple contract transition efforts and performed final review for the claims benchmark test to ensure compliance with government regulations. Show less

  • Operations Director

    Jan 2006 - Nov 2012

  • Operations Manager

    Jan 2000 - Jan 2006

  • Provider Relations Representative

    Mar 1999 - Jan 2000

  • Project Coordinator

    Apr 1998 - Mar 1999

  • Claims Associate

    Jan 1993 - Apr 1998

  • Development Clerk

    Jul 1992 - Jan 1993
• 

  BlueCross BlueShield of South Carolina

  Feb 2014 - Feb 2017

  Quality Assurance Manager

  I oversaw the contract operational audits which provide verification of operating procedures and the development of quality control processes to ensure compliance with federal regulations and company requirements. I fostered and maintained excellent working relationships with internal and external customers including federal government agencies. I evaluated and analyzed procedures to develop process improvement recommendations based on quality auditing outcomes. I developed quality assurance plans for new business contracts and proposals. I created and delivered highly effective quality assurance presentations for executives, peers, and partners. Show less

• 

  UnitedHealthcare

  Feb 2017 - now

  I managed digital projects across the enterprise to meet program milestones and aggressive deadlines. I worked collaboratively and independently to plan, coordinate, and execute efforts between various business areas, IT application support groups and segment platforms in an agile environment to ensure the business is operationally ready for digital initiatives. I led, managed, and facilitated project implementation through the duration of the project across all operating platforms and functional domains. I drove analysis and remediation efforts, working with upstream and downstream functional domains. I tracked and monitored project process related procedures to ensure ongoing success in the operation and ensure appropriate modifications to process as required by the business. I identified potential process improvements and promoted best practices and lessons-learned with/for key stakeholders. I conducted process analysis to increase overall performance and consistency across all functional domains. Show less I managed Polaris projects impacting the Cirrus platform directly and indirectly to meet all project and program milestones. I led, managed, and facilitated project implementation through the duration of the project program across all operating platforms and functional domains. I drove analysis and remediation efforts within the Cirrus platform, working with upstream and downstream functional domains. I worked collaboratively to plan, coordinate and execute efforts between various business areas, IT application support groups and segment platforms in an agile environment. I conducted process analysis to increase overall performance and consistency across all functional domains. I demonstrated leadership skills within the team to facilitate achieving goals across the business and the enterprise. I served as a primary resource and subject matter expert related to project efforts. I assisted in the development of training of any required procedures and polices to ensure understanding in project business adjudication requirements across all platforms. I tracked and monitored project process related procedures to ensure ongoing success in the operation and ensure modifications to process as required by the business. Show less

  • Director Business Process

    Mar 2024 - now

  • Associate Director Business Process

    Aug 2021 - Mar 2024

  • Senior Project Manager / Business Process Consultant

    Nov 2018 - Aug 2021

  • Business Project Manager

    Feb 2017 - Nov 2018