Griselda Priest

Background

About Griselda Priest

Healthcare and Customer Service: Over 20 years of Manage Care Healthcare experience including Medicaid & Medicare, Claims, Provider Data, Pharmacy, Call Center, Quality Assurance, and Enrollment. Project Management: 10+ years of IT and Ops Project Management experience with outstanding organization skills, ability to multitask and prioritize tasks. Utilize project management tools to monitor system scope and project objectives, as well as the role & function of each project team member or functional area. Partner with business stakeholders to make decisions regarding resource alignment/dedication and prioritization people resources, dollars/funding, project criticality. Business System Analysis: Over 15 years of business analysis experience and working knowledge of managed care systems, and customer applications*. Make technical and functional business recommendations based on evolving technologies and evolving application trends to include infrastructure and software. In addition to create detailed business requirements documents, process flow documentation and software functional design. Develop crucial functional requirement specifications, creating detailed use cases and process flow diagrams to support functional specifications. Process Improvement: Work closely with the Business and IT to identify areas of improvement and standardized best practices. Document as-is and to-be processes for various departments using Vision flows. Successfully implemented and/or participated in the following process improvement initiatives for Anthem’s National Call Center: Quality Assurance Incentive Program, New Hire Teleworker, and Member Privacy Unit Optimization, which resulted in saving the NCC approximately 3 minutes per member grievance calls. Recommended and implemented following process improvement initiatives as an Account Manager for Amerigroup/Anthem: Ohio State Provider File. Regulatory Reporting. As a result, State sanctions were reduced by 30%.