JESSICA A.

LEE 4004 Hope Court Louisville, KY 40220

Jalee008@gmail.com • (727) 644-6327
M.S.Ed.• Business Professional • Pi Lambda Theta
SUMMARY
Results driven individual who specializes in fast-paced, multi-tasking environment. Proven ability to lead others and assign tasks to fellow employees
to ensure goals are met Expert user of Microsoft Office systems including Excel, Access, Word, and PowerPoint. Experienced creator and developer
of curriculum using TedEd platform, Adobe Captivate, and interpretation of analytics using Human Performance Technology. Strong background in
presenting and communicating information in a training environment. Effective communicator and motivator of united and helpful work
environments

EDUCATION
Indiana University, Bloomington, IN May 2019
Master of Science in Education- Adult Education
Indiana University Southeast, New Albany, IN May 2016
Bachelor of Science in Business - Human Resources Management, Minor: Economics Minor: Psychology

PROFESSIONAL EXPERIENCE
Humana Pharmacy Solutions, Louisville, KY August 2018-present
Senior Pharmacy Contracting Professional
 Business owner for all testing initiatives for Pharmacy networks and pricing projects working collaboratively on cross-functional project
teams across organization
 Recipient of STAR award for contributions to contracting processing through creation of relational databases that greatly improved team
processes and efficiency
 Responsible for maintenance of claims pricing tables, monitoring, and enhancing processes and claims adjudication logic as it pertains to
general pharmacy point of sale claims
 Greatly expanded testing capacities for Pharmacy Networks through partnership with Cognizant and expansion of full regression suite.
 Responsible for identifying impact on department processes and ensuring appropriate project requirements are created as well as testing
projects end to end
 Reviewing pharmacy claims for trends, anomalies, and providing process improvement solutions to leadership to create more efficient and
error-free plan administration processes.

Business Analyst September 2017-August 2018

 Analyzed data with a proven ability to synthesize quantitative results, derive business implications and make clear recommendations
 Completed routine and moderately complex data analysis (including data retrieval and report creation), provide regularly scheduled
reporting and communicate meaningful results to leadership
 Creation of Access relational databases and SQL queries to manipulate pharmacy contracting data and detect trends and develop strategy
to support contracting initiatives
 Responsible for providing ad-hoc data requests for claims utilization, network integrity, loading network rates and maintaining data for
over 65,000 pharmacies in accordance with their contracted rates.

Grievance and Appeals Specialist May 2016-September 2017

 Recipient of Life Saver award for consistently assisting Expedited Team members and contributing to team performance and morale
 Reviewed and compiled documentation to support Medicare Prescription Drug Plan member and provider appeals and communicate
determination to appellants
 Assisted leadership in researching cases to determine root cause of case going out of compliance and find resolution to issues
 Piloted new process changes and provide feedback to leadership to optimize results
 Maintained 100% compliance with CMS guidelines and 97.5% quality for PDP plan cases

American Commercial Barge Line, Jeffersonville, IN August 2015-April 2016

Human Resources Intern – Benefits Administration
• Delivered weekly benefits presentation to new team members as part of orientation and assisted with completion of enrollment in benefits
through enrollment platform in person or over the phone
• Performed audits of payroll deductions, file and process benefits election appeals, build and run reports in ADP and OBA Reporting, and
complete correspondence by composing mail merged letters and emails
• Processed benefit terminations by using necessary reports through ADP and Excel and communicated with ADP to enroll terminated
employees into COBRA coverage
• Assisted in transition of acquisition of company with 1,100 new team members through completion of enrollment in benefits while
concurrently completing Annual Enrollment for 2,800 current team members
• Assisted in mass interview events, administer reading tests, and is involved in hiring decision process

REFERENCES Available upon request