847.612.3976 | nina.naples15@gmail.

com

NINA NAPLES

Agile professional, linear thinker, and fearless problem solver who drives changes to advance cross PROGRAM DEVELOPMENT
functional collaboration and data integrity. Draws from years of experience as a health care business PROCESS IMPROVEMENT
consultant to develop unique programs based on quality and cost data to enhance member experience. BUSINESS OPERATIONS
Creates connections at all levels of the organization. A lifelong learner who embraces challenge and BUSINESS ANALYSIS
COMMUNICATIONS
creativity.

CAREER EXPERIENCE
BLUE CROSS BLUE SHIELD ASSOCIATION, Chicago, IL 2015-Present
Commercial Markets: National Program Development Senior Consultant October 2018-Present
 Manage the facility portion of the Blue Cross Blue Shield Flexible Network program to ensure accuracy of the data by researching and
solving any inconsistencies found.
 Work directly with external vendors in the creation of the reports sent to the Blue Cross Blue Shield Plans.
 Communicate analytical findings to internal and external stakeholders through written and verbal channels after thorough research.
Commercial Markets: National Network Delivery Consultant October 2017-October 2018
 Assisted in refining the Blue Cross Blue Shield Flexible Network national tiering program methodology for acute care hospitals and
ambulatory surgical centers based on quality and cost.
 Designed and documented operational plans, approaches and timelines for Flexible Network to improve the processes for the facility
portion of the program.
 Analyzed data to make and test hypotheses, monitor results, and produce findings that are actionable and support decision making.
 Researched and analyzed CMS quality data for acute care hospitals and ambulatory surgical centers in Flexible Network.
 Maintained cross-team coordination for Plan implementation on to the Value-Based program platform.
National Programs: National Network Delivery Associate Consultant March 2015-October 2017
 Enhanced the Value-Based program database by assisting in the redesign of the Value-Base program resources in tableau to be used across
the 36 Blue Cross Blue Shield Plans.
 Analyzed and audited the program database, snapshots and survey for Plan Value-Based programs.
 Created Value-Based program production trend data to capture inconsistencies in the monthly data submissions.
National Programs: Business Execution Associate Consultant Contingent Staff via Kelly Services August 2015-March 2016
 Prepped, sent and executed Data Use Agreements for Blue Cross Blue Shield Plans and external vendors as the data is requested.
 Managed and updated multiple tracking systems for agreements in Microsoft SharePoint.
 Assisted in the composition and distribution of Plan communication and implementation materials.
 Created and updated multiple web pages on BCBSA’s intranet that is accessible to Plans.
National Programs: Health Information Technology Intern April 2015-July2015
 Researched and generated reports on electronic quality measure standards.
 Completed an audit for the national programs privacy and security tracking system for employee access to personal health information.
 Updated national programs procedures for completing privacy and security request forms and created procedural flow charts for the
department.

ADVOCATE LUTHERAN GENERAL HOSPITAL, Park Ridge, IL July 2014-August 2014

Health Information Management: Intern
 Learned roles and responsibilities of each position in the health information management department.
 Analyzed and coded inpatient and outpatient medical records within their electronic health record system in the HIM medical coding
department.

EDUCATION
B.S. Health Information Management | Illinois State University, Normal, IL May 2015.........................
Certified Registered Health Information Administrator (RHIA) 2015-2018
 American Health Information Management Association Member 2013-Present
Microsoft: Excel, Word, PowerPoint, Access | Medical Terminology | ICD-9 and ICD-10 Coding | Tableau