NICOLE C.

DeBRINCAT
2312 Cardinal Lane, St. Joseph, MO 64503
(734) 765-3239 | nicole.c.debrincat@gmail.com

OBJECTIVE I am a professionally prepared Public Health Educator looking for a position within the
private or public health domain, where I can use my master skills of excellent repute as well
as my 22 years of customer service, training, quality control, and instructional design
experience, to promote better, healthier outcomes for all.

EXPERIENCE Customer Advocate I - Customer Service

September 2021 – Current / Blue Cross Blue Shield of Kansas City

Line of Business: All Blue KC Commercial PPO and HMO Products

Division: Service Operations

Advocate for First Call Resolution on Behalf of Blue KC Membership

I provide resolution with a service level that ensures members and customers feel valued and
understood. I utilize information, claims data, and membership records to resolve issues
independently or with minimal assistance, within first call whenever possible. I educate and
work with members at different health literacy levels with cultural sensitivity. I research
applicable medical policies and corporate, divisional, and departmental policies and
procedures to gather information needed to advocate on the member’s behalf with regard to
claims and medical services.

Senior Instructional Developer - Content Development & Support

September 2015 – December 30, 2020 / Blue Cross Blue Shield of Michigan

Lines of Business: Blue Care Network HMO, BCN Advantage HMO

Division: Operational Development and Learning Management (ODLM)

Design & Maintain Curriculum / Design & Maintain Assessment Tools

In 2018, BCBSM was inducted into Training magazine’s “Top 125 Hall of Fame” after
earning the unique designation by capturing a spot in the Top 10 of the magazine’s “Top 125”
for four years in a row. Projects that I worked on contributed to BCBSM qualifying and
earning these esteemed honors.

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EXPERIENCE Senior Analyst – Quality Program Administration
CONTINUED
October 2012 – September 2015 / Blue Cross Blue Shield of Michigan

Lines of Business: Blue Care Network HMO, BCN Advantage HMO

Division: Operational Development and Learning Management (ODLM)

Check the Checker, Launch Quality Programs at Vendor Locations, Track Quality Data to
Suggest Procedural and Servicing Improvements

Earned an overall score of “Exceeds” on my Annual Review, two (2) years in a row, which is
the highest performance rating possible (and a rarity to be awarded back-to-back).

I was a key contributor to the launching of Blue Care Network’s/BCN Advantage’s

supportive off-site vendor locations in Highland Park, MI; Holland, MI; Coral Springs, FL;
and Palestine, TX where I trained CSR1s, CSR2, Leadership, and Quality Analysts on all
HMO processes, systems, and procedures; and launched their on-site quality assurance
programs.

I analyzed the quality evaluations that the Quality Evaluators completed, while assessing
CSRs’ performances (aka: “check-the-checker”) and identified learning opportunities /
suggested new processes for performance improvement; while abiding by all NCQA, HEDIS,
CAHPS, and STARS guidelines and metrics.

Operational Trainer - Content Development & Support

February 2008 – October 2012 / Blue Cross Blue Shield of Michigan

Lines of Business: Blue Care Network HMO, BCN Advantage HMO

Division: Operational Development and Learning Management (ODLM)

Trainer of CSR1s, CSR2, Unit Leaders, Document Support Clerks, Leadership, and other staff
as assigned on the skills/systems needed for them to perform their jobs.

Operational Trainer in support of Customer Service and other areas as assigned.

Unit Leader - Customer Service

November 2005 – February 2008 / Blue Cross Blue Shield of Michigan

Lines of Business: Blue Care Network HMO, BCN Advantage HMO, Written Inquiries
(Claims)

Division: HMO Service Operations

Subject Matter Expert; Help Desk Agent.

Help Desk Agent assisting Customer Service, Written Inquiry, and Service Operations leaders
with complex customer (member/provider/written) inquiries while using a variety of systems
to provide excellent, high-quality first-call resolution.

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 EXPERIENCE Customer Service Representative II – Member and Provider Inquiry
CONTINUED
April 1999 – November 2005 / Blue Cross Blue Shield of Michigan

Lines of Business: Blue Care Network HMO

Division: HMO Service Operations

CSR2; Member and Provider Inquiry.

Dozen+ “STAR” Quality Program award winner, in acknowledgement of earning perfect,

monthly quality scores; Member Inquiry, Provider Inquiry, Full-Service Representative (pilot
program). As part of a special project, I was cross-trained as a Written Inquiry Representative
and processed/paid/denied claims on STAR and Facets systems.

Teacher

October 1998 – April 1999 / Berlitz Languages Intl.

Teacher of English, German, and Accent Reduction using The Berlitz Method.

CERTIFICATIONS Ulysses Call Strategy Master Coach

I am a certified soft skills Ulysses Call Strategy Master Coach, which is rooted in behavioral
psychology.

NCHEC Certified Health Education Specialist

Anticipated: April 2022

VOLUNTEER Founder of “R.A.W.” - The Recovery Ally Workshop at Eastern Michigan University
WORK (EMU) – Ypsilanti, MI

January 2021 to Present / EMU, Office of Health Promotions

❖ I am the designer, developer, and primary investigator (remotely) of the Recovery Ally
Workshop (R.A.W.) at Eastern Michigan University.
❖ This grass-roots, volunteer-based program aims to narrow the knowledge gap about
Substance Use Disorder and persons living in Recovery, in college-aged individuals
between the ages of 18 and 24, while cultivating a culture of recovery allies.
❖ R.A.W. participants experience the workshop virtually through an asynchronous, self-
guided eLearning software ("Canvas") which includes a pre/post-workshop survey (to
gauge participants' pre- and post-workshop beliefs, intentions, attitudes, and supportive
behaviors), educational videos, ally-building activities, and a Print-and-Post Pledge.
❖ R.A.W. is evidence-based and is rooted in the "Theory of Reasoned Action" and "Health
Belief Model" behavioral health theories.

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EDUCATION Eastern Michigan University – Ypsilanti, MI

Master of Science – Public Health in Health Education (MPH-HE)

Attended: September 2017 – August 2021

Graduated: August 11, 2021

GPA: 4.00

Award:

Master of Public Health Student of the Year – EMU College of Health and Human Services
Academic Year, 2020-21

Eastern Michigan University – Ypsilanti, MI

Bachelor of Arts – German major / Sociology minor

Attended: September 1993 – August 1998

Graduated: August 21, 1998

GPA: 3.00

Presenter:

1997-98 EMU Senior Symposium: Special Topic – Schubert Lieder (Engl.: Schubert Songs)

William D. Ford Career-Technical Center – Westland, MI

Medical Assistant

Attended: September 1992 – May 1993

Graduated: May 1993

GPA: 4.00

John Glenn High School – Westland, MI

High School Curriculum

Attended: September 1990 – May 1993

Graduated: May 1993

GPA: 3.00

LANGUAGES English – Native

German – Conversational

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 SKILLS & I am a Public Health Education Specialist trained to lead and contribute to the needs
ABILITIES assessment of/for health promotion and wellness programs aimed at encouraging adults to
adopt healthy lifestyles.

I have applied knowledge and understanding of health behavior change theories, motivational
interviewing techniques, adult education theory, and technical training methods.

I can plan, implement, and evaluate the outcomes of training programs, including statistics.

I can design health education programs rooted in Behavioral Health Theory (i.e.: Health
Belief Model, Self-Determination Theory, Transtheoretical Model, PRECEED-PROCEED,
etc.) and can design tools necessary for measuring the program’s outcomes and/or need for
improvements.

I am trained to perform research and communicate on relevant topics in health promotion and
disease prevention; including epidemiology, needs of diverse populations.

I am prepared to facilitate collaboration between health education resources, the community,

and stakeholders in an organized, logical, and professional manner.

I am trained to collect, synthesize, analyze, and report data – using proven statistical formulas
and theories – and report outcomes in an understandable manner appropriate for the targeted
audience and/or stakeholders.

I have 6 years of professional Instructional Development experience with Blue Cross Blue
Shield of Michigan, applying my expertise of adult learning methodologies, Training &
Development, and Instructional Design guided by proven project planning skills and the
A.D.D.I.E. process.

I design curricula that are multifaceted and engaging, incorporating ILT, CBTs, eLearnings,
job aids, infographics, games (i.e.: Kahoot!), call simulations, quizzes, assessments, boosters,
and more.

I am a high-energy, proactive, self-starter who works very well in teams or individually, with
minimal supervision, and a proven track record of flexibly, and managing multiple tasks with
a strong customer/patient focus.

I have excellent written, verbal, and inter-personal skills and exhibit a strong attention to
detail in everything I do.

I am sought out for partnering and subject matter expertise amongst coworkers and peers
from all levels.

I have professional knowledge of HIPAA, CAHPS, NCQA, HEDIS, and CMS Star program.

I have an excellent driver’s record and am willing to travel.

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COMPUTER ❖ ACI ❖ Kahoot!
SYSTEMS & ❖ ASPECT ❖ MACESS
SOFTWARE ❖ Canva ❖ MARx
❖ Canvas ❖ Medco eSD/Express Scripts
❖ Captivate ❖ Medical Informatics
❖ Care Advance ❖ Member Self Service
❖ Care Approval ❖ Outlook
❖ Continuum ❖ PowerPoint
❖ CSR Portal ❖ RefCust
❖ CXT (Claims Extend) ❖ RefHome
❖ eBilling ❖ SharePoint
❖ Excel ❖ SPSS
❖ FACETS ❖ Unify Connect
❖ Google Docs ❖ VoIP
❖ iHT Claims Inquiry Tool ❖ Weebly
❖ JIT (Just in Time) ❖ Word