Dawn Zayas Email & Phone Number | • 35 plus years of experience working as a Medicaid /Medicare/Commercial/Dental & Behavioral Health Operations Director, including Claims, Customer Service (Member/Provider), Provider & Network Management, Enrollment, Compliance (including Grievance and Appeals), System Configuration, System Migrations/Integrations, Quality Assurance, Training, Process Improvement and Vendor/Account Management. • Adept at managing large enterprise wide relationships while maximizing contractual savings for upper management. • Responsible for increasing vendor and organizational processes. • Monitor, evaluate and communicate with vendors and clients to ensure SLA compliance, price competitiveness and product effectiveness. • Proven ability to manage complex system migrations, including the successful integration of multiple Health Plans from home grow claim platform, to vendor owned Trizetto product, QNXT. The total conversation statistics include movement of 1,639,410 members, 235,219 providers and 31,988,437 claims moved. • Experienced at managing multi-million dollar operating budgets. • Experienced at preparing, writing and presenting RFI and RFP responses. • Significant contract negotiation experience resulting in new agreements. • Adept at developing and executing customer satisfaction and improvement programs that have significantly improved client customer satisfaction ratings. • Certified as a Six Sigma Greenbelt, as well as Lean. Currently managing all Achieving Business Excellence (ABX) events within the Medicaid Operations teams. • Acting Chief of Staff for Sr. VP of Operations

Dawn Zayas

• 35 plus years of experience working as a Medicaid /Medicare/Commercial/Dental & Behavioral Health...
750 Prides CrossingSuite 200, Newark, United States

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Dawn Zayas’s Email dzayas@wellcare.com

Dawn Zayas’s Phone Numbers +1 813-290-6220,+1 800-238-****

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Dawn Zayas’s Location 750 Prides CrossingSuite 200, Newark, United States

Dawn Zayas’s Current Industry Aetna Coventry Health Care An Aetna

Dawn Zayas’s Prior Industry Amerihealth Caritas | Cigna

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Work Experience

Wellcare Health Plans

Director, Configuration

Present

Aetna

Director, Service Operations - Process Improvement

2013-01-01 00:00:00 - Present

Coventry Health Care An Aetna

DIrector Operations

2011-10-01 00:00:00 - Present

Amerihealth Caritas

Director Vendor Management

2006-01-01 00:00:00 - 2011-01-01 00:00:00

Cigna

Site Administrator

1998-01-01 00:00:00 - 2003-01-01 00:00:00

Skills

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Languages

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FAQ About Dawn Zayas

Dawn Zayas is located at
750 Prides CrossingSuite 200, Newark, United States

Dawn Zayas is a • 35 plus years of experience working as a Medicaid /Medicare/Commercial/Dental & Behavioral Health Operations Director, including Claims, Customer Service (Member/Provider), Provider & Network Management, Enrollment, Compliance (including Grievance and Appeals), System Configuration, System Migrations/Integrations, Quality Assurance, Training, Process Improvement and Vendor/Account Management. • Adept at managing large enterprise wide relationships while maximizing contractual savings for upper management. • Responsible for increasing vendor and organizational processes. • Monitor, evaluate and communicate with vendors and clients to ensure SLA compliance, price competitiveness and product effectiveness. • Proven ability to manage complex system migrations, including the successful integration of multiple Health Plans from home grow claim platform, to vendor owned Trizetto product, QNXT. The total conversation statistics include movement of 1,639,410 members, 235,219 providers and 31,988,437 claims moved. • Experienced at managing multi-million dollar operating budgets. • Experienced at preparing, writing and presenting RFI and RFP responses. • Significant contract negotiation experience resulting in new agreements. • Adept at developing and executing customer satisfaction and improvement programs that have significantly improved client customer satisfaction ratings. • Certified as a Six Sigma Greenbelt, as well as Lean. Currently managing all Achieving Business Excellence (ABX) events within the Medicaid Operations teams. • Acting Chief of Staff for Sr. VP of Operations