Danyel Forlu
Upper Marlboro,MD
Summary
Detailed Quality Assurance Specialist with proficiency in Total Quality Management and quality control. First-rate creative thinking, problem-solving and time management abilities. Skilled in collecting and analyzing data and resource allocation.
Overview
13
13
years of professional experience
1
1
Certification
Work History
Quality Assurance Supervisor - Customer Service
Sierra7
06.2021 - Current
- Supervise and manage teams of quality auditors
- Maintain security and data integrity by having established dedicated work area that provides information privacy
- Work directly with Operations management to identify and report quality needs, provide feedback for process improvement, reduce error rate, and increase quality metrics for operational business units
- Utilize Microsoft Excel to analyze data; develop quality control procedures such as pivot tables, pareto analysis, and charts; provide quality reporting on weekly and monthly basis to business operation management teams; track auditing data, auditor’s accuracy, productivity, and key performance indicator goals
- Complete Appeal Claim audits, conducted claims research and data collection to support claims audits
- Analyze audit data, present audit findings, and quality improvement recommendations to Operations and Training departments to increase accuracy
- Conduct weekly calibrations with quality auditors and monthly sessions with Operational teams (internal and external partners) to maintain program compliance and accuracy
- Complete Auditor the Auditor for multiple quality programs to validate accuracy of audit results
- Respond to Appeals end-to-end; coached auditors on overturned appeals to facilitate defect reduction
- Create and manage SharePoint lists used to conduct audits
- Develop, correct, and adjust work instructions, documentation, and process mapping as needed to ensure quality adherence
- Calibrate with Operations and Training teams to develop auditing scorecard; provide recommendations to process design and work instructions
- Preformed special project audits such as those required for Go No Go program and conduct reviews of new hires as requested
- Update auditing form formatting to support continuous quality improvement efforts in quality
- Followed Six Sigma methodologies to design and implement process to reduce and eliminate process errors
- Participate in designing and evaluation of Total Quality Management programs
- Utilized ServiceNow, OnBase, SharePoint, PGBA, OneNote, Excel, Outlook, Teams, Skype, PowerPoint, and Word frequently to complete daily tasks.
Quality Assurance Supervisor
Sierra7
04.2021 - 05.2021
- Supervise and manage a team of quality auditors, oversaw daily operations of auditors
- Communicated process and system changes, hosted weekly team meetings to review new expectations and initiatives
- Worked directly with Operation management to report quality needs, provided feedback for process improvement and reduce error rate
- Communicated to Business Operations negative trends and provided recommendations to improve accuracy and quality
- Established and tracked staff key performance indicators
- Coordinated with training department to maintain accuracy of work instructions and documentation; provided program overview to new hire training classes
- Hosted weekly calibration with quality auditors to ensure program compliance and accuracy
- Utilized SharePoint, OneNote, Excel, Outlook, Teams, Skype, PowerPoint, Citrix, and Word frequently to complete daily tasks.
Quality Assurance Analyst
Sierra7
11.2020 - 04.2021
- Evaluated customer interactions in accordance with monitoring program guidelines
- Participated in weekly calibration to establish and maintain inter-rater reliability along with continuous improvement in performance metrics
- Incorporated frequent changes into workflow and consistently built on knowledge base
- Exceeded all personal and team goals of 60 audits per week
- Completed agent level and corporate level audits, used coaching notes to provide agents with feedback regarding quality improvement.
Medical Service Coordinator
Sierra7
05.2020 - 11.2020
- Handled large volume of inbound calls in a timely manner and transferred calls as needed
- Identified patient’s needs and provided solutions and/or alternatives; Responsibilities included COVID testing and COVID Vaccine appointment scheduling in multiple states
- Utilized Ignite and Mitel for all inbound/outbound calls, utilized MedNet to access patient records
- Exceeded personal weekly and monthly auditing score targets
- Assisted patients with creating online accounts, diagnose and troubleshoot issues
- Worked in the capacity of a SME – provided assistance to MSCs, conducted outbound follow-up calls, trained new hires in one on one sessions and assess their accuracy with process requirements
Elementary School Teacher
Prince George's County Public Schools
, MD
08.2015 - 06.2016
- Instructed 4th grade student in math, science, and health
- Prepared lesson plans, administered assessments, tracked student growth, developed solutions for students not preferring at grade level
Academic Instructor
Woodland Job Corps Center
, MD
09.2014 - 06.2015
- Instructed students in math in preparation for the GED test
- Tracked student goals and progress
- Completed student case notes and accessed student progress through Citrix
Administrative Assistant
Grace And Mercy Health Services
, MD
06.2010 - 05.2020
- Answered phone system, routing calls, delivering messages to staff and greeting visitors.
- Executed record filing system to improve document organization and management.
- Scheduled office meetings and client appointments for staff teams.
- Monitored supervisor's work calendar and scheduled appointments, meetings and travel.
Education
Bachelor of Science - Elementary Education
Saint Mary-of-the-Woods College
Terre Haute, IN12.2013
Skills
- Microsoft Office - Excel, Word, PowerPoint, OneNote
- SharePoint - List creation and management
- Effective written and verbal communication
- Leadership experience and willingness to learn
- Adaptability to process changes
- 2 years healthcare experience
- Issue Resolution
- Customer Service
- Data Analysis
- Process Documentation
Certification
- Six Sigma White Belt - 2022
Timeline
Quality Assurance Supervisor - Customer Service
Sierra7
06.2021 - Current
Quality Assurance Supervisor
Sierra7
04.2021 - 05.2021
Quality Assurance Analyst
Sierra7
11.2020 - 04.2021
Medical Service Coordinator
Sierra7
05.2020 - 11.2020
Elementary School Teacher
Prince George's County Public Schools
08.2015 - 06.2016
Academic Instructor
Woodland Job Corps Center
09.2014 - 06.2015
Administrative Assistant
Grace And Mercy Health Services
06.2010 - 05.2020
Bachelor of Science - Elementary Education
Saint Mary-of-the-Woods College
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