Susan Bayer

Susan has more than 30 years of experience in clinical nursing and with healthcare operations-related software. She is a licensed registered nurse who specializes in the use and maintenance of various healthcare and insurance software programs. Susan has expertise in the development of training and educational materials for health insurance-specific software classes. She has been a subject matter advisor on multiple system implementations and enhancements across all lines of business, including Medi-Cal and Medicare. Although her primary focus is on UM and CM, she has knowledge regarding claims, benefits, enrollment, and provider elements of insurance.

Experience

  • Supported project teams by developing test cases, following iterative processes for configuration, creating documentation, and completing analysis of results
  • Worked as a trainer with project teams and individuals to develop training materials, references, and schedules
  • Experienced with QNXT, Medecision Aerial, and home-grown authorization and claims systems
  • Significant experience in reviewing CM business requirements, conducting extensive stakeholder interviews, and exploring system configuration and capabilities
  • Refined and prioritized core problem areas on several projects, resulting in faster, more efficient issue resolution
  • Worked with stakeholders to define business requirements and assisted in translating results to software applications

Qualifications

  • Licensed RN
  • Clinical and health insurance experience

Education

  • Bachelor of Business, Finance and End User Computer Support, University of Wisconsin – Oshkosh
  • Associate Degree, Nursing, Milwaukee Area Technical College