Oct 2021 – Present · 4 yrs 6 mos

• Oversight of incoming Specialty Benefits Operations acquisitions, which currently includes Healthplex Call, Claims, and Appeals operations. Healthplex business consists of dental, vision, and financial protection insurance portfolios. Responsible for daily performance and strategic integration of resources, programs, policies, business targets, applications, and technologies into UHC legacy operations.

Jun 2020 – Oct 2021 · 1 yr 4 mos

• Specialty Benefits Operations (Dental & Vision) - Claims and Appeals Organizations

Mar 2015 – Jun 2020 · 5 yrs 3 mos

• Manages SAM Edit Developers, Programmers, and Workforce/Inventory Management Teams, as well as oversees the Global Relations of the organization’s offshore resources. Responsible to ensure business needs and service level agreements are met, inventory is managed efficiently, day to day operations are effective, and vendors are in compliance of contracts.
•  Provides operational support for more than 900 processors across all lines of business (C&S, E&I, and M&R) with up to 500 resources aligning to the Global Relations responsibilities
•  Supports in the development of new vendor contracts to ensure the business and vendor’s needs are met, while encouraging innovation and efficiency efforts through the contractual alignment
•  Collaborates in developing and hosting a Top Talent program to mentor and cultivate career oriented supervisors interested in pursuing manager level positions
•  Leads the department’s inventory management program, which improved achieving service level agreement targets by 17% within a 2 year span, resulting in meeting targets 98% of the time
•  Creates forecasting models to successfully oversee the operational staffing projections and overtime budgets ensuring business requirements are met
•  Leads multiple projects that impacted department and, at times, companywide initiatives to improve performance/efficiencies and ensure the voice of our customers were priority in those efforts

Jan 2014 – Jan 2015 · 1 yr

• Supervised the Global Support Teams for Global Regulatory Review Group (RRG) and Global Tracking and Check Receipt (TRACR), as well as manages the Transaction Interest Remediation program to ensure objectives are defined, actions are taken, and results are delivered.
•  Implemented RRG quality initiative and remediation programs to ensure accurate interest payouts and claim quality
•  Developed workflow and implemented processes for the partnership of areas to collaborate on over dollar threshold interest payments
•  Compiled and delivered presentation regarding team’s project work and progress to Executive Leadership

Jan 2011 – Jan 2014 · 3 yrs

• Dedicated lead of the transaction support team driving the Southeast Region’s and National External Audit’s quality results in a positive direction through staff supervision and development, project management, process improvement programs, and business partnership.
•  Led the analyst team to work towards regional blue chip initiatives associated with quality, reducing performance guarantee payouts, and improving the pass rate of external audits
•  Oversaw remediation efforts for the manual processors in all regions for domestic and global employees
•  Collaborated with multiple departments to improve processes, implement automation opportunities, and improve turnaround time for project implementation

Jan 2008 – Jan 2011 · 3 yrs

• Responsible for the department’s quality program through data analysis, process/workflow development, and remediation plans, resulting in improved individuals and operational performance.
•  Provided innovative tips and recommendations based on quality driven concerns to multiple teams
•  Designed and implemented new workflow processes creating more efficient, quality oriented, and consistent processes amongst team members

Jan 2007 – Jan 2008 · 1 yr

• Provided team support and training needs to create a successful and productive team environment, as well as continued to strive to exceed my own production and quality standards.

Feb 2004 – Nov 2004 · 9 mos

• Provided exceptional customer service by ensuring claims were processed promptly and accurately.

Jan 2004 – Jan 2007 · 3 yrs

• Handled adjustments associated with call centers, appeals, system limitation creating known quality impacts. Supported multiple Adjustment & SAM Edit Rule training classes as an On-The-Job Trainer.