Experience

Phaedon
• United States
• Marketing Services
• 1 - 100 Employee
• Manager, Business Consulting

  • Sep 2023 - Present


ICF Next

• United States
• Marketing Services
• 700 & Above Employee

• Manager, Consumer Healthcare Division

  • Sep 2017 - Sep 2023

  Provide strategic and tactical support to clients through facilitation of all phases of transformative projects, including planning, design and implementation. Responsible for delivery of exceptional results by leveraging a deep understanding of all aspects of healthcare payer operations, benefit designs, claims, underwriting, membership, account management, strategic business solution development and end to end process improvement. Draw upon more than 20 years' experience inclusive of strategy development, client implementation, customer experience analysis and business process redesign. Show less



Optima Health

• United States
• Insurance
• 700 & Above Employee

• Manager, Enrollment & Eligibility

  • May 2015 - Feb 2016

  Direct management responsibility for the recruitment, development and performance of Enrollment & Eligibility Team members. •Responsible for the timely and accurate completion of all activities required to build newly sold client groups, process all group and member additions, changes and terminations in the Optima Health systems. •Ensure adherence to all federal and state regulations, as well as client performance guarantees. •Conduct analysis of current procedures, and identify, develop and implement both departmental and interdepartmental process improvements. •Establish a stable and scalable framework within department to allow for substantial growth of business. •Ensure consistent delivery of excellent service to external and internal clients. •Direct management responsibility for Customer Service Training and Audit Team. •Facilitated Training Team's development and implementation of Customer Service Excellence training curriculum to Sentara. Show less



Anthem Blue Cross and Blue Shield

• United States
• Insurance
• 700 & Above Employee

• Program Director

  • Apr 2009 - Mar 2012

  Represented Anthem National Accounts Service Operations in the development and implementation of programs resulting in expense reduction and service improvements through increased economies of scale.• Migration of over 1 million members from 4 legacy systems to target platform, mitigating significant ICD10 expenses associated with multiple system platforms.• Transitioned service functions of 150,000 Indianapolis, IN based National Accounts subscribers to Columbus, GA location in support of creation of Centers of Excellence.• Managed implementation and business as usual activities for program involving Partner Vendor providing outsourced customer service functions to provider community.• Represented Operations area for the migration of National Accounts from call router technology to VSS IVR technology, resulting in increased utilization of self-service functionality and decreased staff. Show less

• Project Director, Service Operations

  • Apr 2006 - Mar 2009

  Represented Anthem Local and National Accounts Service Operations in the development and implementation of programs resulting in expense reduction, service improvements and increased membership resulting from product line launch.• Acted as a consultant in the development and implementation of Consumer Driven Health Plan (CDHP) product line for Local Regional Markets.• Implemented 3 Richmond-based CDHP Local Market Service Centers, including product literacy, development of staffing models, budgetary planning, facility build out planning and coordination.• Managed all Operations activities of project to simultaneously implement Pomona, CA, Indianapolis, IN and Richmond, VA based National Accounts CDHP Service Centers.• Received Impact Awards from Project Team Executive Sponsor for efforts resulting in CDHP product line definition and establishment of new CDHP Service Centers. Show less



Lumenos

• Insurance
• 1 - 100 Employee

• Senior Implementation Manager

  • Jun 2005 - Jan 2006

  Developed, documented and implemented processes and procedures to facilitate implementation of new clients and renewal of existing clients; oversaw daily activities of Implementation Team. • Developed and administered extensive Implementation training materials resulting in consistency and completeness of Implementation process. • Developed, implemented and managed formalized processes to evaluate, render decisions regarding, and implement client requests for customization to ensure service delivery capabilities were in place. • Managed processes and staff responsible for generation and accuracy of web based and client tools, enhancing utilization of self-service functionality by clients and members. • Facilitated implementation and reimplementation activities for all client companies, ensuring client satisfaction and retention. Show less



Unum

• Norway
• IT Services and IT Consulting
• 1 - 100 Employee

• Director

  • Mar 2002 - May 2005

  Responsible for 20+ claims evaluators, ensuring appropriate staffing levels, decision making, financial results and turnaround time. Increased net productivity by 100% Decreased average turnaround times by 65% Developed staff through coaching, resulting in the promotion of 6 staff members Developed and managed within departmental budgets Achieved 96% voluntary retention Responsible for 20+ claims evaluators, ensuring appropriate staffing levels, decision making, financial results and turnaround time. Increased net productivity by 100% Decreased average turnaround times by 65% Developed staff through coaching, resulting in the promotion of 6 staff members Developed and managed within departmental budgets Achieved 96% voluntary retention



CORE, Inc.

• United States
• Real Estate
• 1 - 100 Employee

• Director, East Operations; Account Executive

  • May 1992 - Oct 2000

  Managed the performance and results of 50 clinicians, Account Managers, Customer Service Representatives and Administrative Staff. Managed multiple geographic business sites simultaneously Decreased voluntary turnover ratio from 60% to 10% Developed cross training program to gain efficiency through product line staff integration Transitioned organization structure into Client Teams Participated in Process Mapping initiative facilitated by Motorola University Black Belts  Reduced average turnaround time from 30 to 2 days Achieved account retention of 100% Project management of client implementations and service enhancements Developed detailed Implementation Specifications Developed service definition for increased standardization and profitability Show less


Consolidated Group, Inc.
• United States
• 1 - 100 Employee
• Manager, Underwriting; Manager, Dental Claims

  • 1989 - 1992

CIGNA Corp.
• Assistant Manager

  • 1985 - 1988