Experience

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  Gradient AI

  • United States

  • Senior Solutions Consultant

    • Jan 2024 - Present
    • United States

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  Insurance | Claims | Underwriting | Workers' Compensation

  • United States

  • WC Claims Director | Vendor & Program Manager | Complex Claims | QA | Underwriting | Operations

    • Nov 2023 - Jan 2024
    • United States

    Workers' Compensation Consultant

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  Westfield

  • United States
  • Insurance
  • 700 & Above Employee

  • Commercial Lines Workflow Optimization and Process Leader

    • Jan 2023 - Oct 2023

    Created and led a team serving all commercial lines that cultivates innovation and provides leadership and expertise in the entire lifecycle of business workflow and process, considering people, process, and technology.• Automated workflows for Endorsements and Renewals, including reducing legacy system quoting by 8+ days• Designed and implemented process improvements to reduce turn-around-time and average-handle-time of various operations processes. (backroom processing, paper processes, etc.)• Supervised and managed a team of Process Managers and Agile team including developers, testers, Product Owner and Scrum Master.

  • Commercial Lines Underwriting Operations Team Leader

    • Sep 2021 - Jan 2023

    Led 4 Operations teams - Quality Assurance, Education and Compliance, Policy Conversion, and Process teams, plus an additional offshore business process optimization (BPO) team.• Business Owner Co-Leader of the new Commercial Lines Legacy Agile teams.• Managed BPO offshore team including training of new tasks, quality assurance, optimizing workflows, performance measurement, forecasting, and roadmap planning. • Formed new customer-centric, collaborative, and consultative commercial lines Quality Assurance team and implemented technology protocols to optimize impact.

  • Commercial Lines Underwriting Operations Process Leader

    • May 2019 - Sep 2021

    Leadership rotation to commercial lines. Recruited to apply claims best practices to commercial lines underwriting operations, including vendor management, process improvement, strategic planning, and innovation.• Assisted in building Westfield’s most profitable underwriting segment by implementing best practices and new middle market underwriting methodology, resulting in profitable growth since. • Implemented a new virtual and self-service Risk Services survey protocol resulting in reduced turn-around time, reduced expenses, and increased internal and external customer satisfaction.• Formed and managed a new business process optimization (BPO) offshore practice to optimize speed, service, and expenses, including contract negotiation, creation of service level agreements (SLA), and staffing.

  • Workers' Compensation Claims Process Leader

    • Dec 2016 - May 2019

    Assumed exclusive leadership for strategy, vendor integrations and management, continuous improvement, compliance, results and outcomes, training, and compliance for WC claims processing. Served as the government relations SME. • Generated over $100MM per year medical management savings for our WC and PIP customers.• Assisted with the selection, configuration, installation, and training of a custom version of Guidewire Claim Center software to replace the legacy claims management system to create ‘low touch or no touch’ claims experience. • Optimized the medical bill review program, increasing savings significantly while substantially reducing expenses. Created straight through processing (STP) protocols so that a high percentage of bills are processed without claims professional intervention.

  • Westfield Workers' Compensation Complex Claims & Process Leader

    • Sep 2006 - Dec 2016

    Promoted to build a team responsible for overseeing WC claims quality and outcomes nationally. Created processes, programs, and compliance for all WC claims, including complex claims and catastrophic injuries. SME for Government Relations, including legislative agendas. • Turned around WC line of business from a loss leader to a consistently profitable line of business, with combined ratios and loss ratios out-performing the industry. • Supervised a team of claim professionals, including Complex Claims team and TPA team in primary jurisdictions of AZ, DE, FL, GA, IA, IL, IN, MD, MI, NC, NM, OH, PA, SC, TN, VA, WI, and WV and all other non-monopolistic states. • Created a vendor management strategy, protocols, and guidelines to implement a portfolio of medical management and RTW programs, including RFPs, vendor selections, procurement and contract negotiations, SLAs, and managing vendor relationships.• Created a Return-To-Work (RTW) program, protocols, and marketing resources, including creating and implementing an innovative offsite RTW program - WesWorks® that supported a high level of full-duty return to work. • Designed, developed, and implemented, in collaboration with Best Doctors® (n.k.a. Paradigm’s Better Backs®) an early-intervention back injury program. • Created a recognition program to drive an outcome and advocacy-based WC claims approach called “Can You See the End of The Claim?” ®. • Generated substantial savings on Medicare compliance settlements by designing and installing an industry-leading MSA and settlement program.• Developed, implemented, and managed a Third-Party Administrator (TPA) program.

  • Quality Assurance Analyst, Workers' Compensation

    • Dec 2004 - Sep 2006

    Recruited by Westfield to create a Claims Quality Assurance operation and to turn around an underperforming and underdeveloped Workers’ Compensation (WC) Claims operation. • Created and implemented Quality Assurance procedures and practices.• Developed WC Claims Department claims protocols, including the development of claims guidelines and SOPs. • Reviewed Workers’ Compensation claims to ensure adherence to guidelines and protect corporate assets. • Performed a current state assessment of WC Claims operation nationally and developed recommendations and a roadmap to transform the department. • Part of corporate project team that created Westfield University, a new approach to corporate training at Westfield.

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  American Property Casualty Insurance Association

  • Greater Chicago Area

  • Workers' Compensation Committee Member

    • Jan 2009 - Mar 2019
    • Greater Chicago Area

    Workers' Compensation Committee member as well as Pharmaceutical and Medicare subcommittee member collaborating in advocating for the Insurance Industry in identifying and pursuing innovations and reforms

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  Kemper Insurance

  • Workers' Compensation Claims - Various Roles

    • Oct 1989 - Dec 2004

    Part of entrepreneurial leadership team that created Ohio self-insured start-up.Multistate claims handling/supervision/management 10 years of Ohio Self-Insured Experience, including:Account ManagementProgram DevelopmentComplex Claims Litigation ManagementSales Hearings AuditsWorkers' Compensation Claims Handling and Supervision MI, IN, IL, IA, WI, PA, KY, OH, NC, SC, FL, DE,

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  Insurance Institute of America (IIA)

  • Course Instructor/Grader

    • Sep 2001 - Sep 2004