Experience

Humana Behavioral Health

• United States
• Hospital & Health Care
• 1 - 100 Employee

• Clinical Operations Manager

  • Jan 2015 - Present

  • Manage New Member Assessment Call Centers in St. Petersburg, Florida and San Antonio, Texas simultaneously • Generated over $500k in additional wave work/ stars campaign projects for Humana Behavioral Health for the year of 2016. • Successfully managed and integrated the Health Guide Pilot from Humana at Home to Humana Behavioral Health, representing $250 million in revenue drivers including referrals to broad-based business lines for 2016. • Exceeded EOY target of our referral resource partners resulting in 1.2 million in pre-tax, profit dollars. • Successfully developed and managed the Existing Member Pilot, Diabetic Pilot and Sales Pilot that created over 2,100 new touch points for the business. • Increased productivity by 25% within the first 60 days in my role as Manager • Efficient in Word, PowerPoint, Access, Excel, GCP, CCP2, CGX, Dimension, RX-Look Up, Avaya Dialer, CMS Supervisor, Telnet, Monitor, Analyst and Qlikview Reporting Suite. • North Star Award Recipient in 2016 • Collaborated with Humana Behavioral Health Operations Admin and Staffing Optimization to develop Key Performance Metrics and Reporting for Clinical Research Intake Team and Unable to Contact Measurements. • Organize and manage High Visibility projects • Onboard new leaders and associates • Co-Lead for Caregivers & IMPACT Network Resource Groups • Member of the MTC ( Make the Connection) Executive Leadership Forum • Collaborated with Talent Profile Ambassadors to develop an online scheduling tool to assist associates with scheduling time for professional growth development • Collaborate with CLD (Clinical Learning and Development) on the training curriculum for new hires • Collaborated with IT to create automated reporting for all production lines of business. • Facilitate Process validation and Quality Calibration Meetings • Participated and Organized Volunteer Opportunities for Humana associates Show less



Humana

• United States
• Insurance
• 700 & Above Employee

• Operations Supervisor

  • Oct 2011 - Jan 2015

  • Managed Right Source Operational Metrics Team of Information Specialists• Implemented an internal Service Recovery Team to respond to NPS ( Net promoter Score) surveys• Implemented internal training program to acquire skills in SQL, SSIS and Six Sigma Certification• Created a user manual for an internal Access database tool that was used for requesting various reports from the analytics team and to track all escalation and Medicare complaints• Created IRE Technical Specifications for Humana Clinical Pharmacy Review team to identify compliance errors• Created Standardized Reporting for all internal Escalations and Complaints for URAC• Facilitated Process Validation Meetings Show less

• Operations Supervisor

  • Jan 2009 - Oct 2011

  • Led a team of 22 Customer Care Associates• Created and facilitated Right Source Pharmacy presentations for Humana Cares divisions located in the following states: AZ, CO, ID, OR, UT, WA and WY• Collaborated with State Manger and Field Care Managers of Humana Cares to help maximize benefits• Organized and Managed projects with high visibility and sensitive timelines• Designed and implemented a dedicated concierge team of 18 associates for New Commercial Acquisitions • Created and Implemented an Employee of the Month Program • Led a team of 9 cross-functional associates to set a record for RX Enrollment Inbound with 5, 519 new enrollments within 90 days. Show less

• Operations Supervisor

  • Nov 2007 - Jan 2009

  • Relocated to open and Manage a brand new DMS ( Direct Marketing Sales) Call Center in Phoenix, Arizona• Participated in the Startup of Arizona Pharmacy Call Center• Facilitated New Hire Training for unlicensed agents• Developed New Hire Training Curriculum for unlicensed agents • Managed the USAA/Tri-Care Delegated and Strategic Alliance line of business for all DMS ( Direct Marketing Sales)• Managed the Arizona Market for all DMS (weekly lead load, appointments, seminars and special needs plan specific to Arizona) Show less

• Telesales Agent

  • Oct 2006 - Nov 2007

   Consultative selling via telephone to Medicare beneficiaries Successfully worked lead generation for inbound and outbound Met or exceeded targeted Performance/QA metrics Became Team Lead of my outbound sells team within 6 months Led outbound campaign project that ultimately lead to 400 new positions within Humana’s RX Enrollment Team. Licensed and appointed in 22 states.