Provide on-site Business Assessment, Management Consulting and Support Services to Customer facing business units.Developed, directed strategy and led implementation to strengthened company's customer operational areas.Assess, review and developed Medicare managed care policies related to Grievance & Appeals, Customer Service and Enrollment.Perform business assessment of Customer Service Operations, including technology platform.

Led 240-member Call Center and Member Services team responsible for first-line responseto all Marketing and Member Services inquiries with a call volume of more than 1,900,000calls per year.Planned, prioritized, and delegated assignments to ensure quality performance on a dailybasis.Oversaw staff training to ensure broad knowledge of customer service skills, healthprograms and benefits, and regulatory requirements.Implemented quality and performance-related strategies to improve service, productivity,efficiency and ensured regulatory compliance.Oversaw ACD call flow and distribution systems, established performance requirements,and reported analysis.Collaborated with executive management to plan for and support organizational growth.Strengthened company's business by leading implementation of the Transportation benefitand operations.Successfully led the department and organization in numerous NYS Department of HealthAudits (Article 44

Led a 240 member call center with a call volume of more than 1.9 million calls per year. Implemented quality and performance related strategies to improve service, productivity and efficiency.

Managed daily operations of busy Member Services department and 12 direct reportsProvided daily direction and support to staff, prioritized assignments, and served as liaisonto other departments.Responsible for the Grievance (Complaints) & Appeals unit

Managed the health care processing technology business unit.Responsible for unit.budget and P&L.Responsibilities included: business strategy, information systems,EXECUTIVE PROFILE; technology, telecommunications, client services, provider database, and human resources.

Developed strategy and business model for 90-day new client implementations.Conducted comprehensive assessment of the organization's information system, and maderesource recommendations.Led initiative to introduce a more client relationship-driven process.Developed the departmental program template and operational protocols necessary toestablish the internal organizational structure for the Medicare program.Managed provider database department in accordance with clients' contractual standards.

Worked directly with Corporate Vice President of Government Programs onimplementation of a Medicare Compliance/Operations program.Prepared recommendations on operational issues as they related to regulatory compliancefor the Medicare program.

Managed Medicare/Medicaid Sales Managers, Telephone Sales, and Operations forGovernment programs.Developed Marketing plans and budgets for each product line and worked with regulatoryagencies and advocacy groups.

Oversaw program development, implementation, service area expansion andmanagement of the Medicaid Program.Assured performance and compliance standards were met with all regulatory agencies.

Oversaw day-to-day marketing functions, including direct supervision of marketing staff.

Implemented Nassau and Queens County Medicaid Programs, with responsibility foranalysis of medical costs, member utilization, and enrollment, and working with New YorkCity government agencies.

Managed average caseload of 250 public assistance recipients in the work experienceprogram.