Brian Lightsy Email & Phone Number

Louisville, Kentucky Area

Program Manager on Farm Credit’s Process Improvement and Execution team. I lead programs and projects that comprise the organization’s project portfolio of enterprise-wide strategic initiatives.In addition to strategic program management, l also lead organizational and departmental problem-solving projects, or Continuous Improvement (C.l.) Events, that aim.

Chattanooga, Tennessee

• Managed the Individual Medicare Supplement and Group Medicare Advantage products for BlueCross BlueShield of Tennessee's Senior Care Division (Senior Products). I was responsible for leveraging opportunities to expand.
• Managed the product development and renewal of Medicare Employer Group contracts
• Created project plans for Medicare Supplement activities such as state product filing and new project implementation
• Communicated product updates to cross-functional areas
• Analyzed membership and market data to assess product competitiveness and identify growth opportunities
• Worked with Marketing team to properly position products at the most effective time(s) of year

Louisville, Kentucky

• Served as Business Liaison to coordinate Communications output requiring cohesion among multiple business units
• Managed multiple projects simultaneously
• Wrote and analyzed business requirements to ensure they were aligned with business expectations
• Consulted with business partners, I.T., and Applications Engineers to achieve realistic levels estimates and timelines for projects
• Facilitated kick-off meetings to align stakeholder expectations and uncover any high-level assumptions, constraints, or risks
• Coordinated communications output via cohesive, collaborative efforts between Business partners, Application Engineer coders, and I.T.

Louisville, Kentucky

• Managed the maintenance and filing of 31 Humana Medicare Advantage plans within the Mid-South region (2012) and 36 Humana Medicare Advantage plans within the Gulf States region (2013)
• Served as Liaison between Regional Markets, Corporate, Actuary, and the Centers for Medicare and Medicaid Services (CMS)
• Consulted with markets to develop competitive plan benefit offerings
• Developed competitor analyses for Market specific product strategy and planning.
• Created test cases for Process Improvement initiative for Benefit Communication between cross-functional teams
• Provided analysis of reports to inform business decisions and improve business processes

Louisville, Kentucky

• Created and distributed acknowledgment letters for members and providers informing them of receipt of their appeals and inquiries.
• Provided first touch resolution for critical inquiries and grievances and appeals.
• Case-coded member and provider grievances and appeals and routed to appropriate team for closure.
• Organized and prioritized high volume or time sensitive inquiries to ensure deadlines were met.

Louisville, Kentucky

• Researched Humana Medicare Member enrollment issues and rejections.
• Resolved Medicare reconciliation discrepancy inquiries.
• Communicated work flow numbers from team lead meetings to team members.
• Updated member records and validated members’ eligibility for enrollment.

Louisville, Kentucky

• Continuously met and exceeded monthly metrics and quality expectations.
• Provided guidance and resolved provider, member, and agent issues.
• Resolved pharmacy access to medication discrepancies for providers and members.
• Enrolled, disenrolled, and reactivated member plans.
• Assisted members and providers with claims and benefits information.

Master Of Business Administration (Mba), Business Administration And Management, General

Bachelor'S Degree, Corporate & Organizational Communications

Member of Omega Psi Phi Fraternity, Inc.