Lead, direct and coordinate all activities associated with HAP’s consumer operations department which include call-center, call-center quality and training, service excellence and enrollment premium and billing. Additionally responsible for configuration oversight.

Responsible for all BPO Medicare plan operations including Claims, Enrollment, COB, Member/Provider Services, Payer System Configuration ( benefit, provider and pricing), Appeals & Grievance, Provider Data Management. Additional responsibilities include: Client Relationship Management, Vendor Management and Cost Canter Financial Management.

Responsible for the administration of Aldera configuration across Medicaid, Medicare and commercial lines of business. Servicing our clients with oversight of provider data management and credentialing.

As Director of the Business Configuration Unit, I set the Strategy and oversee the operations for Care Advance, Care Advance Provider and Facets configuration. The 31 employees that reported to me were innovators of complex system configuration producing competitive products, defining networks and solutioning automated utilization management programs for BCN. Additionally, lead projects converting all access database tools to SQL, implementing HP UFT and developing a custom workflow and testing tool in MVC C # and SQL to support system configuration with optimal work tracking and automated testing. Departments overall quality rating: 2016 98%, 2017 99%.My personal contributions include:Creation and implementation of an operating model in 2017-2018 to support greater volume and complexity of work with maintaining high quality system configuration resulting in elimination of our inventory. Introduction of new technology to support growth and stay cutting edge within the industry. Establishment and implementation of a System Optimization Committee for strategic decisions on exploiting our current claims and care management systems functionality and reduce custom coded solutions to simplify our corporate architecture and improve business processes.

licensed broker in Life, Health and Accident Insurance in the states of South Carolina and Georgia.