Ensured customer-experience and risk-management strategy and goals were attained through the resolution of claims, benefit, and policy administration appeals/grievances/complaints from customers, providers, agents, state insurance departments, attorneys, and third-party relationships. • Led and directed a team of 3 Senior Customer Resolution Specialists and up to 20 Customer Resolution Specialists. Planned, prioritized, and directed the work activities of employees, including cross functional and virtual teams. • Coached, developed, and mentored staff, building a culture of resilience and positive response to change. Achieved high levels of employee engagement and retention by mentoring team members through numerous health insurance industry changes by providing ongoing updates, feedback, and encouragement.• Developed, mentored, and coached new Customer Resolution Supervisors and Seniors.• Led the interviewing, hiring, and onboarding of new staff.• Oversaw daily operations for the department, including: ongoing performance management, guidance on complex cases and written communications, managing inventory to ensure work is distributed appropriately, setting weekly productivity goals, creation of inventory reduction plans, and maintaining and enforcing quality standards. • Resolved highly escalated appeals, complaints, and calls that reached the executive level.• Identified, recommended, and implemented process improvements for efficiency gains and to increase customer satisfaction. Managed the pilot and implementation of a department Work Management System and LEAN principles to increase efficiency, reduce handoffs, and improve quality. Drove continuous Work Management System improvements to support changing regulatory requirements and continuous improvement to the routing of work assignments.

Trained underwriters and monitored quality to support the attainment of Underwriting Department objectives and goals for the placement of risk through the coordination of training/quality initiatives and the development, presentation, and evaluation of training and quality programs. • Managed and facilitated Underwriting Department training and quality programs for new hires and existing staff. • Developed, implemented, and monitored training and quality improvement project plans. Acted as a subject matter expert and worked directly with a consultant to redesign the new hire underwriting training program. Developed training curriculum and underwriting exercises to reinforce risk assessment principles. Piloted the implementation of the training program and coached/mentored the training staff on the successful delivery of the new curriculum.• Developed, implemented, and monitored performance improvement plans for learners while providing coaching and feedback to support the process. • Created training and development solutions to maximize individual, team, and organizational performance aligned with the achievement of business results.

Researched, analyzed, and assessed the medical and non-medical risk of new business individual major medical health insurance applications using a systematic and thorough review process to determine the applicant’s eligibility for coverage.