John Kilmer Email & Phone Number

Tempe, Az

PROCESS IMPROVEMENT, CALL CENTER, COMPLAINTS & GRIEVANCESCall Center – Grew department from 40 reps to nearly 100 reps in two remote locations. Created and managed budget. Created and documented policies, procedures, and training curriculum. Established, communicated, and tracked individual metrics. Prepared for and successfully passed all audits.Process Improvement – Led several cross-functional initiatives improving process flows, metrics, and technology that resulted in better outcomes within several multi-site functional areas.Complaints & Grievances – Created a team to record, track, close, and report all occurrences throughout the organization. Worked closely with Compliance to ensure all internal, client, and state audits passed. Key Achievements• Established a clean call reason list for call reps enabling tracking and proactively reducing call volumes.• Transformed a lackluster call center into a model department surpassing customer service levels and maintaining low turn-over during significant organizational and structural changes. • Streamlined a broken clinical documentation process into a flawless process with document revision control, master retention, sign-offs, tracking, and defined roles and responsibilities.• Created new on-line reporting and tracking tool for all complaints enabling tracking and proactive reduction of occurrences.

Scottsdale, Az

Obtained my real-estate license and partnered with 4 other business professionals to create a very large commercial real-estate portfolio taking advantage of a time when inventory levels were high and interest rates were at record low. Gained extensive knowledge about the legal, financial, and contractual aspects of an entirely new industry.

Phoenix, Arizona Area

General Manger, North American OperationsCognizant is a world leader in consulting and business process outsourcing (BPO). With operations in 42 countries, their primary operations are located in India. DIRECTOR OPERATIONS | GENERAL MANAGER, NORTH AMERICAN OPERATIONSLed US-based healthcare operations for all active businesses with over 200 employees and multi-million-dollar budget. Contracts encompassed all areas of operations in Managed Care and PBM business with inbound/outbound call center operations, claims processing, credentialing, and eligibility. Key member in proposal preparations and sales presentations to acquire new business. Ensured smooth implementations of new business with full P&L responsibility. Optimized all operations ensuring client satisfaction during project life span, resulting in positive profitability. Key Achievements• Saved primary client from canceling contract by turning project around in exceeding turn-around time and quality within six months. Became client’s preferred vendor.• Renegotiated contract with large client to increase rates and increase committed volumes.• Won several new projects and new business with current clients.• Instrumental in winning major new client contract. Led all implementation and set-up/build-out to get project underway.• Reduced turnover for past year from over 50% to under 1%.

Phoenix, Arizona Area

Led multi-site teams and vendors in the extraction and analysis of paid claims to uncover erroneous payments. Estimations were a loss of nearly $300 million per year in wrongly coded and/or paid claims.

Scottsdale, Az

Optimized the comprehensive processing of all member, pharmacy, and government paper claims exceeding 4 million transactions annually. Forecasting, managing budget, and people management responsibility. Partnered extensively with internal stakeholders to implement proactive process enhancements. Managed $5.5M budget and up to 125 employees.Key Achievements• Achieved over $2M in cost savings.• Seamlessly consolidated five sites, streamlining processes.• Implemented electronic paperless process, reducing headcount from 250 to 73. • Reduced turn-around time from 10 to <3 days.• Improved quality from 90% to 99.9%, eliminating 100% of warranty payments.• Streamlined processes by standardizing common functions across eight legacy systems. • Renegotiated contracts with three vendors that processed >1.5 million claims/year for contingency planning. • Reduced claim receipt volume by 15% each year. • Reduced turnover from 65% to <5%.

Scottsdale

Eligibility, Electronic Data Transfer, Print Production, Assembly, Mail Optimized operations of multiple departments in multiple locations engaged in managing electronic receipt of client eligibility files and electronic response files on member claim history. Coordination for creation, production, and delivery of member welcome kits and pharmacy cards and all mailroom functions and associated vendor contracts. Forecasting, managing budget, and people management responsibility. Managed operating budget of $10M+.Key Achievements• Realized $4M+ in cost savings. • Reduced turn-around time from 10 to <5 days.• Reduced equipment maintenance agreements by 50%,. • Eliminated 100% of warranty payments.• Improved error rate from 30% to nearly 6 Sigma quality level. • Seamlessly consolidated two sites, streamlining processes.• Implemented print-on-demand that reduced headcount from 92 to 11.• Automated eligibility file loads facilitating a 30% staffing reduction. • Fostered a culture that maintained a low turnover rate and high employee morale during transition to outsourcing.

Scottsdale

MANAGER CORPORATE QUALITY AND PROCESS IMPROVEMENT Established a corporate-wide quality organization to teach and guide departments in approach to cost reductions and quality improvements.MANAGER CALL CENTER PROCESS IMPROVEMENT Established a team of specialized MBA employees with a $5.2 million budget to enhance the efficiencies and member experience within the call center handling 4 million calls yearly. Optimized phone line and routing of calls, IVR system, performance metrics, and operating system enhancements.Key Achievements:• Realized a budget reduction of $5.7 million (15%)• Decreased total call volume 2% and prescription related calls by 28%.• Increased IVR’s total resolve rate by 23%, and “refill” calls by 16%.• Reduced call handle time by 14%.• Increased member satisfaction 29%.• Achieved a 40% increase in IVR satisfaction rate.

Phoenix, Arizona Area

QUALITY ENGINEER SPECIALIST / SIX SIGMA BLACK BELT Designed and implemented several quality program plans within a 1200-person manufacturing facility that enabled business units to reduce poor quality by over 25% and escapes by 500%.PROJECT/PROGRAM MANAGEMENT ENGINEERING Worked various aspects from internal assembly manufacturing projects to after-market enhancements to new product design and development. Managed up to a $5.2 million program budget.

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

Bachelor Of Science (Bs), Mechanical Engineering