Jon Whitfield Email & Phone Number

Keller, Tx, Us

Lead a team that provides information management, business process automation and statistical analysis of the company’s key operational metrics, including sales volumes; customer service quality and efficiency; claims accuracy and timeliness; and underwriting volumes and efficiency.• Led design, development and deployment of a SQL Server-based reporting portal to provide real-time information throughout the company. Portal contains 125+ active reports and information search tools.• Developed scorecards used to track sales quality by agency and by agent. These scorecards are used to measure sales volumes and to improve product taken rates, customer retention, and cross-selling of products.• Designed and built MS Access database for managing products sold by market and sales agency. This database ensures that the appropriate products are visible to agents in the point of sale tool and serves as a vital repository for information on hundreds of products marketed nationwide.• Produced reporting dashboards for measuring and monitoring operational trends as well as facilitating claims administration and customer service.• Created tool to send email notification to agents when a customer’s policy is in the grace period due to non-payment. This allows the agent the opportunity to work with the customer to save the business.

North Richland Hills, Tx

Healthcare Economics, in coordination with the Network Development group, works to ensure that HealthMarkets significantly improves its medical costs and narrows the gap with the Tier One payor competition through the development of strategic relationships with vendors, networks, and other providers to improve the percentage of impacted claims, discounts, unit costs and utilization.• Responsible for identifying and improving unit cost trends and monitoring and assessing financial performance of leased provider networks.• Identify key drivers of unit cost and trend escalation.• Develop reporting tools for measuring and monitoring trends and reporting operational metrics.• Review provider network contract proposals to enhance performance and support negotiation efforts.• Collaborate with Director of Network Development to meet annual targeted discount and trend objectives as outlined by Divisional and Corporate goals.• Manage relationships with outsourced dental and vision provider networks.• Manage the supplemental products claims and customers service quality audit function.

Berlin, Germany

Responsible for managing the business affairs of 50+ workers in Germany, Switzerland and Austria. Resident in Berlin, Germany• Prepared individual annual budgets for the work of each associate.• Coordinated acquisition of housing for personnel.• Managed purchasing and sale of vehicles and/or arranged for routine transportation for personnel.• Managed fleet of company-owned vehicles.• Assisted with the acquisition of immigration documents.• Managed inventory of company assets throughout Germanic Europe.• Assisted personnel with country of residence tax preparation and compliance with tax laws.• Built and maintained database of personnel data and inventory.• Approved major company purchases and employee expense reimbursements.

Albuquerque, New Mexico

• Led department responsible for financial and statistical reporting of health plan book of business.• Developed and implemented new employer group reporting tools and end-user reports.• Developed and implemented reporting used by underwriting in pricing health plan products.• Oversaw development of reporting tools used for reporting to the State of New Mexico on the managed Medicaid product.• Advised on the selection of a new, comprehensive reporting suite to be used for all health plan reporting needs.• Provided data support and assistance in the development of monthly IBNR calculations.• Worked as part of the health plan senior financial management team.

Dallas, Tx

• Managed on-site claims administration and operational audits of national third party administrators.• Managed electronic claims testing to discover overpaid claims, including duplicate payments, missed coordination of benefits (COB) and subrogation opportunities and payments for ineligible members. • Performed claims and membership analysis in support of managed care product pricing.• Managed provider / Health Plan accounts receivable / accounts payable analysis and reconciliation.• Managed prompt pay regulatory compliance assessments.• Provided technical support and application development for property and casualty audit teams.• Led engagements responsible for improving the efficiency of claims operations at large insurers, leading to cost avoidance of over $1M for one national client.• Participated in Sarbanes-Oxley section 404 audits.

Arlington, Tx

• Designed custom reporting application used to automate client and product reporting using Visual Basic and Crystal Reports; designed and tested this application's reports.• Maintained timeliness and improved accuracy of statutory reports despite 33% reduction in Medicaid reporting staff.• Designed and maintained original reporting tool used for client and product reporting and actuarial/underwriting support.• Built Microsoft Access database and wrote reports used for large self-insured client; this database automated and replaced more time-consuming, manual reports.