Kimberly Brzezinski Email & Phone Number

Melbourne Beach, Fl, Us

Responsible for the ensuring provider network adequacy to service Telehealth customers 24/7.

-Establish trusting relationships with key stakeholders and decision makers to influence complex programs.-Develop project approach, identify resource needs and impacted stakeholders, build governance framework, track progress along with risk mitigation.-Execute on business strategies by leading large-scale initiatives that require key enablement activities including: driving change throughout the organization(s), designing new operating models and processes, implementing technology, and ensuring best practices are adopted.-Achieve OpEx savings goals through multi-faceted project, process, and change enablement support.

Operations Lead• Streamlined operational processes by utilizing Lean Six Sigma methodology to identify pain points, remove waste, and implement control plans.• Built cost/benefit plans to influence investment decisions.• Achieved savings of $200K within 3 months of introducing first engagement of Robotics Process Automation into the organizations environment.• Managed global vendor relationship responsible for development of RPA (Robotics Process Automation) technology using Automation Anywhere.• Developed and implemented quality programs for client services.• Partnered with Sales and Account Management to develop engagement processes that improved inter-departmental relationships.Continuous Improvement Lead• Managed deployment teams responsible for identifying organizational opportunities and delivering on targeted business goals.• Generated change plans built on Procsi (ADKAR) methodology.• Identified and managed improvement opportunities for Global Client Services including customer data management, client billing, premium receipts, and broker commissions.• Focused on process efficiency and transformational change within the organization to better serve the global clients.• Implemented the first RPA into Cigna’s environment resulting in winning the 2017 “Innovation in Operating Excellence” for Robotics Process Automation Implementation.

• Led multiple large scale improvement initiatives resulting in cost savings, growth, revenue, and satisfaction opportunities for various organizations throughout the company.• Engaged with senior leadership to develop customized strategies to achieve organizational objectives.• Deployed and managed teams of professionals skilled in various disciplines including Six Sigma, Project Management, Change Management, and Knowledge Management to ensure multi-faceted business solutions.• Developed and implemented Central Operating Effectiveness’ strategic plans.• Established Cigna’s Business Process Management (BPM) program including training and governance.

• Established enterprise process modeling organization.• Managed the process modeling team responsible for gathering artifact and capability data to support enterprise process improvement initiatives.

• Led large-scale improvement initiatives focused on Business Process Management, TMC, and Operational Expense.• Performed in-depth departmental assessments evaluating organizational processes and operational gaps, and presented recommendations with risk, return on investment, and stakeholder impact analysis.• Managed process documentation to support operational organizations of over 2000 employees.• Responsible for 98% of all documentation completed within expected target dates with 100% quality.

• Managed credentialing operation for the Northeast and Mid-Atlantic region.• Negotiated delegation arrangements with high-profile organizations.• Participated in State Department of Health audits and NCQA accreditation preparation.• Increased regional productivity of credentialing by 50%.

Network Provider Contractor

• Recruited providers in assigned territories using target listings and negotiation guidelines. • Created Access database for use by New Jersey, New York and Pennsylvania recruitment teams. • Developed reporting mechanism for territory analysis.

• Promoted electronic solutions to provider community in the Lower Manhattan region to streamline transactions such as referrals, claims, eligibility and pre-certification. • Conducted web-demonstrations to educate providers and office staff on the efficiency of doing business electronically. • Established relationships resulting in direct reduction of overall cost due to volume of electronic transactions.

Newark, Nj

• Assessed targeted physicians and created workplans for office to meet year-end goals in the areas of membership growth, quality standards, and state compliance. • Created Access database to analyze quality scores, membership growth, and EPSDT compliance. • Recruited physicians in Southern New Jersey to meet state capacity standards for major transition. • Assist providers with claims/capitation issues. Negotiated out-of-network rates for non-participating providers. Created provider orientation tools for presentations to large groups.

• Recruit fee-for-service providers to ensure adequate specialty coverage in assigned areas. • Provide service to participating providers located in Middlesex and Somerset counties to resolve various issues such as claims, grievances, contracting and credentialing. • Orientate new providers on policies for referrals, pre-authorization and credentialing.

Piscataway, Nj

• Possess extensive knowledge of National Committee for Quality Assurance (NCQA) standards and New Jersey State HMO Regulations. • Responsible for the development and implementation of policies for the Credentialing Department. • Oversee the complete Credentialing process for all lines of business.

• Educated providers on Medicare Guidelines for E&M Coding. • Orientated providers with specific health plan coding guidelines using pristine presentation skills. • Researched and resolved various claim issues.

Bachelor Of Science (B.S.), Business Management

Obtained my HR Certificate - December 2015

Certified, Human Resources Management And Services