Created a centralized resource management HUB within Jira/Atlassian that included a dynamic FAQ and ticketing tool which permitted 5k plus agent’s self-help options thusly reducing overhead L&D costs and increasing contract compliance.● Dive deep into process analysis to uncover inefficiencies by collecting data, engaging with stakeholders, and mapping workflows, driving impactful improvements.● Design cutting-edge solutions to enhance processes by creating new workflows, recommending innovative tools, and reshaping organizational structures for maximum efficiency.● Propel process improvements by collaborating with cross-functional teams to secure buy-in and ensure the seamless adoption of innovative methods. ● Establish metrics to measure process effectiveness and continuously monitor performance, uncovering new opportunities for enhancement.● Team up with Senior Leadership, the People Team, and Onboarding and Training departments to craft innovative curriculum and offer comprehensive support for teams adopting new processes and technologies

Increased communication turnaround time by 20% by creating and implementing a business continuity and communications plan, effectively addressing communication process gaps and outdated technologies, and decreasing customer abrasion. In addition to this, CSAT was increased by 10% and penalty costs decreased by 40% by establishing BCDR program KPIs and developing a comprehensive business continuity and disaster recovery plan.● Lead the creation and management of business continuity and communications plans, including disaster recovery and BCDR strategies for the digital product suite.● Took ownership of developing and executing the communications strategy for Johnson Controls' digital product suite. This includes driving process development, defining RACI frameworks, and creating compelling content.● Collaborated with key stakeholders to spearhead periodic cyber and disaster recovery exercises, ensuring the organization's readiness and resilience against potential threats.● Developed and established program KPIs that deliver clear visibility into stability, performance, risk, and readiness, ensuring comprehensive oversight and proactive management.

(Promotion)Developed and implemented strategies for cross-functional detection and elimination of fraudulent behavior, increasing audit scores to 95% from 75%.● Responsible for the internal investigative unit of the Legal and Compliance team(s) including risk analysis and fraud detection. Aligned SLAs and department goals with both State and Federal Compliance guidelines.● Oversaw the operations for conducting thorough investigations for both the Legal and Compliance departments.● Developed strategies for the cross-functional detection and elimination of fraudulent behavior from internal and external bad actors.● Prepared investigative reports and analyses pertinent to evidence obtained during investigations.● Oversaw internal and external ethics line which includes response, investigation, recommendations and remediation. Cross departmental investigation partnership with focus on clinically protected materials.

(Promotion)Achieved outstanding outcomes, with all six contact center sites functioning independently, including one international center, while maintaining redundancy and Business Continuity and Disaster Recovery (BCDR) protocols. Maintained consistent service quality across all centers through the implementation of standardized Learning Management Systems (LMS) programs, universal Policies and Procedures (P&Ps), and a robust Quality Assurance program.● Oversaw program delivery for the member-facing business line, ensuring seamless patient-to-provider interactions and achieving high customer satisfaction and operational efficiency across phone, email, and online chat channels. Implemented performance metrics and KPIs, utilizing call routing, IVR systems, omnichannel solutions, AI, and other advanced call center technologies.● Led multiple national and international Customer Service Management projects, collaborating with IT and business leadership to enhance customer service efficiency and effectiveness. ● Developed process metrics for the Call Center Operations Management team to evaluate effectiveness and implemented a standardized change program leveraging stakeholders, systems, training, and resources for successful execution. ● Utilized process mapping and documentation to define and standardize operating procedures, maximizing productivity and work quality. While leading operations for the member-facing product roadmap, supporting the operating plan, optimizing the business model, and exceeding KPI targets.● Led new business integration from acquisition to “go live”, driving process implementation through unified functions and systems for seamless transition and success.● Partnered with cross-functional teams in IT, operations, and marketing to uncover opportunities for enhancing the customer experience, leveraging feedback and insights to drive impactful improvements in service delivery.

(Promotion)Created and maintained effective Quality Assurance and Operations Training programs. Implemented AI call monitoring, boosting QA scores to 92% from 75% and cutting HIPAA failures by 90%. This was done while managing a $4M department budget and leading a team of 7 professionals, excelling in enhancing operational efficiencies and quality of service.● Spearheaded cross-functional training and QA programs across multiple organizational units, including Call Center Operations, Patient and Member Support, and all member-facing programs. Managed training for new hires, vendors, and continuing education courses to ensure excellence and consistency. ● Enhanced knowledge retention at all employee levels through guidance, coaching, recognition, and motivation. Identified unique training opportunities and led programs and workshops to address skill gaps, cultivating successful service behaviors that elevate program performance.● Served as a subject matter expert for call center and support functions during the international expansion of call center services this also included telephony and CRM integration into existing or new applications. Led cooperation with Legal/Compliance teams to address regulatory issues, ensuring seamless and compliant service delivery.● Designed quality assurance and control assessments, process control methodologies, and monitoring programs for call center and transactional processing across Operations functional areas, ensuring high standards and operational excellence.● Acted as Work Force Management (WFM) by tracking key performance indicators (KPIs) like call abandonment rates, average handle time, first call resolution, and customer satisfaction scores, and proactively addressing any areas of concern to drive continuous improvement.

Slashed resolution time from 7-10 business days to <24 hours by establishing member retention team and developing CRM with ticketing management tool, achieving optimal service delivery, payment, and satisfaction while managing a $2 million department budget and leading a team of 5, focusing on operational excellence and enhancing member services. ● Identified and defined needs for process improvement as well as developed and established new policies and procedures● Managed system development ticket request process.● Evaluated, approved and managed special projects including but not limited to determining feasibility of request, resource utilization and ownership of project completion.● Participated/provided/assigned operational support for special projects such as acquisitions, marketing initiatives, and large IT projects.● Implemented policies and procedures that were directly aligned with contractual obligations and organizational goals, enhancing service delivery and client satisfaction.

● Supervised direct-reporting staff with a focus on delivering exceptional client service, supporting national and field sales, and driving lead generation for workers' compensation and liability services. (Action verb) + what you did (more detail) + reason, outcome or quantified results● Established and launched inside sales and collections teams, driving end-to-end client service excellence. ● Launched a quality assurance program to achieve and maintain the highest level of client service excellence.● Ensure compliance with Corporate and Federal policies regarding workers' compensation and liability services, maintaining adherence to all relevant procedures.

Held multiple roles:(Promotion)Senior Manager of Compliance, Member Services(Promotion)Team Manager, Member Services (Promotion)Team Lead, Member Services(Promotion)Resolution Specialist, Member Services(Starting)Sales Support, Member Services● Oversaw all aspects of the call center by driving day-to-day operations and delivering exceptional customer service to the Medicare Advantage plan and its members. ● Played a pivotal role in crafting strategies to boost call center performance, enhanced efficiency, and elevated member satisfaction while ensuring full compliance with DOH and CMS regulations. ● Ensured compliance across all call center operations with Medicare Advantage regulations and other governing bodies, maintaining the highest standards of adherence and quality. ● Drove vendor management excellence by overseeing relationships with third-party vendors and service providers, ensuring they meet contractual obligations and deliver top-tier services. ● Addressed escalated customer inquiries and complaints swiftly and professionally, resolving issues and implementing measures to prevent recurrence and enhance customer satisfaction.