Melissa Alexander

Melissa Alexander Email and Phone Number

Sr. Director of Compliance and Ethics @ BeneLynk
Middleburg, FL, US
Melissa Alexander's Location
Middleburg, Florida, United States, United States
Melissa Alexander's Contact Details

Melissa Alexander work email

Melissa Alexander personal email

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About Melissa Alexander

Executive professional expertly skilled in operations, customer service, and compliance providing a unique blended insight for optimal outcomes. An agile performance driven professional, I am recognized for developing and implementing creative solutions to complex business challenges. I have led teams of 600+ in delivering administration of state and federal regulations, Medicaid, Medicare and commercial procedures, as well as managing quality processes. Successfully managed HITRUST r2 certification audits with zero residual corrective action plans. By blending problem solving and communication skills with strategic thinking, keen intellect and business savvy I deliver results in key areas. Organizational Leadership - Appointed site lead overseeing crisis management, logistics and site morale for 1500+ employees; led teams to achieve stretch targets delivering measurable and sustainable outcomes.Process Improvement – Removed bottlenecks in process flows, reducing process time and contributing to increase in provider satisfaction. Standardized executive-customer communications to expedite responses; utilized robotics to automate communication.Compliance - Successfully designed and implemented the framework of an effective compliance program as defined by CMS. Operational Excellence – Identified top processing/customer pain points utilizing data analytics; Maintained appeals regulatory compliance within budget for 15 consecutive years. Change Management – Designed and led stand-up of specialized provider services segregating from the general service operations and increasing provider survey results.Innovative Solutioning – Created software to manage inventory, monitor performance, improve workload distribution and reporting; Automated mail triage system to eliminate offshore manual processing saving millions of dollars.Customer Experience – Appointed to design and implement customer obsessed culture for Fortune 50 company increasing NPS by seven points; Created industry’s first social media channels to respond “in kind” to customers.Front-Line Production | Audit and Compliance | Quality | Data-driven Analytics | Process Improvement | M&A | Medicare and Medicaid | Team Development & Leadership | Certified Compliance Professional

Melissa Alexander's Current Company Details
BeneLynk

Benelynk

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Sr. Director of Compliance and Ethics
Middleburg, FL, US
Website:
benelynk.com
Employees:
267
Melissa Alexander Work Experience Details
  • Benelynk
    Sr. Director Of Compliance And Ethics
    Benelynk
    Middleburg, Fl, Us
  • Benelynk
    Director Of Corporatecompliance
    Benelynk Jun 2021 - Present
    Serves as Head of Corporate Ethics and Compliance, Data Privacy Officer and Internal Auditor while overseeing business continuity, vendor management and risk management programs.
  • Healthfirst
    Vice President
    Healthfirst May 2019 - Feb 2020
    New York, New York, United States
    This health insurance company wanted to improve its handling of Medicare complaints, grievances and appeals. Recruited for customer/problem-resolution leadership as company was developing and implementing new system to address those issues. Tasked to execute on the changes in preparation for CMS audit. Led six direct reports, staff of 125 in U.S. and offshore and eight-figure budget. Established complaint and appeal function. Aligned regulatory requirements with system design and built controls. Identified and mitigated compliance risks. Directed software implementation. Oversaw third-party mock audit. Structured teams around key functions and instilled management cadence. Developed and implemented quality programs and auditor function. Key participant in executive STARS oversight committee.Impact highlights include…☛ Improved process consistency, tracking, reporting, and quality while improving overall compliance (CMS 5-star appeals).☛ Delivered double digit improvements in cost efficiency, productivity, performance and process quality and corrective actions/regulatory risk in audits.
  • Aetna
    Executive Director Complaints, Grievances And Appeals
    Aetna 2011 - 2019
    Jacksonville, Florida, United States
    Promoted to senior leadership by this insurance company with tens of millions of members, tasked to continue managing complaints and appeals; subsequently appointed to create The Common Purpose and new service model for enterprise. Led ten direct reports and staff of 500+ processing 800K appeals annually, including commercial products, Medicare, Medicaid, disability, dental, life, and other voluntary products. Managed reporting and audits. Represented enterprise around appeals. Created rules for exceptions for sales team. Engaged with customers around appeals processes and improvements. Created and maintained reporting packages. Built and maintained professional relationships with regulatory bodies, including state insurance commissioners. Created business needs RFP for replacement of complaint and appeal system.Impact highlights include…☛ Crafted and implemented Common Purpose and new customer focused service model.☛ Increased member satisfaction/NPS in first year of new service model.☛ Developed and directed enterprise complaint and appeal function. ☛ Built 24/7 social media resolution team. ☛ Partnered with IT vendors to implement inventory and performance management systems.☛ Identified opportunities and procured IT resources to introduce robotics within appeals process.☛ Appointed as site leader over facility, logistics, morale and crisis management for 1500-plus employees.
  • Aetna
    Project Manager
    Aetna 2001 - 2011
    Jacksonville Fl
    Promoted as enterprise leader to develop and implement enterprise appeals function and systems. Worked cross functionally to identify process improvements. Negotiated and trained offshore vendor resource to assist with appeals. Removed redundancy in clinical and non-clinical appeals functions. Key contributor in Medicaid encounter reconciliation improvement. Oversaw implementation of new complaint and appeal software. Implemented best practices. Led Medicaid appeals migration of recently acquired Schaller Anderson.Impact highlights include…☛ Established new service model focused exclusively on providers.☛ Improved efficiencies.☛ Achieved savings in vendor outsourcing. ☛ Maintained compliance with both state and federal regulations.
  • Prudential / Aetna
    Operations | Accounting | Legal Remediation
    Prudential / Aetna 1995 - 2001

Melissa Alexander Education Details

Frequently Asked Questions about Melissa Alexander

What company does Melissa Alexander work for?

Melissa Alexander works for Benelynk

What is Melissa Alexander's role at the current company?

Melissa Alexander's current role is Sr. Director of Compliance and Ethics.

What is Melissa Alexander's email address?

Melissa Alexander's email address is me****@****ynk.com

What schools did Melissa Alexander attend?

Melissa Alexander attended Loyola University Of Chicago, Jacksonville University, University Of North Florida.

Who are Melissa Alexander's colleagues?

Melissa Alexander's colleagues are Krista Lopez, Antonio Mosqueda Riollano, Isabel Cosby, Roberto Reyes, Joshue Melendez, Triniti Adams, Waldy Chacón.

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