Michele Powers Email & Phone Number

Wilmington, Delaware

Lead global operations for expat medical, life, ad&d and LTD products - claims, customer service, enrollment, billing, ID cards, vendor oversight, quality and operational compliance.

Greater Philadelphia Area

Managed 600+ customer service staff handling phone, email, correspondence, grievance & appeal inquiries, servicing 1.3M commercial medical and dental members with $50M annual budget.- Directed operations servicing 3M+ calls and 200k+ written customer inquiries per year.- Drove a multi-year Call Center Transformation project with 8 work streams with a cross functional implementation team targeting improved quality and cost. Reduced operating cost by $5M and improved first call resolution by 5% in first year.

Greater New York City Area

Managed 1900+ claim, customer service, and technical support staff in multiple locations servicing 2.6M medical and 500K dental members with $220M annual budget.- Directed operations adjudicating 30M+ claims with $6B+ in payments; serviced 4.5M+ calls per year with 92% first call resolution.- Managed Government Programs staff servicing CMS Medicare Secondary Payer Recovery and COB Administrator contracts.- Drove $52M in Claim Accuracy and $22M in Coordination of Benefit run rate savings and $20M in administrative expense savings during a 3 year medical/administrative expense reduction project.

Greater Nashville Area, Tn

Managed 500 employees responsible for processing Medicare Part B claims and handling provider inquiries for the States of Tennessee, North Carolina and Idaho.- Responsible for managing a $32M budget and processing 57M+ claims annually.- Expertise in RFP / bid development, government contracting and compliance.- Trained in Six Sigma Lean Principles with documented process improvement projects.

Chattanooga, Tennessee Area

Managed two Customer Service Centers in Chattanooga, TN and Charlotte, NC with 1000+ employees and a budget of $60M+.- Led operation supporting 2.9M members adjudicating 31M+ claims and handling 3.5M+ calls annually.- Managed Six Sigma methodologies that reduced claim rework by 45% through various initiatives aimed at improving customer satisfaction.- Worked in a matrix environment including oversight of outsourced mail operations, claim and customer service functions.

Sugarland, Tx

Moved to Aetna as part of Prudential HealthCare acquisition.- Managed 900+ employees supporting 1.5M members, adjudicated 9.6M+ claims and handled 3.6M+ calls annually.- Managed billing, enrollment, case installation and data entry functions in addition to claim processing and customer service.

Horsham, Pa

Claim functional lead for 4 National Service Centers monitoring inventory and quality nationally while driving quality programs and policy setting. (Director - 1996-1999) Started as a management trainee and held numerous operational roles of increasing responsibility throughout career that included 6 relocations. (1984-1995)

Bs In Commerce, Management & Organizational Behavior

Activities and Societies: Women's Basketball; Zeta Tau Alpha SororityLettered in basketball and field hockey and coached soccer.

Mba, Business Administration

Completed MBA while maintaining full time employment

Education record

- Completed 1 year program

Executive Leadership Program, Healthcare

Completed Executive Leadership Program (ELP) curriculum.