Stan Koper Jr., Mba, Chie Email & Phone Number

Philadelphia, Pa, Us

• Direct multiple teams including Business Optimization, Call Center Performance, Issue Management, and Data Analytics, overseeing 5 direct leaders, ~20 Analysts, and over 1000 Vendor resources• Supported and provided analytics helping Plan achieve 5 STAR ratings for 2 consecutive years in E2E Medicare Operations• Provide Medicare support and guidance to all Shared Services Operational functions• Coordinate successful rollouts of Annual Enrollment period changes and project implementations in partnership with Project Management teams• Utilized Machine Learning to create detection models running Trillions of permutations on multiple claim dimensions• Developed and maintained relationships with various vendors for Operational functions, tracking Vendor Performance through Performance Indicators• Direct a team responsible for dashboard creation and analytics support, including EDI dashboards for monitoring various transactions and compliance collaboration tools for risk monitoring and remediation• Utilized strong analytical skills to identify cost-saving opportunities and streamline processes, resulting in significant operational efficiencies.• Demonstrated exceptional leadership by inspiring and guiding a diverse team to achieve ambitious goals and exceed performance targets.• Built strong relationships with key stakeholders, fostering collaboration and trust to drive successful cross-functional initiatives.• Championed a culture of continuous improvement, leading to the implementation of innovative solutions that enhanced overall business performance.

Newark, Nj, Us

-Identify training and development needs through trending analysis, business partner requirements and service initiatives partner with Training and Development to share results. -Develop and support business partnerships and represent department/enterprise with internal customers and vendor partners where appropriate.-Conduct detailed analysis to determine root cause analysis in connection with deficiencies sited in Audits; develop and implement corrections.-Design/implement audit plan for new audits.-Ensure Service Level Agreements (SLAs) are followed both internally and with vendors, educate vendors on policies & practices, monitor vendor compliance.-Identify, communicate and implement Best Practices across the enterprise as well as new audit initiatives, process improvements and any other observations discovered during the audit process which may impact the Service Division.-Present to stakeholders recommendations and enhancements of underlying processes to improve company performance.-Oversee external audits by government regulators to ensure accuracy of findings.-Accountable for maintaining effective internal controls over the processes and transactions under areas of responsibility including the completeness and accuracy of financial information and transactions, compliance with applicable laws and regulations, and the effectiveness and efficiency of operations.-Design and build job function dashboards, reports, models and visualizations to share data on fundamental measures of organizational success to maximize insight and action for internal/external customers. -Interpret, create final recommendations based on trend reporting to close operational gaps; present the results to key stakeholders and business owners. -Continuously identify processes to automate/eliminate reports by applying business process improvement and process re engineering to the report development.

Chicago, Il, Us

Key highlights in current role include: Ensuring timely and accurate response to our members. Adherence to Centers of Medicare and Medicaid Service (CMS) standards and guidelines which include Customer Service, Service Level Agreements (SLA) set by CMS. Creating communication channels that allow shared knowledge from our Customer service -representatives, and internal business functions. Maintain high level of customer service while containing costs. CAHPS & STARS improvement initiatives focused around improving customer service culture through key initiatives such as implementing a “No Homework” culture, and identification of key root cause issues that contribute to customer dissatisfaction. Appeals & Grievance – monitoring/improvement/analytics for identifying trends in member complaintso Saw over 50% overall reduction in Grievances from 2015 season to 2016 season. Review HPMS memos and ensure compliance to changes in CMS standards. Managed CTM Inventory, and developed cross functional work groups to review trends out team identified to improve overall customer experience. Reduced CTM inventory from 2015 season to 2016 season, and improved overall Plan ranking over 10 positions from previous year. Managed Executive Inquiry, Department of Insurance responses and escalations through team of specialized Customer Service reps. Developed and grew new staff based on improvement initiatives.  Created Operational Analytics team – team optimized various data sets and developed key operational metrics for monitoring and measuring the success of various operational areas. o Developed key metrics that help ensure the service our Medicare Members receive is exceptional. Participated in CMS Program Audit with new 2016 Protocols, including Tracer sample preparation.o Worked with multiple departments to validate alignment of functions to ensure consistency in processes, even in a highly matrixed process and organization.

Chicago, Il, Us

Supports operations through the training, development and leadership of his team of analysts. He drives collaborative sessions with senior leadership to gather, analyze and translate business needs into sophisticated solutions, handling any ad-hoc projects as assigned.Key Achievements: - Captured $5M in savings over four-month period through development of new inventory tool- Received SDO 5-Star Team Award for work on top-tier project regarding the TX Department of Insurance- Developed Root Cause Analysis process to identify and mitigate issues facing claim processing- Promoted from Supervisor (2012) and Customer Advocate (2011) based on exemplary performance

Chicago, Il, Us

Responsible for team that produces Operational Reporting and Analysis to aid in day to day activities of the company.

Chicago, Il, Us

Supervised team of Refund specialists that handled the processing of items related to the return of monies and other related activities.

Chicago, Il, Us

Primary responsibility was to provide Customer Service to members of the Federal Employee Program Members, and Providers.

Master Of Business Administration - Mba, Business Administration And Management, General

Bachelor Of Business Administration (B.B.A.), Business Administration And Management, General

Associate Of Arts And Sciences (A.A.S.) - Multimedia Design, Graphic And Multimedia Design