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Click here or scroll down to respond to this candidateCandidate's Name
Frisco, TX, Street Address ; PHONE NUMBER AVAILABLEEMAIL AVAILABLEEXECUTIVE SUMMARYA seasoned Operations executive with a demonstrated history of excellence in sales, insurance, actuarial science, and healthcare, and possessing over 12 years of experience in people management, applied mathematics, operations oversight, and coordination.EXPERIENCEOne Bariatric, Dallas, TXDirector of Operations Jan 2022-April 2024 Manage operation staffing, scheduling, evaluation, performance, and development within a collaborative team environment, overseeing process changes, enhancements, modifications, and department budgets. Create performance goals for each department, monitor performance against goals, support all departments to meet production goals, and confirm policy/procedures are up to date. Submit monthly operations data to executive leadership, monitor reporting systems, perform analysis, and provide recommendations resulting in improved profitability and revenue growth. Establish and maintain robust relationships with key stakeholders, decision-makers, and influencers within designated accounts, ensuring the dedicated maintenance of strong account relationships. Senior Vice President of Insurance July 2021-Jan 2022 Monitored team performance, tracked progress toward our set goals and metrics, and provided regular reports. Develop, maintain, and revise procedures to streamline patient processes and improve surgery approval. Led a large team of professionals, fostered a culture of collaboration, innovation, and excellence, and ensured compliance with industry standards and regulations. Provided leadership and subject-matter expertise in the area of insurance requirements, approvals for surgery, and industry trends.Advantage Point Behavioral, Dallas, TXSr. Operations Manager April 2018-Jan 2020 Provided leadership and direction for overall efforts of all APB operations to organizational initiatives and teams as they relate to strategic goals. Administered strategic goals for insurance operations including business technology, policy administration, and reconciliation of data. Developed and implemented procedures and regulations, and managed the day-to-day activities of my team. Conducted regular performance evaluations and provided feedback to team members. Group Manager- Insurance Verifications June 2017-April 2018 Supervised and led a team of patient coordinators, assigned tasks, and oversaw their work schedules and performance while providing feedback. Collaborated with other departments, management, and contract companies to ensure adequate support is provided. Documented daily work activities to provide clarity to other team members and give feedback and recognition. Directed the verifications department in verifying benefits and effectively communicating the details to our patients.Manager- Patient Coordinator and Operations Dec 2016-June 2017 Strategically monitored the day-to-day operations of the business to ensure smooth progression. Assisted with control breaks, gaps, and issues which ultimately led to an increased patient volume month over month. Developed Key Performance Indicators and metrics for executive management to capture call audits, call durations, and contract invoices for accuracy. Created coaching tools to set clear, achievable goals, enhancing employee productivity and performance. Led a team of four analysts in designing and implementing operational processes using Full Slate software to meet business needs.Lancme, Frisco, TXBusiness Manager Dec 2013-Sep 2016 Sustained current competitive standings and achieved daily staff goals of $500 by proactively reaching out to clients and advocating for our products. Managed the training and growth of the staff, provided guidance on product knowledge and performance, and consistently maintained key performance indicators (KPIs) Organized communication with field sales representatives, training executives, and department managers. Established targets for employees to achieve and implemented incentives for meeting sales objectives. Lap Band Solutions, Dallas, TXOperations Manager Sep 2012-Sep 2013 Oversaw operational efficiency and developed and refined procedures and documents pertaining to policies. Streamlined processes for verifying insurance benefits, eligibility, requirements, and predeterminations. Directed the pre-determination and appeals department, appealed denials at both first and second level for potential reconsideration, utilizing both in-house and external financing options. Established targets for employees to achieve and implemented incentives for meeting sales objectives. Sr. Operations Analyst June 2011-Sep 2012 Orchestrated and produced presentations for seminars to educate patients on the lap band procedure. Managed complaints, facilitated resolutions, resolved issues, and streamlined processes. Appeal denials by providing additional information as requested by the insurance pre-approval department. Met budgetary goals, analyzed statistical data, assessed insurance policies, and enhanced patient experience. Sr. Insurance Analyst March 2008-June 2011 Examine patients medical records and submit pre-determination letters to their insurance for approval. In case of insurance denial, devise a plan of action with the patients to overturn the decision of the insurance. Appeal denials by providing additional information as requested by the insurance pre-approval department. Upon approval, arrange the surgery date, review pre and post-operative dietary guidelines, discuss preoperative testing, and explain surgical details with the patient. Insurance Analyst Oct 2006-March 2008 Verify patients benefits and acquire the requirements for surgical approval. Develop a plan of action with patients, reviewing their needs and explaining the workings of the requirements. Collect patients medical records and review their past doctor visits to determine if they meet the specific insurance requirements, expediting the approval process. Prepare all necessary documents and records to turn over to our pre-determination department. EDUCATIONThe University of Texas at Dallas May 2021Bachelor of Science, Actuarial ScienceCollin County Community College May 2018Associate of Science, General StudiesPROFESSIONAL CERTIFICATIONS AND EXAMS Project Management Professional Nov 2022 Exam Financial Mathematics- FM April 2021 Exam Probability- P September 2021TECHNICAL SKILLS C++, Java, R Language, SQL, MATLAB, Python, Microsoft Office suite, Advanced Microsoft Excel, Word, PowerPoint, Care360, EDI, Patient Point, Remedy MD, Full Slate, Nextech |
