Dynamic team-building,leadership skills and evaluating situations to increase the number of possible solutions. Strong, results-oriented problem solver. Comprehensive experience advancing workforce training initiatives and innovative programs. Able to set effective priorities and implement strategic plans to achieve goals and to meet deadlines. Coordinating relationship with vendors and contractors to cultivate new business, and expedite sales processes. Cultivating team relationships to better understand client needs and acting as a client advocate. Presenting and communicating across all levels within the organization.
Manager June 2014 to CurrentOptum － Providence, RI
Results-driven manager and analyst with documented success driving bold initiatives to support the Rhode Island Health Benefits Exchange SHOP program supporting small businesses throughout the state.
Implemented performance management standards and expectations, improving overall department performance and through feedback and training improved team's quality score by 10% Responsible for oversight of the operations/process which includes all service related activities as well as activities around the customer facing portions of SHOP operations Provide analysis of results and client processes and responsible for making recommendations on program enhancements to appropriate client services and operations leadership Investigate and resolve escalated inquiries involving enrollment and system issues; review and research client appeals Review monthly discrepancy reports; analyze data to identify trends and root cause issues to find solutions Perform research on a variety of health insurance and government topics for development of instructional materials; write instructional articles for internal publication Responsible for designing, editing, and producing standardized company communications, including operational and account emails, business letters, financial statements, and client documentation Educate, motivate, and lead 10-15 specialists that work directly with Rhode Island business owners Conduct biweekly performance reviews and weekly side-by-side coaching sessions as well as monitor calls to provide developmental feedback and ensure compliance of policies and procedures Ensure all Client quality and enrollment quota demands are met and exceeded Work with Human Resources to investigate and provide documentation for employee concerns, claims, disciplinary action, performance reviews, and discharge disputes.
Quality Analyst August 2013 to June 2014Optum － Providence, RI
Monitored inbound/outbound calls of 35 agents weekly for 2 lines of business (Individual & Family and Small Business healthcare) Assisted in researching appeals Liaison for supervisors to submit challenges on completed monitors Analyzed trends and offered feedback on improving call quality and processing Developed procedures for proper handling of calls, emails, and chats Led and participated in call calibration sessions with management and coaches Assisted supervisors in making performance improvement plans for agents Responsible for reporting of weekly averages, trends, and HIPAA violations Compared phone calls to completed applications to confirm adherence to federal and state policies Participated in creating recognition programs based on specialists' performance Knowledge of the Affordable Care Act.
Customer Service Team Leader January 2003 to May 2013MetLife － Warwick, RI
Responsible for communicating new procedures to the team Monitored phone calls and emails for accuracy and soft skills Assisted in development of Knowledge Base Reviewed policy provisions for English and Spanish-speaking customers through inbound calls and emails Resolved customers' service or billing escalations Processed financial transactions such as loans, withdrawals, and policy surrenders Processed and reviewed fund transfers, reallocations, and investment strategies Kept records of customer interactions or transactions, recording details of inquiries, complaints, or comments, as well as actions taken.
BA : Psychology, 2007Rhode Island CollegeGPA: Cum LaudePsychology Cum Laude
Bilingual - Fluent in Spanish (speaking, reading, and writing)