leader in Pharmacy Benefit Management responsible for client facing product
development, new client implementations, and client renewals. Extensive operations leadership in all facets
of Pharmacy Benefit Management and Health plan benefits. Successful agency sales and telemarketing
leadership expertise. Significant experience in leading high
performing, process improvement teams in the healthcare industry.
Strategic business planner
Active 240 - Life, Health and Variable Annuity license
Specialize in retiree healthcare and financial planning
Expanded the employer group waiver plan business by 75% while maintaining 93% rate of customer retention.
Grew the broker and agency partnerships from two agencies to seven strategic broker relationships in ten years.
Earned the Presidents award at American Express, and Express Scripts for excellence in service and product improvements.
Responsible for the account management of several National and Labor Union clients.
Ensure client satisfaction is maximized with timely issue resolution, and providing accurate product subject matter expertise.
Actively triage every aspect of the Medicare Part B, Part D, and Specialty drug experience with the clients, which included enrollment and eligibility processing, reporting, service, strategic planning, compliance guidance, training, installation, and operational support.
07/2002 to 09/2006
Marketing and Compliance LeaderBlue Cross Blue Shield of Florida － Jacksonville, Florida
Recruited to manage a staff of telemarketing sales agents, and management team responsible for direct to consumer business, including small group sales - size 1-50, individual under, and over 65 consumer health, Part D, and ancillary sales.
11/2000 to 07/2002
Senior Project Consultant Blue Cross Blue Shield of Florida － Jacksonville , FL
for the leadership of service delivery process improvements for the individual
consumer sales market.
initiatives implemented included improved sales channel integration,
streamlined medical underwriting guidelines, and improved contract automation
in the individual market.
01/1998 to 11/2000
Senior Project ConsultantBlue Cross Blue Shield － Jacksonville , FL
for Health Options, Inc. accreditation and compliance standards for Centers for
Medicare and Medicaid Services, and National Center Quality Assurance for
Member Rights and Responsibilities for managed care plans
Product oversight for all HMO, PPO, dental,
vision and long term care products.
03/1996 to 11/1997
Grievance Coordinator Blue Cross Blue Shield of Florida － Jacksonville , FL
for direct to consumer coordination and compliance of regulatory guidelines as
directed by Centers for Medicare and Medicaid Services, and National Center
Quality Assurance standards for Health Options, Inc.(HOI), Member Rights and
02/1995 to 02/1996
Transitional Customer Service Representative Blue Cross Blue Shield of Florida － Jacksonville , FL
for delivering accurate and timely information regarding benefits, contract
coverage, and policy decisions direct to consumers and business decision
11/1988 to 01/1995
Senior Fraud Prevention AnalystAssistant Team LeaderAmerican Express － Jacksonville, Fl.
Leader responsible for recruitment, coaching, development, and training on
product and technical fraud prevention tactics
05/1987 to 10/1988
SupervisorMemorial Medical Center Telephone Service Center － Jacksonville, Fl.
Supervised "Self - pay" Collectors for the Medical Billing Department.
Accountable for all monitoring, coaching, and forecasting of staffing volumes.
06/1986 to 05/1987
Account RepresentativeBarnett Recovery Center － Jacksonville, Fl.
Actively followed a portfolio of greater than $1 million in delinquencies to final resolution through personal depositions, garnishments, and levying of assets.
Education and Training
Masters of Healthcare ManagementUniversity of Phoenix
Bachelor of Business Administration: FinanceUniversity of North Florida － Jacksonville, FlFinance
Six Sigma e-Yellow Belt certification through Breakthrough Management, Inc.
Account / Client Management
Medicare, Medicaid and Healthcare Reform expertise