Driven Strategic Account Executive in the employee benefits and web base technology solution industry. Accomplished in vendor management, leading client negotiations, managing contracts, process improvement, and project management. Confidently handles a wide variety of different detailed and sensitive tasks while managing shifting priorities. Establish a healthy pipeline of early, mid and late stage opportunities to drive consistent results. Develops strong internal and external professional relationships as the basis for successful client service and retention. Effectively interface with all levels inside and outside the company, including senior management with efficient corporate level problem-solving. Interpersonal skills and teamwork are the key elements used to manage critical projects and meet deadlines, resulting in high-level problem resolution and client retention. Project Management: Directs strategic, customer specific initiatives, which deliver 'value added' services through the execution of client specific business plans Clearly demonstrates the value propositions for specialty and ancillary business to improve customer growth and retention Complete full client implementation at point of sale for Third Party Administration (medical), Pharmacy Benefits Management and Web Base Prior Authorization Application. Creates synergy by coordinating efforts between internal department's consultant-broker and clients to deliver results on time and within budgetary parameters. Leadership and Teamwork: 19 years' experience working in the health care industry Lead client negotiations, and manage the contracting process by working with client, internal business and legal participants, develops executive relationships, identify and leverage growth strategies Consistently meets with customers quarterly, identifying trends and offering consultative solutions to resolve areas of concerns Works comfortably across all corporate functional areas with all involved to evaluate, prioritize requirements, estimate efforts and lead teams into successful implementation.
Strategic Account Executive06/2014 to CurrentHealth Information Designs IncAuburn, AL
HID is an independent, objective clinical services company dedicated to providing solutions that focus on maximizing quality of care while limiting financial or regulatory risk.
In a changing pharmaceutical landscape, HID provides clinical experts who use evidence-based protocols and innovative technology to empower clients.
Responsible for management of sensitive State, Commercial, Medicare and Medicaid client accounts.
Manage multiple contract specific requirements, reports, quality management and project management protocols (proposals, statements of work, program documentation).
Coordinate with clinical pharmacy staff to convey recommendations for new and updated clinical edits.
Manage expectations internally and externally to represent client requests for product development enhancements as well as custom needs by individual client solutions Accomplishments: Successfully managed state and government regulatory audit Improved client confidence and relationship by establishing organized approach to projects and deliverable tracking that align with their contract requirements Successfully implemented and upsold letter print and mail service (total revenue upsell $900k) Successfully implemented and upsold business process outsourced services to software as service (SaaS) client (total revenue upsell 2.4 million) Successfully upsold product enhancement opportunity (total revenue upsell 2.2 million).
Client Relationship Manager04/2011 to 06/2014OptumRx
Company profile: OptumRx, a leading PBM, specializes in the delivery, clinical management and affordability of prescription medications and consumer health products.
Responsible for the overall management of a book of National Accounts.
Primary point of contact for day to day operation activities for 38 pharmacy clients ranging in size from 7,500 to 100,000 employee lives.
Directly working with Clients/ Broker and Consultants providing extensive operational and client-sensitive support to ensure pharmacy claims are adjudicating according to the plan intent.
Complete data analysis to improve benefits or initiate an up sell on a better product or service.
Maintain a high level of healthcare industry knowledge as well as customer's industry.
Accomplishments: Successfully implemented 5 new PBM clients Completed renewal process for all 38 client benefits for upcoming calendar year, coding changes, UAT testing, employee benefit booklet updates and call center training Participated in final sales meeting providing claim demo and full overview of day to day operations Attended client benefit fairs to meet face to face with members to assist in day to day benefit questions and provide marketing material specific to their pharmacy benefits Successfully managed 12 large project specific to medical and pharmacy deductible/out of pocket integration across book of business working internally and externally to ensure member claims paid correctly.
Client Service Consultant06/2008 to 04/2011UMR United HealthcareWausau, WI
Company profile: UMR is a third-party-administrator for employee benefit plans.
Primary point of contact for day to day operation needs for 28 + employer groups.
Responsibilities include implementation and assisting them in all aspects of problem solving to fully support the company's decision to pay medical claims and provide excellent customer service based on the clients intent.
Accomplishments: Successfully implemented 35 new client implementations from point of sale Primary Client Service Consultant lead in final sales meeting providing medical claim demo (CPS) and overview of day to day operations Served as primary point of contact for sales executives to provide onsite claim tour and company overview Attended client benefit fairs to meet face to face with members to assist in day to day benefit questions and provide marketing material specific to their medical benefits.
Medical Claim Supervisor03/2005 to 06/2008UMR United HealthcareWausau, WI
Company profile: UMR is a third-party-administrator for employee benefit plans Lead a group of 18+ individuals, providing support in all aspects of claim processing, plan benefit training and customer service, as well as providing performance appraisals for each employee.
Accomplishments: Assist with the work flow of the Claims Department, successfully implementing 6 new process improvements, testing through pilots within my team.
Update payroll time records for the Claims Department Prepare Claims Production Analysis Reports Review all written referrals from the Claims Examiners Participate in the hiring and interviewing process Review and adjudication of medical claims based on policy provisions Provide Claims Examiner training.
Education and Training
Bachelors of Science: Healthcare ManagementRasmussen CollegeHealthcare Management
High School DiplomaAntigo Area High School
business process, data analysis, marketing material, product development, sales