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Vice-President, Employee and Individual Claim Resume Example

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VICE-PRESIDENT, EMPLOYEE AND INDIVIDUAL CLAIM
Executive Profile

VICE-PRESIDENT LEVEL OPERATIONS/IT EXECUTIVE

More than three decades of experience in healthcare operations, manufacturing, distribution, supply chain, operations, and business systems integrations. Experience encompasses senior operations and executive positions as well as business systems management. Experienced and driven problem solver with proven track record in streamlining operations and maximizing productivity while increasing company profits. Leads teams by example in performance management, employee development, coaching and mentoring to drive individual and corporate success.



Skill Highlights
  • Health Care Operations
  • Enterprise Resource Planning/Management
  • Cost Control
  • Supply Chain Management
  • Database integration and application delivery
  • Process Analysis,Design and Improvement
  • Client Relations
  • Strategic Planning and Budgeting
  • Performance Appraisal
  • Project Management
  • Risk Mitigation
  • Infrastructure design
Professional Experience
Vice-President, Employee and Individual Claim04/2010 to CurrentUnitedHealthcareGreensboro, NC
  • Accountable for claim operations including 850+ onshore employees and 600+ offshore employees
  • Assigned accountability for new under performing operations into span of control to streamline and improve
  • Leading operations including E&I Appeals and Grievances, Specialty Benefits Appeals and Grievances, Inquiry Resolution Rework Unit, Specialty Operations (Accumulator Source of Truth functions), E&I Member Rework Operations, TRACR (Check recovery operations), Interest Reduction Team, Rework Reduction Team, National Regional Mail Operations, and Network Repricing Operations
  • Reduced $17m interest spend in one year
  • Reduced operational costs by $18m+ through process improvements, productivity improvements and rework reduction efforts
  • Improved employee engagement scores from 61% positive rating to 82% rating with 98% participation rate.
Principal Executive Vice-President04/1997 to 04/2010ABEAM ConsultingDallas, TX
  • Implemented ERP systems for 18 multi-million dollar organizations.
  • Defined and implemented B2B e-commerce collaboration portals for 2 multi-million dollar organizations.
  • Managed 20 direct reports and $20 million dollars of revenue
  • Led efforts in sales and marketing, supply chain management, manufacturing operations, inventory management, procurement, project management and finance.
  • Accountable for pre-sales support including product demonstrations, proposal creation, contract creation and contract negotiations.
Corporate Project Manager06/1994 to 04/1997Ferguson EnterprisesNewport News, VA
  • Led efforts in business process re-engineering and ERP system evaluation and selection
  • Developed a new shared services division to consolidate all purchasing into regional purchasing centers resulting in $10m savings
  • Re-designed the material planning philosophy and processes for all material planning and management.
Satellite Branch Manager08/1992 to 06/1994Ferguson EnterprisesPinellas Park, FL
  • Accountable for P&L management for $13 million division, 10 direct reports, sales management, account management, inventory and procurement management, direct sales and budget management.
  • Increased sales revenue $3 million in first year while lowering operating costs 10%.
  • Integrated new revenue division into existing market.
Operations and Purchasing Manager05/1989 to 08/1992Ferguson EnterprisesPinellas Park, FL
  • Accountable for P&L management of $25 million division, 35 direct reports, purchasing and inventory management, sales management, finance and accounting management and budget management.
  • Reported directly to Branch President.
  • Reduced operating costs of division 8% in first year
  • Improved material costs by through purchase negotiations and inventory management
  • Created new concept of sole supplier relationships with major accounts that increased revenue 75% with these customers.
Systems Integration10/1987 to 05/1989Ferguson EnterprisesPinellas Park, VA
  • Led integration of manual business operations onto new computer systems for all divisions of $3 billion organization, training of all personnel on new systems and project management of implementations.
  • Responsible for 5 direct reports.
  • Implemented new back office operational systems in 6 divisions of $3 billion organization.
Management Trainee08/1986 to 10/1987Ferguson EnterprisesColumbia, SC
  • Performed duties in receiving, shipping, city counter sales, inside sales and outside sales for assigned customer accounts.
  • Created job proposals and pricing for all customers for Columbia division.
  • Promoted through the management trainee positions quicker than any previous management trainee.
Education
Bachelor of Arts: Political ScienceFurman UniversityGreenville, South Carolina
Wharton Business School Executive Development Program - 2012 *UnitedHealthcare Executive Development Program - 2012 *Emotional360 Training - 2015
Awards

2012 UnitedHealthcare Innovation Award

Skills

account management, budget management, business development, business operations, business process improvement, contract negotiations, direct sales, E-Commerce, ERP, finance, inside sales, inventory management, Microsoft Office Products, Microsoft Project, negotiations, procurement, project management, receiving, sales management, sales support, shared services, shipping, supply chain management

Community Service

Board of Directors - American Red Cross - Greensboro, NC

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Resume Overview

Companies Worked For:

  • UnitedHealthcare
  • ABEAM Consulting
  • Ferguson Enterprises

School Attended

  • Furman University

Job Titles Held:

  • Vice-President, Employee and Individual Claim
  • Principal Executive Vice-President
  • Corporate Project Manager
  • Satellite Branch Manager
  • Operations and Purchasing Manager
  • Systems Integration
  • Management Trainee

Degrees

  • Bachelor of Arts : Political Science
    Wharton Business School Executive Development Program - 2012 *UnitedHealthcare Executive Development Program - 2012 *Emotional360 Training - 2015