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Customer Service Six Sigma

Location:
United States
Posted:
April 18, 2014

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Resume:

DOUG STEWART

* ******** ***** • Clifton Park, NY 12065

559-***-**** • acdq1z@r.postjobfree.com

OPERATIONS EXECUTIVE

Claims • Customer Care • Six Sigma & LEAN • Restructuring • Cost Reduction • Audits

Executive Profile: High-powered Executive with results-charged career in growth and profitable

leadership of dynamic enterprises doing business in domestic and global markets. Expert in identifying

inefficiencies and generating continuous process improvement strategies. Effective in high-profile roles

making high-stakes decisions and overcoming complex business challenges. Talented leader with

motivational, decisive management style. Assertive and innovative, achieving exceptional rather than

expected results.

Signature Leadership Qualities Include:

Organizational Design • Staff Development • Training • Client Relations • Budget Management •

Reporting • Strategic Planning • Customer Service • C-Level Presentations • Business Development •

Marketing • Recruiting • Vendor Relations • Cost & Benefit Analysis • Workforce Planning • External

& Internal Audits • Employee Relations • Enrollment • EDI Exchange • Military Leadership Training

PROFESSIONAL EXPERIENCE

Davis Vision – Latham, NY 2011 to 2013

Leading provider of fully integrated, comprehensive vision care services with 20M+ members.

Director, Administration

Hired to analyze operations, identify areas for improvement, and spearhead enhancement

strategies. Managed administrative services for 20M consumers nationwide. Directed quality control

initiatives including external audit validation. Maintained full responsibility for billing, claim

processing, client reporting and enrollment functions.

Coordinated electronic data services and client reporting procedures. Participated in RFP and

presentation activities. Served on Corporate Compliance Committee ensuring operations aligned

with state and federal regulations. Supported sales personnel. Provided customer service.

Achieved 99% customer retention rate, 99.5% financial accuracy rate, and completed

97% of transaction work in 14 days

Managed and completed successful project transitioning clients from paper invoicing to

electronic billing system with adoption rate of 90% resulting in cost reductions and

improved efficiencies

Slashed billing department operating expenses 25% and reduced turnaround times up

to 7 days by introducing new technologies and continuous process improvements

Developed and established new administrative guidelines around client reporting and

performance metrics leading to consistent and predictable experiences for internal and

external customers

Improved customer satisfaction and expanded operational capabilities by overseeing

customer migration from legacy claim processing platform to new state-of-the-art claim

processing platform

United Healthcare – Springfield, MO 2008 to 2010

Division of UnitedHealth Group and one of nation’s largest claim service centers supporting

6M+ customers.

Service Center Director/Site Leader

Recruited to initiate service turnaround operation. Tasked with leading activities within Service

Center and enhancing employee, customer, and community relations. Supervised 600 domestic and

global reports responsible for claim & rework processing, medical management, utilization review,

and pre-payment evaluation. Controlled 7M monthly claim transactions. Managed $60M annual

operating budget.

Improved overall accuracy and performance by 20%

Awarded Employer of Choice in the region by area university and Chamber of Commerce

Recognized as Service Center with highest ratings of passing external audits and

receiving superior marks in operational assessments

Enhanced operating efficiencies 15% by leveraging technology (macros & scripting) and

reallocating resources to forward-facing customer impact positions

CIGNA HealthCare – Visalia, CA 2004 to 2008

th

Global health services company and nation’s 4 largest health insurer.

National Accounts Director

Selected to support turnaround operations at regional office. Coordinated claim & call service

deliveries to major national accounts. Managed 150 cross-functional reports including Customer

Service, Medical Claim Processing, Rework Processing, Complaint/Grievance/Appeal Processing,

external audit activity, client presentations. Controlled annual operating budget of $25M.

Evaluated and restructured service operation teams to focus on customer needs and

achieved 20% increase in client retention rates

Served on project team developing and deploying informational video distributed to

clients showcasing recent service center improvements and JD Power certification

Introduced Six Sigma process improvement techniques as well as formal training plan

resulting in improved awareness and consumer experience

Appointed to local United Way Board of Directors

Additional professional experience includes Strategic Operations Director for United Healthcare.

Honorably discharged from the Air Force National Guard in three states (Utah, Colorado, New Mexico)

PROFESSIONAL DEVELOPMENT

Six Sigma (Kaizen and LEAN)

The OZ Principle

Performance Catalyst

Brekke Lessons in Public Speaking

Achieving Extraordinary Customer Relations



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