MARJAN FAKKI

** ***** ***** **, ****** Mills, MD 21117 (C) 310-***-**** e-mail: ig8c5b@r.postjobfree.com

EXECUTIVE SUMMARY

A results-driven Business Operations executive, with strong leadership skills and experience in implementing highly effective business practices in operations, call center management and healthcare operations. A proven leader with an extensive track record in business development, program implementation, quality assurance and managing change in a dynamic environment. Highly skilled in leading people to achieve superior results.

EXECUTIVE STRENGTHS

• Call Center Management & Start-up • Budget Management • Strategic Planning

• System/Telephone Integration • Retention and Outreach • Change Management

• Intelligent Call Queuing/WFM • Remote Team Management • Mergers/Acquisitions

• Learning Module Systems Design • Project Management • HIPPA/Regulatory Compliance

• Vendor Management • Team & Culture Building • Operation Start-ups

PROFESSIONAL EXPERIENCE

BRAVO HEALTH, Inc., Baltimore, MD

A $1.5 Billion managed healthcare company

Vice President of Member Service Operations October 2007 - Present

Oversight of a multi-site Call Center Operations Team, which consists of seven functional units of 200+ staff members. Additionally, oversight of the Appeals and Grievance Department which has responsibility for processing the company’s regulatory complaints. Managing a $13 M Operational budget. A member of the Senior Leadership Team, focused on positioning the company to be an industry leader in the Medicare Advantage (MA), Medicare Advantage Prescription Drug (MAPD) and Prescription Drug Plan (PDP) arena.

• Restructured the inbound call center teams, resulting in an increase in customer satisfaction by 40% and earning the CMS 5 Star Rating of Customer Service, for all products.

• Implemented a new ACD system and reporting platform, prior to Medicare’s Open Enrollment Period (OEP), improving service levels by 13%, staff productivity gains of 25% in reporting and 100% preparedness for OEP.

• Responsible for ensuring all inbound/outbound regulatory call center requirements are met.

• Instituted a retention-based team for the 2009 OEP, focusing on meeting new member needs, improving overall member retention resulting in a 20.8% company-wide improvement in disenrollment year-over-year, saving Bravo Health more than $26MM in 2009.

• Restructured the Management Team to better leverage strengths and experiences in the areas of expertise.

• Created a Broker unit, focused on supporting and educating the contracted Brokers on Bravo Health’s products and processes, that has been rated as “the best in the industry” by independent Brokers.

• Implemented the Concerns tracking process, to meet CMS and NCQA regulatory requirements and to identify and address member issues in a more systematic manner.

• Led the Customer Service Operations team initiatives for NCQA accreditation, gaining that accreditation in 2009.

• Partnered with the Compliance Department to ensure that all CMS CTM’s (Complaint Tracking Modules) are addressed and resolved within the set turnaround time standards. Have reduced CTM’s by 46% in 2010.

• Led the charge in streamlining the internal documentation and resolution process company-wide, gaining an 80% improvement in issue resolution and a 67% improvement in documentation.

• Aligned our training and data archiving efforts with the Corporate Training Department, automating the entire process by creating a Wikipedia-type environment and a home-grown Learning Management System.

• Revamped the entire “Welcome Call Verification” process for new PFFS members in order to meet regulatory turnaround time standards and improving overall retention.

• Represented the Call Center Operations Department and participated in CMS and HEDIS Audits, meeting all areas of review for three consecutive years.

• Part of the design and implementation team for creating an e-Learning educational model, for the company, improving consistent and accurate information delivery.

SIERRA HEALTH SERVICES, INC. , Las Vegas, NV

A $2.6 billion diversified managed healthcare company

Director of Operations, Government Programs and CR&R June 2004 – October 2007

Managed a $12M Operations budget and over 100 clinical and administrative staff members. Responsible for directing Government Programs/Medicare/Part D/Medicaid Member Services/Call Center, Appeals and Grievances department, Reporting/Forecasting unit, and the Enrollment department.

• Led the implementation of a new Call Center, which resulted in supporting of over 70,000/month additional new member calls, within 6 weeks, and reducing the operation expenditures by $1.1M a year.

• Led Complaints database migration initiative onto a new platform, which resulted in a $250,000.00 savings per annum, a 64% productivity improvement, and mitigated risk of data loss by 80%.

• Introduced and led the implementation of e-Workforce Management, Integrated Call Queuing (ICQ) and upgrade of the Interactive Voice Response system, which resulted in reduction of operating expenditures by $325,000.00 per annum and increased customer satisfaction by 57%.

• Developed and directed the implementation of proper controls and effective business processes in the Call Center, Complaints & Grievance and Enrollment departments, thus securing the Medicare Part D (Pharmacy) contract of over $2,000,000.00 revenue value to the company

• Integrated CMS & NCQA guidelines in operational practices in support of annual audits, which resulted in maintaining the company’s Commercial HMO, PPO, POS, Medicare and Medicaid contracts. This initiative was completed without incurring additional costs, and was well received by the Audit Committee members and the company’s external auditors.

Senior Project Manager of Business Operations September 1998 – June 2004

Reported to the Operations AVP and managed a $9M Operations budget. Responsible for defining and implementing Business Process Improvement initiatives, in support of company’s objectives and strategies.

• Launched a new Customer Service Training program which resulted in 24% improvement of first call resolution and 28% increase in customer satisfaction.

• Revamped and restructured the call center reporting system and thus improved operational visibility by 58% and data accuracy by 65%.

• Created the Research and Resolution unit in support of meeting the performance measurements for claims reconsiderations and issue resolution. This initiative required coordination and consensus building with various functional executives and resulted in reduction of operating expenditures by $192,000 per year.

• Introduced and led the implementation of e-Workforce Management, Intelligent Call Queuing (ICQ) and upgrade of Interactive Voice Response System, which resulted in reduction of operating expenditures by $245,000.00 and increased customer satisfaction by 48 %.

VALUE BEHAVIORAL HEALTH, Long Beach, CA A $1.4 billion national managed care mental health and chemical dependency company

Director of Customer Service/Call Center June 1996 – August 1998

Reported directly to the Regional Vice President and managed a staff of over 70 clinical and administrative employees. Responsible for the development of customer focused service teams and moving the organization rapidly through effective strategy management and leadership. Worked closely with Sales and Client Services, regularly meeting with clients, to ensure that performance expectations were being met.

• Transformed the region from a functional model into a self-directed team model; implemented a formal auditing program, developed call center performance standards, and trained customer service on call management techniques, which resulted in a 27% increase in the Customer Satisfaction Survey for “Overall Customer Service Performance”.

• Achieved a savings of over $200,000.00 in operating expenditures, by revamping the reconsideration process and improving the timely response to claims inquiries.

• Developed a formal Grievance/Complaint Team and company policies and procedures, ensuring complete compliance with the Department of Corporations, NCQA and other regulatory and compliance agencies, which resulted in the renewal of the company’s managed care contract of over $10 million revenue potential.

MANAGED HEALTH NETWORK, INC., Los Angeles, CA

A $300 million comprehensive mental and behavioral health services company

Supervisor of Member/Provider Services Team September 1992 - May 1996

Responsible for leading daily operations of the Provider Services Team, ensuring compliance with providers’ guidelines. and the development of Customer Focused Service teams.

• Developed training materials and conducted extensive training on provider contractual and claims issues, which increased the service team’s efficiency by 38%.

• Developed metrics and feedback processes, which resulted in 46% increase in customer service quality.

• Developed department guidelines and ensured compliance to the standards for handling incoming calls, which improved performance by 38%.

• Worked closely with the Clinical Groups on reconciling case rates, individual claims issues, and procedural issues, thus improving the response time by 54%.

EDUCATION

Bachelors in Biology, California State University, Northridge, Northridge, CA

Certification of Completion in Project Management and Quality Assurance

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