Customer Service Management

Dana Lynne Miley

*** **** ***** *****

Huntsville, AL 35824

Mobile: 256-***-****

Evening Phone: 256-***-****

Email: ****.*****@******.***

Country of citizenship: United States of America

Contact Current Employer: Contact me first

AVAILABILITY Job Type: Permanent

Work Schedule: Full Time

WORK EXPERIENCE Blue Cross Blue Shield of Alabama 7/2007 Present

Huntsville, Alabama US

Consumer Insurance Territory Representative

Contribute to defining and supporting product success and member satisfaction

Document a comprehensive territory plan to achieve goals and objectives for growth and problem

resolution

Six (6) years experience in progressively responsible sales, account management and problem

solving positions with individual government funded products

Extensive knowledge of CMS governmental laws, policies and practices

Interface with senior management and advise management on employer relations issues including

providing advice on grievances and adverse reactions

Interpret and understand complex situations in an extremely dynamic environment to develop action

plans to advise management of options and resolution approaches

Subject matter expert for CMS marketing regulations

Develop team approach working with multiple organizational departments such as Provider Relations,

Contracts and Credentialing, Customer Service and other management officials to facilitate most

effective approach to increased market share and reduce disciplinary and adverse actions

Conduct and gather competitive technical intelligence to provide management advisory services

Document and review complaints and grievances from beneficiaries and advise management of

options and approaches to a resolution

Provide guidance to community regarding Medicare product offerings under strict compliance of

Medicare Marketing Guidelines

Alert management to identified issues related to execution of product design and identify resources

needed to assure success

Establish atmosphere of compliance in highly charged emotional situations related to benefit

requirements

Extremely knowledgeable of key contractual and regulatory requirements related to departmental

activities and reference materials supporting these

Prepare territory marketing budgets and quarterly variance explanations

Participate in organizational Quality Assurance workgroups and recruiting other staff to participate

Develop customer retention strategies

Ensure capture and appropriate storage of complete and accurate member records

Review activity reports and other performance data to measure productivity and goal achievement to

determine cost reduction areas and product improvement

Provide counsel and advice to management and product beneficiaries

Directs in service training confidentiality

Uncommon ability to communicate clearly and concisely

Self starter with strong human resources background

Coordinate and participate in job fairs, health fairs, other community events

The 2009 top producer for Blue Cross Blue Shield of AL Consumer Insurance Division The 2010 top

producer for Blue Cross Blue Shield of AL Consumer Insurance Division

Analyze organizations for productivity and efficiency gains

Provide recommendation to management officials on most effective skill mix and organizational

structures

Verified extensive experience in managing multi faceted projects

Remarkable problem solving and conflict resolution skills

Superior oral, written and public presentation communication skills

Apria Healthcare 5/2006 7/2007

Huntsville, Alabama US

Director of Business Development

Developed new business and expanded existing business with physicians to exceed branch revenue

targets

Advised physicians, hospital personnel, home health provider agencies and other traditional referral

sources regarding Apria’s respiratory care program

Developed and executed territory business plans

Established and maintained customer relationships and act as primary liaison between customers

and management officials

Reviewed complaints and grievances to advise management of options and resolution approaches

Generated monthly queries for management review

Monitored key metrics related to product success, identified and classified problem areas, and

recommended strategies to management for resolutions

Provided advice on preparation of disciplinary and adverse actions for incompliant employees

Developed team approach working with multiple departments and services such as Logistics, Clinical,

Administrative and Customer Service to facilitate successful productivity

Strong organizational and project management skills

Extremely proficient in Microsoft Office products

(Contact Supervisor: Yes, Supervisor's Name: Michael Isbell, Supervisor's Phone: 800-***-****)

Huntsville Hospital/First Community Health 9/1998 5/2006

Plan/North Alabama Managed Care Inc.

Huntsville, AL US

Director of Business Development

Developed sales and marketing strategies for Workers Compensation Injury Management Program

and Group Health Insurance Preferred Provider Organization (PPO) Network

Coordinated all new business development and marketing activities for Comp One PPO – tripling

revenue between 2000 and 2005

Increased profitability and exceeded sales growth every year

Interfaced with senior executive management for contract negotiations

Provided regular briefings to managers and clients on all aspects of case management and presented

at numerous health care/provider conferences

Resolved all customer/physician issues for the PPO

Coordinated occupational health conferences for North Alabama medical community

Reduced customer documentation errors 75% by implementing a Quality Assurance program

Chosen among several thousand employees of Huntsville Hospital as one of 12 participants in the

Emerging Leaders Class of 2005

Developed the first of its kind wellness/disease management program for hospital employees

Extremely results oriented and detail oriented

Successfully managed complex/dynamic clients

Identified areas in need of improvement and recommended solutions to management

Analyzed benefits of outside organizations and provided recommendations to management officials

on the most effective benefit plan and structure

Maintained high level of knowledge in relation to health benefits, pharmacy benefit management,

workers compensation and case management

Recruited, Interviewed, Hired and Supervised Account Executive staff and marketing support staff

Developed and maintained strong intercompany relationships to deliver superior customer service

Identified areas of need and recommended solutions to management officials

Provided proactive client support through pricing, contract negotiation, contract management and

consultation

Classified clients' benefits and prepared necessary documentation for contracts

Analyzed network utilization and identified efficiency gains to management officials

Assessed current processes, appropriate resources and contacts needed to complete and respond to

product inquiries

Established new workflow processes for improved efficiency

Established and maintained a position classification system to determine appropriate pay,

occupational grouping, title, and advising management on position and occupational design

Advised senior management in identifying, attracting, and retaining a high quality and diverse

workforce to accomplish the organization's mission

Researched, questioned and obtained pertinent information to solve management and operational

issues

Assisted in job classification for obtaining workers compensation insurance quotes (Contact

Supervisor: Yes, Supervisor's Name: Sherree Clark, Supervisor's Phone: 256-***-****)

Calhoun Community College 3/1995 9/1998

Decatur/Huntsville, Alabama US

Assistant to Dean of Students/Recruiter

Recruited, interviewed and advised new students

Developed, implemented, monitored and assessed retention activities and advise management of

results to ensure compliance with community college guidelines

Solved problems associated with student services with minimal supervision

Represented college in community on matters pertaining to student recruitment and retention

Counseled and advised individuals and groups on matters pertaining to personal problems,

educational and vocational objectives, social and recreational activities and financial assistance

Reviewed reports of student misconduct cases and recommended advice on the preparation of

disciplinary and adverse actions

Sponsored and advised student organizations

Taught Time Management and Conflict Resolution training classes

Taught Orientation to College training classes

Classified and prepared documentation to award credit to Veterans who submitted official

documentation of military service and educational credits earned based on recommendations in the

Guide to Evaluation of Educational Experiences in the Armed Services

Classified, Evaluated, and Cross referenced DD 214 forms to determine credits towards degreed

programs

Mediated student concerns related to conduct, grades, degree plan and instructor issues and made

recommendation to management officials

(Contact Supervisor: Yes, Supervisor's Name: Dr. Jo O’Neal)

Sunrise Retirement Homes 1/1994 3/1995

Arlington, Virginia US

Marketing Coordinator

Marketed assisted living and skilled care unities resulting in 98% occupancy rate

Served as administrative director on call

Assisted in the evaluation of residents’ Activities of Daily Living and medication monitoring

The University Of Alabama 1/1989 6/1993

Tuscaloosa/Huntsville, Alabama US

Admissions Counselor/Recruiter

Recruited students from Alabama, Florida, Georgia, and Tennessee

Interviewed, hired and supervised student recruitment team

Planned/implemented campus events

Designed promotional materials and displays to support student recruiting activities

Performed student placement testing

Initiated new and innovative technologies for assisting prospective students and parents with

procedural information

Organized and participated in admission fairs

Analyzed satisfaction surveys and provided recommendations to management officials

Classified and prepared necessary documentation for transferring credits from another institution

(Contact Supervisor: Yes, Supervisor's Name: Thomas Davis, Supervisor's Phone: 205-***-****)

EDUCATION Alabama A & M University

Huntsville, Alabama US

Master's Degree 12/1997

64 Semester Hours

Major: Human Resources Management

GPA: 3.75 out of 4.0

The University of Alabama

Tuscaloosa, Alabama US

Bachelor's Degree 12/1988

136 Semester Hours

Major: Social Science

GPA: 3.35 out of 4.0

REFERENCES Steven Miley NASA Associate Director of Engineering

Phone Number: 256-***-****

Email Address: ******.*.*****@****.***

Reference Type: Personal

Ashley Dawson Associate Pharmacies Inc Contract Administrator

Phone Number: 256-***-****

Email Address: ********@*******.***

Reference Type: Professional

Contact this candidate