LISA D'SOUZA

***** **** ****** ***, **********, MD 20874

Mobile: 301-***-**** Email: abmq1o@r.postjobfree.com

SUMMARY

A top performing and results oriented management professional with 13 years

progressive experience in strategic planning, operations management,

training and development, technology implementation, direct marketing and

contract negotiation. Successful leadership experience in the health care,

pharmacy benefits, insurance, e-commerce and fraud prevention industries.

Demonstrated ability to be technology focused to drive maximum efficiencies

and high performing teams. Possess excellent communication skills acquired

through experience in multicultural and cross-functional environments.

PROFESSIONAL EXPERIENCE

Catalyst Health Solutions, Inc., Rockville, MD

06/2005 - 04/2010

Executive Director, Customer Service Operations (01/09 - 04/10)

Director, Customer Service Operations (09/05 - 12/08)

Manager, Supplemental Benefits (06/05 - 08/05)

Manage all operational aspects of six major functional areas including

National Training, National Quality Assurance, New Client Implementation,

Pharmacy Audit, Pharmacy Paper Claims, and Supplemental Benefit programs.

. Launched two major price increases in the Supplemental Benefits

program between 2005 and 2008 that directly generated an additional

$4.5 million and $1.5 million in top line revenues each year

respectively as well as run off margin improvements

. Key involvement in successful mitigation and strategy development in

litigation and contract disputes relating to the Supplemental Benefits

programs including serving as a key witness

. Developed and led the creation of a national department to process

paper claims including but not limited to staffing and implementing

compliant processes, technology and reporting

. Implemented a comprehensive e-learning program including guidelines

and measurements to determine the program's effectiveness

. Reduced cost per paper claim processed by 60% from 2006 to 2009 due to

the institution of agent productivity standards and comprehensive

automation of scanning and optical character recognition software to

greatly reduced manual data entry

. Implemented a robust SharePoint intranet site from concept to launch

that improved a majority of processes, provided an extensive

knowledgebase and document repository and led to reduced new hire

training completion times by at least 25%

. Overhauled the problem resolution process and tracking by implementing

a web based technical solution called FootPrints which enhanced the

ability to review trends and implement solutions to improve quality of

service

. Automated processes relating to the desktop pharmacy audit function by

implementing a proprietary fraud detection tool, organizing and

streamlining the pharmacy communication process and reduced manual

work through automated reporting

. Negotiated purchase price, selected and implemented new call

monitoring quality assurance and e-learning tool, Verint Impact 360,

to replace and advance the company's call monitoring program and

establish e-learning for the new hire training and ongoing educational

programs

. Improved project management for new client implementations and

communications through customized workflows using the company's

SharePoint intranet site

. Supported many compliance efforts related to URAC accreditation, NCQA,

SAS70, SOX, Medicare Part D / CMS through the interpretation of

regulations followed by implementing revised operational processes,

writing policy and procedures and tracking improvements and turn

around times

. Identified risks and rewards related to acquisitions and mergers

through due diligence efforts as well as successful project management

for integration efforts and high profile projects

. Analyzed capital expenditure purchases through ROI modeling and

contract evaluation

. Demonstrated success with client presentations and creating strategic

sales and marketing collateral

Banner Life Insurance, Rockville, MD 02/2002 -

06/2005

Policy Issue Supervisor

. Managed, directed, and planned the operation and workflow of a

customer service team of 11 staff in order to meet and exceed customer

expectations and company standards

. Monitored and evaluated incoming and outgoing telephone communications

to ensure compliance with customer service standards and also track

abandoned call rates

. Led a project to develop a graphical user interface (GUI) system for

the Policy Issue department. Completely responsible for the training,

implementation, and coordination of new program releases

. Built effective business relationships with General Agencies by

representing the Policy Issue department at vendor meetings.

Responsible for business presentations, communicating new developments

within the Policy Issue department and demonstrations of new software

. Validated contract integrity to ensure contract provisions were in

compliance

. Communicated with the IT department on all technical issues affecting

the Policy Issue department including the implementation of new

products

. Controlled expenses for the department's cost center through accurate

budget and forecasts

AOL Ltd. (Formerly CCGI), Greenbelt, MD 08/1999 -

02/2002

Risk Manager, Greenbelt, MD (05/01 - 02/02)

Customer Service Manager, St. Maarten, N.A. (08/99 - 05/01)

. Developed a new department to monitor and manage the company's risk

. Reduced chargeback ratios from 10% to 3% within 2 months as a result

of implementing fraud prevention measures in the company

. Coordinated with credit card processors, banks, risk management

organizations and others to identify all potential sources of fraud

. Identified and analyzed negative trends and variances in profit levels

and implemented necessary adjustments in risk management policies and

procedures in accordance with organizational goals and budgets

. Prepared regular statistical reports on fraud activity, customer

satisfaction and workload levels to facilitate strategic business

decisions

. Created analytical reports on market conditions and new Internet

payment mechanisms in the marketplace to strengthen the company's

competitive strategy

. Formulated and maintained policies and procedures for the risk

management department

. Established and implemented a quality control program to objectively

evaluate e-mail and telephone service levels in all call center

locations

. Supervised a call center staff of 10 people with an emphasis on cross

training

. Formulated, implemented and supervised an online customer satisfaction

survey

H R Owen Audi Plc, London, UK 11/1997 -

05/1999

Customer Care Manager

. Led a team focused on improving degrees of customer satisfaction.

Initiatives generated from this resulted in nearly doubling the

customer service measurement scores from 38% in April 1998 to 76% in

May 1999

. Assisted IT manager with systems administration and was involved in

the migration of a new AS400 network server that supported

approximately 100 users

. Supervised all customer service issues resulting from customer

responses to customer satisfaction surveys

EDUCATION

Bachelor of Science in Business Administration, University of Maryland,

University College

ADDITIONAL INFORMATION

Computer Proficiencies: Advanced knowledge of Microsoft Office including MS

Project and Visio, SharePoint, Enterprise Content Management, Kofax Ascent

Capture, IBM AS/400, Verint Impact 360, FootPrints

Languages: Basic knowledge of Spanish and French

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