Management Customer Service
Resume:
RICHARD O. FIFIELD, MIS, CLSSBB
N**** STEEPLE DRIVE
APPLETON, WI 54913
EMAIL: *******@*********.***
Objective:
To advance my career in a challenging and rewarding industry with an organization that is a proven leader in operational excellence.
Education:
Masters of Information Systems from University of Phoenix (2/2010)
Bachelor of Arts degree in History with a minor in Political Science from the University of Northern Colorado-Greeley, CO (12/99)
Graduate of Big Sandy High School, Simla, CO (5/93)
Related Work Experience:
(November 2010- Present) Lean Leader, Affinity Health System – Performance Excellence
Work with leaders throughout the organization to implement daily and visual metrics that reflect operation’s ability to deliver value to their customers and identify process improvement opportunities that align with the strategic objectives and goals
Develop and instruct lean training courses, including hands-on coaching and mentoring to develop lean champions who apply lean principles to optimize safety, quality, productivity and service in order to drive improved customer satisfaction as defined by the customer
Assists with the lean cultural transformation through implementation of lean philosophies and methodologies to engage and empower associates to improve their daily work.
Provides coaching/mentoring to leaders and associates around lean tools and principles, problem solving to root cause, project management, change management and facilitation.
Acts as a catalyst to spark synergy and encourages teams to be creative in generating ideas to eliminate waste to improve performance through daily management
Lead groups and facilitate events, including kaizen, rapid improvements workshops and six sigma projects.
(July 2008- November 2010) Systems Analyst, Network Health Plan – Health Management
Assist Network Health Plan Health Management Department in designing, coding, testing, documenting and training Care Management Staff on related information within the QNXT software platform.
Provide ongoing maintenance to the Authorization, Reporting Services, and Case Manager Modules within QNXT.
Evaluate functionality of other QNXT Modules and AHS software system related to Health Management.
Research and analyze Technological, Operational or Business problems from multiple perspectives, reach sound conclusions, and make appropriate decisions and recommendations.
Work collaboratively with NHP IS team to provide cross-functional analysis of proposed functionality across applications/systems.
Support Health Management Department programs and goals through active participation.
Identify, initiate, participate and sustain LEAN process improvement activities that eliminate waste, create value, increase quality and promote standardization across the system.
(December 2006- June 2008) Business Systems Analyst, Navitus Health Solutions
Manage and implement the transition of new pharmacy products to the Pharmacy Management System allowing Navitus to effectively move and compete in competitive Pharmacy Benefit Management field.
Test and implement system enhancements to allow for increased productivity to meet future business needs that are essential in being competitive in the field of Pharmacy Benefit Management.
Develop and manage enhancements, projects, and processes to increase efficiency and productivity
Develop and trouble shoot new innovative ways to use the system to assist in building new and specialized benefits.
(March 2006 – November 2006) Business Analyst – Dental Model Office, Humana Insurance
Develop and manage enhancements, projects, and processes to increase efficiency and productivity in the Dental Product Line.
Manage and implement the transition of new dental products to the EDS Metevance system allowing Humana to effectively move and compete in competitive Insurance Field.
Perform the role of Subject Matter Expert for the Dental Product Build Department, and training and mentoring a new staff of builders.
Test and implement system enhancements to allow for increased productivity to meet future business needs that are essential in being competitive in the field of Insurance.
(October 2004 – March 2006) Product Build Lead, Humana Insurance
Lead and mentor fellow associates in building quality products for customers by providing guidance and creating individual action plans for each associate.
Utilize Excel to Manage and Monitor Quality and Productivity within the team.
Attend interdepartmental meetings to coordinate successful initiation of new groups and products to Humana.
Develop and trouble shoot new innovative ways to use the system to assist in building new and specialized benefits.
Assisted in developing the roles and responsibilities in the Team Lead Role.
(January 2003 – October 2004) Customer Service Claims Specialist, Humana Insurance:
Reviewed and processed claims to ensure the correct benefits would pay out in accordance to Humana, State and Federal Regulations.
Assisted the insured in a way so they would understand exactly how the benefits paid out and answered any questions they have about their policy.
Adjusted any claims that did not pay out according to the correct benefits.
Related Skills and Training:
(March 2014) Six Sigma Black Belt – University of Wisconsin- Milwaukee
(April 2012) Six Sigma Green Belt- Fox Valley Technical College
(November 2011) Graduate of the Dale Carnegie Skills for Success Program- Dale Carnegie Training
(February 2011) Certified Lean Master Facilitator- WCM Associates, LLC
(July 2010) Certified Lean Healthcare Facilitator- Optima
Agile, Hoshin Kanri, Kaizen, RPI, Rapid Improvement Event, Strategic Planning, Policy Deployment, Continuous Improvement, Performance Excellence, Operational Excellence, Performance Improvement, Project Management.
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