Customer Service Grand Canyon
Resume:
MICHELLE L. LATHON
Cypress, TX *****
********@*****.***
EDUCATION / TRAINING / ATTRIBUTES
MBA, Grand Canyon University - July 2021 – November 2022
BSBM, Grand Canyon University – February 2021
Areas of Expertise
Account Management: Effective management of benefit programs for one of the nation’s largest healthcare corporations for 15+ years.
Staffing and Vendor Management Working for one of the largest healthcare systems for 18+ years.
Customer Service: Ability to communicate effectively and establish diverse socio-economic backgrounds.
Communication: Excellent written and oral communication skills.
Liaison between Aetna and the Plan Sponsor.
Problem Solving Skills: Significant experience managing complex scenarios to secure perspective business.
Routinely review clients’ reporting procedures and operations for efficiency.
Able to identify problem areas and implement corrective action to improve performance.
PROFESSIONAL EXPERIENCE:
CVS Health, Home Based FTE February 2023 - Current
Benefit Relationship Manager
Building relationships with key client partners through a consultative approach to understand client benefit plan design needs.
Translating client needs and requirements to internal CVS Health teams such as Benefits Coding and Quality Analysis.
Facilitating internal and external meetings and presentations to provide status updates and make decisions relative to client benefit setup.
Memorial Hermann Healthcare System, Houston, TX January 2016 – February 2023
Vendor Program Specialist
Receive and process vetting information for potential vendors electronically.
Coordinate and review potential clients’ documents based on services provided to the healthcare system.
Communicate with the directors, managers, and vendors regarding government validation requirements and resolve issues as they occur to ensure the vendor are approved.
Interact with internal and external clients through various forms of communication.
Oversee, document, and enforce Memorial Hermann policies for all approved vendors and representatives working virtually and at a given facility.
Promote and meet departmental goals to meet the expectations of management.
Verify credentials and vet the vendors and staff that have a partnership with the facilities.
Maintain a relationship with our third-party credentialing partner to vet vendors and staff
Training incoming staff to the department and monitor the overall vetting process.
Aetna Inc., Sugar Land, TX August 1998 - August 2002/ March 2007 - October 2015
Sr. Eligibility Consultant/Home Based FTE
Acted as a liaison between the plan sponsor and information technology in identifying business requirements and approved programming. [1]
Assisted with and /or evaluated recommendations regarding reporting methods and negotiated with internal/external customers to reach an agreement regarding electronic reporting solutions.
Developed and provided coaching tools, coding supplements, eligibility file specifications and error listings to clients and/ or vendors.
Customized file layouts to Aetna’s electronic eligibility standards.
Uploaded clients’ information to Aetna’s business systems and placed confidential data on the client specific secure server.
Reviewed enrollment information for completeness/accuracy.
Input enrollments, changes, and terminations into appropriate Aetna systems.
Applied technical policy, legislation, plan sponsor account structure and benefits to basic eligibility decisions.
Led and participated in team, regional, and company-wide eligibility projects.
Memorial Hermann Healthcare System, Houston, TX May 2006 – January 2016
Facility Staffing Coordinator
Received daily oral report from the Operations Administrator and advised Patient Flow Coordinator of the hospital status.
Coordinated with Premier as well as external agency staff for long term assignments and/or daily scheduling in designated areas.
Communicated with the directors and managers regarding staffing requests and issues for the facility.
Documented, implemented, and managed Memorial Hermann policy for all agency staff working at the facility.
Senior Staffing Coordinator June 2003 - May 2006
Introduced staff to the Memorial Hermann system and the HR standards and/or requirements according to medical specialty.
Interviewed new employees for their preferences as far as facilities and availability.
Placed staff for designated shifts according to hospital needs.
Verified credentials according to Texas Workforce requirements.
Met with clinical managers and/or directors to assess and address staffing performance and retention issues.
Acted as interim office management as needed.
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