Call Center Health Insurance

John Crews

**** ******** *** ************ / ************, IN 46106

Phone: 317-***-**** E-mail: **************@*****.***

Professional Summary

Executive Level Call Center Operations Professional with 25+ years global healthcare & financial inbound/outbound/ call center & back office management experience (Onshore, Offshore, India, Philippines, Jamaica, SE Asia) Successful career in managing large and complex healthcare call center /BPO operations Administrator with deep knowledge of offshore markets (9+ years expat living assignments, 4 years India/3 years Philippines) Built one of the industries’ most successful insurance Telesales licensed agent organizations Built, launched and maintained 10 captive offshore sites and over 20 domestic operations. Visionary with track record of implementing best practices and improving KPI’s on some of the industry’s most difficult projects Architect and operator in the “Work at Home” industry Committed to exceeding customer expectations Meticulous about Quality Control Passionate about leadership by example Comprehensive knowledge of CRM solutions (Sales Force & People Soft) Expertise includes Commercial Health Insurance, Medicare, Medical Supplement, Part D, other various insurance verticals, Mortgage, Financial Services, Telecom. Transformation BPO offshore vendor management strategic sourcing healthcare

Professional Experience

Goldman Sachs -Consultant to the healthcare Industry Indianapolis, IN

Aug 2017 – Present

Independent consultant to the Healthcare / Telesales industry supporting a wide variety of disciplines.

Launched and managed licensed agent pools for Telesales supporting Medicare Advantage, MMP, DSNP and Market Place products

Business plan development for a health insurance client’s sourcing strategy

Architecting and implement call center technology including telephony and digital strategy

Build virtual recruiting engines for various verticals

Launched State Medicaid plans for MCO’s which includes all operational functions.

Anthem

Aug -2010 TO OCT - 2016 Indianapolis, IN

The largest U.S. managed health care company with revenues of $100B annually. WellPoint Health Networks, Inc. was formed when they merged into Anthem, Inc.

Senior Director of Shared Services / Project Management / Call Centers – Medicaid / Medicare

Responsible for managing call centers, enrollment and billing, vendor relations and shared service.

Manage operations for Med Advantage /Med Supp. which includes 2,200 FTE of which 700 FTE were outsourced

Managed the Medicare Advantage Telesales licensed agent team

Managed 3 in-house operations and 4 vendors sites

Develop and implement transformation projects for the Medicare division

Manage an $80M budget for Medicare

Lead key initiatives for Stars ratings

Lead the shared services team which houses Quality, WFM, Grievance and Appeals, Enrollment & Billing, Analytics reporting and the PMO organization

Direct involvement with CMS and Medicare compliance

Sourced and offshored over 2500 FTE with an overall 4 year save exceeding $70M

Developed and implemented new outcome based contracting for all of WellPoint’s call center suppliers

Led the call center initiatives for WellPoint’s multi- year plan to reduce health care costs

Accenture Partners Limited Dallas, TX

A $42B publicly-held global provider of management consulting, information technology/systems integration, and business process outsourcing services.

Senior Executive / Partner Offshore Delivery BPO Operations Director – Jan 2004 – Aug 2010

Reported directly to Senior Partner of Outsourcing. Completed world’s largest offshore call center migration involving three countries and six large outsourcing firms, consolidating 6,000 seats offshore (India, Philippines) for major US-based ISP; processed inbound/outbound/email/chat/back-office.

P&L responsibility for $400M annually.

Marquee clients included Aetna, United Healthcare, Anthem, AT&T, British Gas

Managed 6 direct reports and 20 support personnel 6000 plus employees

Within first year, achieved 25-30% improvement in CSAT surveys.

Supported multi-tower Financial and Healthcare client contracts including front and back office operations.

Consultant with United HealthCare on internal operations and BPO vendors

Developed security and disaster recovery leveraging the “Work-at-Home” environment.

Business plan development for a health insurance client offshoring 500 seats

Architecting and implement an outsourcing / off shoring strategy (includes a captive site) for one of the US largest health insurance provider.

IT platform implementation for a NYC based catastrophic insurance provider.

Strategic outsourcing initiative for a Fortune 50 health care insurance company in Indianapolis

SITEL Corporation Baltimore, MD

A $2B provider of CRM Business Process Outsourcing services to Fortune 500 companies; offerings include customer acquisition, back-office processing, collections, and technical support.

Director of Offshore Operations – Nov 1993 – Nov 2003

Reported directly to VP, International Operations. Developed new and previously unexplored offshore solutions, including development of “cold-start” multi-site operation (Jamaica and India).

P&L responsibility for $45M+.

Managed 2 direct reports and multiple indirect reports in Joint Venture structure.

Conducted market research, identifying potential partner organizations to develop low-cost solutions.

Formed joint venture with TATA International, India’s largest manufacturing and software development company, offering low-cost, offshore solutions in India for US based clients.

Provided direction for 2,000+ employee site operations in 950-seat environment, processing nearly 1M calls per month.

Marquee clients included AOL, Direct TV, McAfee, Palm and back office imaging for General Motors.

Implemented unique half-hour interval scheduling in compliance with India’s complex labor laws and shift rotations while maintaining exceptionally high occupancy rates (90%).

Transitioned responsibilities and management staff to new CEO in 2.5 years, meeting business plan compliance.

Formed Jamaican Joint Venture in Montego Bay offering low-cost offshore solutions in Jamaica for US-based client (Philips Electronics).

General Manager of Operations, Technology Services

Reported directly to President of SITEL Tech Services. Directed multi-site inbound call center operations supporting ISP and hi-tech clients including AOL, Hughes Direct TV and PC, and Palm Computing.

P&L responsibility for $80M.

5 sites.

Operations contributed 10% of SITEL’s overall revenue ($80M) and employed 2,500 hourly and 250 salaried employees.

Ranked #1 in company Earnings Contributions.

Regional Manager of Operations, Insurance Division –

Reported directly to the President of SITEL’s Insurance Division. Developed and managed 7 outbound Telesales call center sites within the continental US and 5 contract sites; combined total of 2,000 hourly and 185 exempt employees.

P&L responsibility for $200M+.

Primary focus was outbound insurance sales utilizing one- and two-tier verification for clients including JCPenney Life, Physicians Mutual, All State and Minnesota Mutual, and American Express. The Insurance Division generated 40% of SITEL’s net earnings.

Education

MARSHALL UNIVERSITY, Huntington, WV

B.S., Accounting/Industrial Business Management (dual degree); advanced studies in General Accounting, Cost Accounting, and Taxation

GPA 3.2/4.0

Professional Development, Notables

Accenture Leadership Development Program, Senior Executive Training

Published three industry white papers regarding offshore call center work

Featured in interviews with CEO Magazine and CNN Asia

BPO Company of the Year Representative, 2006, Philippines

High achieving temperament (Eagle Scout)

Boy Scouts of America/Eagle Scout Prep Volunteer, Trail Guide

COPC Trained and Certified, May 2006

Member, American Chamber of Commerce of the Philippines

Presented Outsourcing Comparisons between Countries to Chamber of Commerce

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