Operations, Training, Customer Service Director

Francisco A Franco

315-***-**** **********@*****.***

Fort Lauderdale, FL linkedin.com/in/francoflny

Leader in Operations, Process Improvement, Training & Business Strategy

Driven leader with extensive experience working in an operations environment. Ability to transform teams and create efficiencies that enable improved operational performance. Experience implementing new methodologies, technologies and streamlined processes to ensure high quality results. Anticipates customers and business partners needs and proactively develops solutions to meet and exceed them.

Key Strengths

Critical Thinking Problem Solving Strategic Planning Prioritization Root Cause Analysis Project Management Program Management Employee & Leadership Development Change Management Business Partnership Relationship Building Staff Development Team Building Six Sigma Black Belt Process Improvement Talent Management Microsoft Office Continuous Improvement

Leadership Experience

• Led large (100) and small (10) teams both front line and professional healthcare roles.

• Received 100% manager effectiveness score consistently on employee engagement survey.

• Developed new business structures, including roles and key performance metrics.

• Created development plans by role, individual, teams as well as for business partners that included performance management and sourcing.

• Architected a change management processes for multiple business partners resulting in training time reduction of 25% for new system implementations and in some cases training avoidance.

• Mentored and coached new managers and supervisors to inspire their own personal impact on their teams and to the business.

• Presented solution options, recommendations and support to executive leadership on performance strategies, growth targets, expansion efforts and improvement initiatives to maximize results and enhance execution.

• Partnered with operational teams for improvement on the members and provider experience, including provider contracting, provider network management, claims processing and billing.

Operations Experience

• Experienced in workforce planning, workforce management, recruiting and leading call center operations agents, claims processors, and overpayment recovery teams.

• Drove optimization and increase of key performance indicator (KPI) operational metrics, NPI, and financial performance across production, member services and provider service teams through business innovation, creativity and performance.

• Accountable for successful claim and customer service quality programs, including outbound calls, with mandate to improve overall quality and identify problems, opportunities, root cause and potential gaps.

• Partnered with global PMO operations teams in India, Manilla and Ireland.

• Created business plans, return on investment (ROI), governance process and ensured integrity and compliance to prioritize initiatives and projects.

• Collaborated successfully with business partners, including clinical and medical operational teams, in a highly matrixed environment to coordinate and implement multiple cross-functional initiatives, including member and provider strategies in over 16 locations enterprise wide.

• Evaluated training and quality programs as a member of mergers and acquisitions (M&A) team by improving process and removing duplication.

• Responsible for ensuring business, state, federal laws, healthcare regulations and compliance including HIPAA, CMS, STARS and DSNP/Medicaid were current and communicated.

Project Management Experience

• Certified as a Six Sigma Black Belt and Agile management method practitioner.

• Led multiple large and small projects, including those that impacted over 5,000 employees.

• Created and owned end-to-end governance process on expectations and metrics as well as a learning map for project managers.

• Acted as product and program manager for project management system (Clarizen).

• Conceived, managed and executed the implementation of major initiatives across a matrixed environment that focused on user needs, system performance and technical specifications.

• Provided strategic alignment between organizational departments on implementations. (Health Technology, Clinical Operations, Technical Operations and Customer Service).

Experience

UnitedHealthcare Insurance Company, Virtual Globally 5/1990 – 5/2019

Director – Learning Solutions Design & Business Strategic Advisor (10/2014 – 5/2019)

· Responsible for talent acquisition, employee management and career development through coaching and mentorship.

· Accountable for over 40 job roles requiring curriculum needs analysis, design and development.

· Created and led the project management process and standardization for Learning Solutions.

· Created and facilitated a change management and communication process for business partners that engages and promotes adoption of all major initiatives, marketing and process changes to achieve company policies and vision.

· Supported and directed over 300 business partner supervisors and managers by creating a leadership hub with professional learning tracks.

· Reduced new hire claim training by two weeks leveraging a test system for practice that reduce and improve administrative cost.

· Provided strategic plans, strategic direction and recommend improvements, solutions by using analytical research skills, industry trends, publications, reporting and proven methodologies.

Strategy & Planning Director (Training) (6/2011 – 10/2014)

· Consulted with an open mind that created engagement strategies on performance for all internal business partners (Employee & Individual, Medicaid & Medicare).

· Responsible for overall success of the training request inventory pipeline and active.

· Researched, analyzed reports, and prioritized to ensure the right solutions were applied.

· Owned project and program management for learning and business operations teams.

· Developed data driven team processes that improved efficiency and responsiveness of training requests.

Director of Training (4/2007 – 6/2011)

· Created a team using an entrepreneurial approach with new process and tools that focus on partner management, needs analysis, project management with inventory exceeding 1400 requests per month and a strong track record of completing requests on time.

· Streamlined multi divisional teams’ processes including standardized templates.

· Led instructional designers and created quality program around content development.

· Influenced leadership to reduce staffing for technical writers responsible for policies and procedures by 75% leveraging and implementing standards and templates.

· Responsible for training programs that included one or more formats; instructor led, virtual training, Webinar and self-paced for employees, member and provider education.

Senior Quality Consultant – Six Sigma Black Belt (2/2006 – 4/2007)

· Certified as a UnitedHealthcare Six Sigma Black Belt.

· Managed projects that measure performance, budgeting and improved operating goals.

· Led multi projects by understanding operational outcomes and leveraging time management skills, technical knowledge, sourcing, collaboration and interpersonal skills.

Regional Training Manager (3/2001- 2/2006)

· Led the training operations aspect of mergers & acquisition– Evaluated, recommended and implemented efficiencies, best practices and staffing realignment. (PacifiCare, Americhoice, MAHP, Definity, Oxford etc.).

· Led training delivery in multiple locations, influencing local leadership to support requirements (Including legacy operations, virtual employees & acquired locations).

· Mentored and evaluated new training managers, acted as resource and led training projects.

· Provided strategic and tactical leadership for the integration and rollout of a new customer service workstation to 15 contact center locations, including scheduling and security procurement.

· Created a training department with UnitedHealthcare’s first call center, Business Process Outsourcing, BPO initiative in Montego Bay, Jamaica.

· Coordinated and Scheduled the rollout of membership portal training to 15 call center locations.

Business Operations Manager – Training/Quality and Adjustments (3/1999 - 3/2001)

· Managed 100+ employees including, reviews, compensation, performance management, employee development and budget.

· Managed and improved office quality audit credibility scores – Claims Processing & Customer Service.

· Managed all office training programs, claim adjustment and overpayment recovery team.

· Partnered to create business requirements for a new customer service workstation.

· Presented status and initiatives to strategic accounts, sales and customers, GE, IBM, FEDEX.

· Responsible for business planning and business goals to include growth objectives and savings.

Training & Development Consultant (5/1990 - 3/1999)

· Managed the on-line university – UnitedHealthcare’s first Learning Management System.

· Led the implementation of a customer service workstation.

· Led Y2k system conversion training strategy.

· Experienced claim coding for hospital, ancillary and physician services, processing, customer service, appeals, grievances and authorizations.

· Interacted directly with clients and customers to address issues and provide value propositions and improve satisfaction and the customer experience.

Education

SUNY (State University of New York) Polytechnic Institute, Marcy, NY

Bachelor of Science - Communication & Information Design

Volunteer Work

Boys & Girls Club of America

Activities Support/Tutor/Life skills training

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