Consumer Experience Leader and Advocate

Maria Belen Alcala

****************@*****.*** 956-***-****

Skills:

Call Center Technologies

Modern Leadership

Problem solving

Client Facing Point of Contact

Customer Service Queues

Establish Large Scale Performance Measures

Account Management

Microsoft Excel

Culture Initiatives

WORK EXPERIENCE

Consumer Experience Consultant

United Healthcare – November 2015 to present

•Consumer Experience Consultant-Specialized Support Team for Consumer Resolution Center signifies that we start with the consumer first and end with resolution of all member concerns. We consider each situation and their own issue urgent and important, and therefore treat all individuals as a priority. Complex problems require teams of empowered people to do their best and I’m proud to be part of that team. This is achieved with empathy and showing no judgement. We identify the issue and use all available resources including our leaders and team to help member from start to finish.

•Part of transforming our organization to relentless focus on building and fostering an environment centered on the end-to-end experience for our members across all aspects of their health care journeys. Building a consumer-focused mindset through enterprise-wide rotation into existing roles that are front-line facing with our key consumers (Members, Patients, Providers). Further developing into an employee who is passionate about the consumer experience into leaders and who will make a lasting impact on the health system and the people we serve. Understanding our consumer must be at the center of our culture. Having thorough enterprise partnerships with all lines of business and Optum, we will support growth objectives. Participating in meaningful and differential engaging experiences closest to our consumers. Completing CCL will result in me becoming one of the enterprise talents of consumer-oriented leaders.

•Team Lead for Advocate for Navigate4me program in which I service members in assisting with navigating through COVID19 diagnosis, care, and recovery I use the knowledge I gained in my role of National Experience Center to escalate issues and resolve complex requests in a timely manner.

•Empowered to start our team chat within my team as well as lead team meetings in my supervisors’ absence. Work independently & share best practices so I can mentor others and function as a resource for others as needed so we can coordinate activities for member wellbeing. Use my knowledge in my own area, and I can apply this outside of own my function. Can solve complex problems on own & proactively identify new solutions to problems.

•Culture Ambassador for United Healthcare. It is a fundamental movement within our enterprise to set the right direction for our character, our thinking, our behaviors, internally and externally. It is how we make important decisions and conduct ourselves every day as responsible members of healthcare and corporate communities.

•M&R Certified levels 1 and 2, and 3. I have invested in myself to learn more about Medicare & Retirement so I can understand how my everyday work impacts the bigger picture. Have more detailed knowledge of Medicare terms and the language of the Medicare business. Gained exposure to information to light my innovation spark & I can more easily move faster from ideas to concrete execution to work for positive change in people’s lives.

•Refer claims to investigators for further review. My work does not usually require established procedures & gives me the freedom to “think outside of the box” to use all available resources to solve complex issues the member may have therefore they can focus on health concerns.

•National Experience Center advocate servicing our members by the utmost courtesy and respect. Deliver one on one care to members that have or may have had ongoing issues. Use phone and email case assignment to solve any issues the member may encounter.

•Expertise in customer service and support for our members as part of our UnitedHealthCare by directly phone-based interaction to address complex member needs and provide recommendations on services that may help close gaps in care for the member and/or members’ family. Anticipates customer needs and proactively identifies solutions.

Full ownership of any obstacles that my member may face and stay with matter at hand until it is fully resolved to make matters hassle free for my member by navigating through systems ICUE, COSMOS, RXCLAIMS, UFE, ODM, EDSS. I also use said systems to verify any prior authorizations or referrals as needed.

Educate members on fundamentals and benefits of health care topics to include managing their health and well-being & maximizing the value of their health plan benefits and choosing a quality care provider and assist in navigating their proper UHC website for self-help options. Acts as a facilitator to resolve conflicts on team; seen as key team member on project teams spanning more than own function.

Subject Matter Expert to assist in training in a vendor site in Highland Park Michigan 2016/2017. It was a great experience in not only learning about the training aspect of UHC but in learning more in depth how to assist my fellow coworkers as needed.

Account Maintenance Coordinator

Greenpath Debt Solutions - December 2014 to November 2015

Maintain debt management programs by developing positive and collaborative relationships with clients and communicate and respond empathetically to clients and creditors to maintain successful relationships resulting in successful operations.

Maintain a high level of discretion and professionalism regarding client financial information.

Document client files all activity and conversations with clients and their creditors.

Review customer concerns cordially and professionally.

Review assigned clients’ account activity to identify potential or existing problems such as short, late or missed payments.

Work with assigned clients proactively to prevent or resolve problems identified.

Respond to client inquiries concerning account activity and monthly statements.

Communicate with creditors to resolve issues with rejected Debt Management proposals or missed payments.

Add additional debts to Debt Management Plan as needed.

Supervisor Level II

Advanced Call Center Technologies, LLC - August 2001 to January 2013

Began as Customer Service Representative and my duty was to collect on delinquent accounts for Sears.

Skiptracing, to find someone that doesn't want to be found.

SWAT, our job was to be both collector and skip tracer, the best of the best.

Team Manager October 2002 in which I had 10-12 representatives in my team at any given time.

Make sure they were performing all job duties. Would provide my team with weekly statistics and feedback and advice of any areas of improvement.

American Family Supervisor June 2005 in which I have 10 claim representatives under my direct authority. Our department deals directly with all Spanish speaking customers for American Family Insurance, a company based out of Madison Wisconsin. A series of reports are sent out daily to advise my supervisor of hours worked, activity code totals and call volume report. I also keep track of attendance for my representatives and evaluate each person individually. Required to monitor each representative in which they are given feedback for a job well done and any changes that need to be made.

Supervisor for Ecommerce Online Fraud from August 2010 to January 2013. Team consists of a total of 35 customer service representatives under my direct authority. Our department deals directly with verifying online transfers by asking a series of questions to verify caller's identity.

Enrollment in safe pass. A program designed to allow our customers to transfer a higher amount of cash daily.

Series of reports are sent out daily to advise my supervisor of hours worked, daily statistics, and call volume report via IEX. Keeping track of attendance for my representatives and evaluate each person individually is a high priority. Required to monitor each representative in which they are given feedback for a job well done and any changes that need to be made.

EDUCATION

Harlingen High School diploma

Harlingen High School - Harlingen, TX

References

Available upon request.

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