Vice President of Operations
Resume:
LISA WALSETH
Bohannon, VA *****
*********@*****.***
Dynamic Vice President with a Master's degree in Business Administration and 25 years of comprehensive experience in the Insurance Industry, including 16 years in management. Proven track record of driving operational excellence and strategic growth initiatives. Adept at leading cross-functional teams to achieve business objectives while fostering a culture of innovation and accountability. Committed to leveraging extensive industry knowledge to enhance organizational performance and achieve long-term business goals. Analytical skills
Bid/Proposal Development
Budget Monitoring
Business Process Improvement
Change Management
Coaching and mentoring
Collaborative leadership
Continuous Improvement
Decision making
Effective communication
Government contracting
Human Relations
Large-scale management
Multi-tasking
Operational Efficiency
Quality Improvement
Regulatory requirements
Coordination of Benefits
09/2019 to 06/2025
WISCONSIN PHYSICIAN SERVICES
Hampton, VA
Vice President of Operations
Lead all functional operations of the TRICARE East (T-17) Contract, including but not limited to operational oversight of claims processing, provider certification, recoupment, and call center duties. Developed the strategy for the contract, and oversaw the execution. Ensured the team was meeting all contractual service level agreements and contract requirements. Developed the contract budget, as well as forecasting. Improved operational efficiency resulting in staffing reductions. Earned top-tier incentives from the prime for contract performance. Delivered expert thought leadership, recognized for driving process improvements. Set clear goals for directors and managers, and implemented systems for measuring results in support of optimal decision-making.
Boosted company profits by optimizing performance strategies and increasing efficiency. Developed and deepened relationships with functional leadership to interconnect revenue generation initiatives with day-to-day operations.
Leveraged analytical, design, and implementation skills to offer leadership and support to all operations areas. Coordinated work across departments and shared services to keep teams on track with company goals. Established excellent working relationships, both internally and externally. 07/2018 to 08/2019
WISCONSIN PHYSICIAN SERVICES
Hampton, VA
Director of Operations
Evaluated operational trends and made proactive strategy adjustments to maintain alignment between performance and objectives for provider certification, claims processing and recoupment teams for TRICARE East.
Directed training improvements to reduce knowledge gaps and eliminate workforce performance inefficiencies. Motivated and supported frontline workers completing work to increase work quality and efficiency. Worked closely with other stakeholders to immediately address issues and implement effective solutions. Generated reports to assess performance and make adjustments. Optimized productivity, streamlined program efficiency, and boosted profitability. Assessed team proficiencies, identifying and targeting areas for improvement. SUMMARY
SKILLS
EXPERIENCE
Forecasted outlook by mitigating operational risk and compiling performance, financial, and headcount data. Monitored progress by establishing plans, budgets and measuring results. Provided oversight of over 400 employees through coaching, feedback and performance management. Conducted staff evaluations and determined promotions and realignments or reductions in workforce. 03/2014 to 05/2018
NORIDIAN HEALTHCARE SOLUTIONS
Fargo, ND
Manager/Director of Provider Enrollment
Primarily responsible for overseeing workload monitoring and performance standards for Medicare Provider Enrollment.
Supervised three managers and over 200 frontline staff. Initiated process improvements and technology implementations. Enforced strong internal controls and compliance programs within operational area. Achieved contractual and performance metrics.
Led the team to increase the percentage of metrics met from 27% to 100% through process improvements and developing an enhanced program for measuring staff production. Decreased staffing levels while meeting 100% of performance standards. Developed tools and resources to meet application timeliness. Met requirements by developing budgets and working within available funding. Implemented Corrective Action Plans to improve processes and meet contract requirements. Met 100% on external audits.
04/2009 to 02/2014
NORIDIAN HEALTHCARE SOLUTIONS
Fargo, ND
Team Leader
Responsible for monitoring and meeting Medicare Secondary Payer and Recoupment Team goals. Supervised a team of 15-40 staff.
Provided skills, tools, and training to develop the team. Conducted hiring and maintained staffing levels.
Served as a contact with external stakeholders such as CMS. Responsible for managing annual budget requirements. Successfully implemented a new contract.
Met performance expectations by setting expectations for staff and facilitating and coaching them to success. Implemented numerous Change Requests.
11/2008 to 03/2009
NORIDIAN HEALTHCARE SOLUTIONS
Fargo, ND
Quality Improvement Program Analyst
Responsible for monitoring effectiveness of quality improvement activities. Created quality reports for management responsible for Medicare Business. Completed data analysis to measure quality.
Served as a quality improvement resource to all internal departments, as needed. Facilitated an environment that prioritized quality performance. Ensured that processes were suitable to achieve contractual performance requirements by conducting process improvement reviews.
05/2006 to 10/2008
NORIDIAN
Fargo, ND
Quality Improvement Program Analyst - Appeals
Responsible for updating, maintaining, and reporting activities for the Redeterminations (Appeals) Quality Improvement Program. Coordinated data analysis results with appropriate individuals. Developed and completed Redetermination reports per CMS reporting requirements. Facilitated monthly Redeterminations Quality Steering Committee meetings to determine areas of concern and completed analysis as appropriate. Coordinated and reported Redetermination edits and data analysis requests as required by CMS. 01/2003 to 04/2006
NORIDIAN HEALTHCARE SOLUTIONS
Fargo, ND
Fair Hearing Officer
Conducted on-the-record, telephone, and personal appearance hearings with Medicare beneļ¬ciaries and providers for services rendered under the Medicare law. Wrote decisions in accordance with Medicare law in regards to payment or denial of Medicare claims.
MBA: BUSINESS MANAGEMENT 03/2018
University of Mary, Fargo, ND
BACHELOR OF SCIENCE: BUSINESS MANAGEMENT 03/2016
University of Mary, Fargo, ND
EDUCATION
Contact this candidate