Operations

Rachel Stanton

Beverly Hills, FL • 715-***-**** • ***************@*****.***

linkedin.com/in/rachel-stanton-b7526818

CUSTOMER SUCCESS & HEALTHCARE MODERNIZATION OPERATIONS LEADER

I drive tech enabled innovation that improves the patient journey and strengthens operational performance. I turn high value business problems into practical solutions by evaluating platforms, leading build versus buy decisions, and managing vendor partnerships. I work across teams to implement, adopt, and measure technology that creates real, sustainable impact for patients, families, and business.

CORE CAPABILITIES

Enterprise Solution Deployment • Market Optimization • Cost-of-Care Program Leadership • Workflow Modernization • AI Enabled Process Design • Provider & Physician Engagement • Operational Playbooks • Change Management • KPI Governance • Strategic Roadmapping • Multi-State Operations • Clinical & Operational Alignment • TPA & Carrier Workflow Support

Remote Work Strengths: Async communication • Cross-timezone collaboration • Remote team leadership • Independent project ownership • Virtual stakeholder management • Measurable outcomes tracking • International call center collaboration

Technology: CareExchange • Unified Provider Database (UPD) • Caregiver Advocate • Salesforce • Zendesk • Power BI • Excel (Advanced) • MFA/Authentication Systems • Geolocation Tools • SOP Development • UAT Testing • HIPAA Compliant Systems

PROFESSIONAL EXPERIENCE

Illumifin – Woodbury, MN

Operations Management, Innovative Solutions – Supervisor (Manager/Director Level) 2024 – 2026

Directed modernization, customer success strategy, and operational excellence across three national product lines supporting long term care carriers, clinical teams, and 300,000+ providers. Rebuilt the department with scalable workflows, enterprise metrics, and automation that improved satisfaction, reduced turnaround times, and strengthened retention.

Key Achievements

Built a costofcare database of 1,000+ providers, increasing verified rates by 20,000+ in year two.

Accelerated UPD adoption, driving 120% enrollment growth through expanded provider self service capabilities.

Shortened claims approval turnaround time by 1.5 days through targeted provider follow ups and workflow optimization.

Implemented automation that eliminated manual work assignment and significantly improved operational efficiency.

Maintained 96%–98% quality scores through audits, calibrations, and continuous improvement initiatives.

Leadership Scope

Spearheaded modernization and performance improvements for CareExchange, enhancing caregiver geolocation accuracy, MFA adoption, and user experience through weekly collaboration with India based developers.

Strengthened Unified Provider Database (UPD) operations by optimizing verification workflows and improving data accuracy for 300,000+ providers.

Elevated clinical operations for Caregiver Advocate by leading LPN staff, managing affiliate partnerships, and strengthening customer experience for carrier facing benefits platforms.

Customer Success & Strategy

Delivered customer insights, health metrics, and trend analysis to VP level leadership to inform modernization roadmaps and strategic planning.

Facilitated monthly carrier meetings to review usage trends, system updates, and alignment with product roadmaps.

Partnered with Sales to demo product features and support new business acquisition.

Resolved escalations across product lines, protecting relationships and reducing churn risk.

Operational Excellence & Modernization

Developed new metric systems, SOPs, and a comprehensive training manual enabling consistent onboarding and measurable performance.

Introduced AI supported workflows and contributed to automation design for repetitive tasks.

Managed workload distribution and capacity planning to ensure SLA adherence across product teams.

Collaborated with Fraud Investigations using system logs, geolocation data, and workflow documentation.

Conducted quarterly compliance reviews to align workflows with federal and state regulations.

Cost of Care Program (Revenue: $1.5M–$1.8M annually)

Directed annual costofcare data collection and delivery across multiple formats: spreadsheets, Caregiver Advocate access, and custom carrier websites. Supporting program revenue and improving carrier reporting accuracy.

Underwriting Telephonic – Supervisor II 2012 – 2024

Led a remote team of 40–50 clinical and non-clinical staff performing health interviews for underwriting.

Managed domestic and offshore teams, ensuring compliance, service consistency, and alignment with organizational goals.

Strengthened onboarding programs, achieving 90%+ retention after one year.

Improved production metrics through workforce planning and realtime monitoring, with staff exceeding minimum requirements by 5–10%.

Enhanced system usability by partnering with developers to test legacy system updates in UAT.

Resolved escalations across Underwriting and Operations with clear communication and thorough follow up.

Supported TPA and carrier workflows by improving provider verification accuracy, strengthening data integrity, and resolving claims/underwriting related escalations.

EDUCATION

Bachelor of Business Management, Healthcare Management – American InterContinental University

Curriculum focus: healthcare operations, compliance, and organizational management.

Associate of Applied Science – Medical Assistant – High Point Institute

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