Summary
Work History
Education
Skills
Timeline
Generic

Akenya S. McCaleb

Summary

Akenya McCaleb is an accomplished operational leader with 7+ years at Optum and over a decade of leadership experience, driving performance, process improvement, and workforce engagement in complex, high-volume environments. Known for translating organizational strategy into executable plans that improve productivity, quality, and customer outcomes. Demonstrates strong business judgment, change leadership, and the ability to identify operational inefficiencies and implement sustainable solutions. Adept at leading teams through transitions, strengthening workflows, and reinforcing Optum’s patient-centric mission while delivering measurable results. Seeking to transition into a supervisor role to further influence operational excellence, talent development, and enterprise goals.

Work History

Team Lead

Optum Specialty Pharmacy
  • Lead and support high-performing teams by providing daily guidance, coaching, and real-time issue resolution to ensure service excellence.
  • Act as a subject matter expert and technical resource, assisting team members with complex cases, system navigation, and policy interpretation.
  • Coordinate daily workloads, establish priorities, and monitor progress to meet service-level agreements and business objectives.
  • Identify operational gaps, recommend process improvements, and remove barriers to improve efficiency and quality outcomes.
  • Facilitate team engagement, promote collaboration, and address performance or behavioral challenges to maintain a positive work environment.
  • Monitor customer service escalations to ensure timely, accurate resolution and first-call resolution whenever possible.
  • Conduct quality audits and 'shoulder surfing' sessions to evaluate performance, ensure compliance, and provide actionable feedback.
  • Prepare and deliver performance reports, activity updates, and trend analysis to leadership and team members.
  • Ensure adherence to Standard Operating Procedures (SOPs), Special Account Instructions (SAIs), and workflows; contribute to updates reflecting evolving business needs.
  • Train new hires and existing employees through formal instruction, one-on-one coaching, and upskilling initiatives.
  • Serve as lead trainer and subject matter expert for Oncology, REMS, Celgene, Health Trust, Diplomat, Officebase, Core, Advance, and Expert systems.
  • Support enterprise-wide system migrations, including PCC Health Trust and Diplomat, ensuring continuity of operations and staff readiness.
  • Maintain strong relationships with clients and Regional Sales and Account Management teams to support account success.
  • Partner closely with Provider Management, Finance, Training, and Quality teams to resolve issues and align operational goals.
  • Act as a liaison between frontline staff and leadership to communicate expectations, changes, and performance outcomes.
  • Coordinate staffing, scheduling, and overtime coverage across teams to ensure call volume and workload demands are met.
  • Maintain a visible leadership presence by spending significant time on the floor supporting staff, answering questions, and reinforcing best practices.

Supervisor

Premier Choice Health Service
  • Support the Director of Nursing Services in planning, organizing, directing, and evaluating daily nursing operations in compliance with federal, state, and local long-term care regulations.
  • Provide day-to-day leadership and oversight of nursing staff to ensure safe, compassionate, and high-quality resident care.
  • Participate in admission decision-making, including pre-admission assessments when required, to ensure appropriate placement and continuity of care.
  • Represent nursing leadership in daily and weekly management meetings to address resident status, census changes, staffing, and quality or service concerns.
  • Contribute to the development, maintenance, and revision of nursing policies, procedures, and clinical workflows to support regulatory compliance and best practices.
  • Ensure the Nursing Service Procedure Manual remains current and accurately reflects daily clinical operations.
  • Communicate and interpret policies and procedures to nursing staff while monitoring adherence and implementation at the unit level.
  • Demonstrate working knowledge of Key Clinical Quality Indicators (KCQIs) and assist in implementing systems and corrective actions to meet or exceed company benchmarks.
  • Evaluate nursing staff performance, provide coaching and corrective guidance, and administer discipline in accordance with organizational policies.
  • Assist with recruitment, selection, and onboarding of nursing personnel to maintain appropriate staffing levels.
  • Oversee nursing schedules to ensure adequate coverage, compliance with budgetary guidelines, and alignment with resident care needs.
  • Foster accountability, professionalism, and teamwork among nursing staff to support optimal resident outcomes.
  • Monitor daily 24-hour reports from each unit to ensure timely response to changes in condition, transfers, discharges, falls, behavioral episodes, medication errors, restraints, and unexplained injuries.
  • Ensure care delivery standards are consistently met, including cleanliness, infection control, pressure injury prevention, and maintenance of resident dignity and function.
  • Collaborate with physicians, consultants, community agencies, and external providers to resolve clinical concerns and improve service delivery.

Customer Service Provider / Lead Support

Aetna Insurance
  • Consistently met or exceeded NPS, Quality, Productivity, and Attendance performance requirements.
  • Ensured high levels of patient and provider satisfaction by maintaining accurate documentation, completing required follow-up actions, and proactively identifying and resolving potential issues to prevent repeat calls.
  • Maintained proficiency across all required technical systems and applications, demonstrating strong system knowledge and adaptability.
  • Adhered to all company policies, procedures, and workflows, ensuring compliance and consistency.
  • Successfully de-escalated and resolved complex or escalated patient and provider concerns using professional judgment and empathy.
  • Provided coaching, mentoring, and subject-matter expertise to team members to support performance improvement.
  • Delivered high-quality customer service and operational support to members, customers, and providers.
  • Coordinated, supervised, and was accountable for the daily activities of a business support/production team, ensuring operational efficiency.
  • Reviewed and analyzed call center metrics and performance data, identifying trends and communicating insights to leadership and Subject Matter Experts.
  • Led and facilitated training sessions, one-on-one coaching, team huddles, new-hire onboarding, and refresher training as needed.
  • Established priorities and managed workloads to ensure team performance goals and service-level objectives were achieved.
  • Collaborated with other supervisors and teams to align workflows and promote cross-functional efficiency.
  • Identified and resolved operational issues using established processes, sound judgment, and problem-solving expertise.

Supervisor / Inbound Sales Representative

Time Warner Cable – Ohio
  • Delivered exceptional customer service while supporting both sales and service objectives within a high-volume telesales environment.
  • Served as a consultative sales professional, effectively identifying customer household needs and recommending appropriate solutions.
  • Promoted and supported residential cable, internet, home phone, and home management services, contributing to revenue growth.
  • Maximized sales opportunities by providing tailored product recommendations while maintaining a customer-first approach.
  • Performed a wide range of customer service initiatives to improve customer experience and satisfaction.
  • Received, investigated, and responded to customer inquiries across multiple channels regarding products, services, billing, and account concerns.
  • Effectively resolved customer service issues and inquiries, applying problem-solving skills and company policies to ensure timely resolution.
  • Supported team operations by modeling professionalism, strong communication skills, and performance accountability.

Customer Service Representative

PNC Bank, OH
  • Consistently deliver high levels of customer satisfaction aligned with organizational core values and service standards.
  • Demonstrate a strong commitment to quality through professional, accurate, and empathetic interactions with customers and internal service partners.
  • Resolve customer inquiries efficiently while ensuring first-contact resolution whenever possible.
  • Accurately document customer interactions, service requests, and account updates in accordance with compliance and documentation guidelines.
  • Maintain attention to detail and adherence to procedures to support operational efficiency and risk mitigation.
  • Build positive relationships with customers and colleagues to support team goals and overall service excellence.

Customer Service Representative

GC Services – Student Loan Collections
  • Reviewed and analyzed financial documentation including payroll stubs, tax returns, and income verification forms to determine program eligibility.
  • Accurately entered and maintained income and account data within internal systems to support servicing and eligibility decisions.
  • Generated and sent follow-up correspondence to customers regarding missing, incomplete, or additional required documentation.
  • Provided student loan collections support, educating borrowers on repayment options and guiding them toward solutions to resolve delinquent accounts.
  • Assisted customers in identifying paths to financial stability and debt resolution through clear communication and empathy.
  • Responded to customer inquiries professionally while ensuring compliance with federal guidelines, company policies, and data privacy standards.
  • Maintained attention to detail and accuracy in a regulated, high-volume environment to support timely account resolution.

Sales Supervisor

Dial of America, OH
  • Coordinate internal resources across multiple departments to address client needs, resolve issues, and escalate complex situations appropriately.
  • Conduct outbound sales and service calls to resolve customer questions, address concerns, and support account retention and growth.
  • Apply in-depth knowledge of benefit structures and plan designs for contracted and acquired companies to ensure accurate communication and effective issue resolution.
  • Demonstrate strong understanding of established workflows, support processes, and available internal and external resources to drive efficient outcomes.
  • Assist with side-by-side training and onboarding of new employees, providing coaching on systems, sales techniques, and customer engagement best practices.
  • Support team performance by reinforcing standards, sharing knowledge, and promoting consistent execution of sales and service processes.

Medical Assistant

Physical Medicine Pain Center
  • Greeted patients and visitors, provided requested information, and managed high-volume front-office communication, including incoming calls, filing, faxing, and data entry.
  • Scheduled appointments and maintained accurate provider and patient calendars, ensuring efficient clinic operations.
  • Maintained professionalism in a medical office environment, adhering to safety protocols, confidentiality standards, and effective communication practices.
  • Obtained and recorded medical histories, vital signs, and clinical data; assisted with exam preparation and patient flow.
  • Performed lab and specimen collection, phlebotomy, EKGs, diagnostic tests, and supported minor surgical procedures and office emergencies.
  • Screened patients using targeted intervention business rules to identify required medical services and made appropriate referrals to clinical staff.
  • Coordinated medical services in alignment with patient benefit plans and care protocols.
  • Monitored non-targeted cases to ensure accurate documentation of discharge dates and disposition.
  • Identified outlier cases (e.g., length of stay variances) and escalated concerns to clinical leadership as needed.
  • Recognized triggers for referral into Case Management, Disease Management, Mixed Services, and Specialty Programs, including Aetna-aligned services.
  • Utilized ATV, ASD, and other Aetna systems to research, update, and enter member information accurately.
  • Supported the development and implementation of patient care plans, collaborating with clinical and administrative staff to ensure continuity of care.

Education

Bachelor’s degree - business and management

University Of Phoenix

Medical Assistant -

Cambridge Institute of Allied Health & Technology
Altamonte Springs, FL

Skills

  • Leadership & Communication
  • Coaching & People Development
  • Process Improvement & Change Management
  • Patient-Centric Focus
  • Decision-Making & Problem-Solving
  • Time Management & Multitasking
  • Technical Proficiency
  • Adaptability & Resilience

Timeline

Team Lead

Optum Specialty Pharmacy

Supervisor

Premier Choice Health Service

Customer Service Provider / Lead Support

Aetna Insurance

Supervisor / Inbound Sales Representative

Time Warner Cable – Ohio

Customer Service Representative

PNC Bank, OH

Customer Service Representative

GC Services – Student Loan Collections

Sales Supervisor

Dial of America, OH

Medical Assistant

Physical Medicine Pain Center

Bachelor’s degree - business and management

University Of Phoenix

Medical Assistant -

Cambridge Institute of Allied Health & Technology

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Akenya S. McCaleb