Anthony Carter
Spring,TX
Summary
Dynamic Sr. Operations Manager with a proven track record at Willis Towers Watson, excelling in process improvement and regulatory compliance. Adept at contract negotiation and performance reporting, I drive operational excellence and mentor teams to achieve strategic objectives. Committed to optimizing workflows and enhancing service delivery in fast-paced environments.
Overview
35
35
years of professional experience
Work History
Sr Operations Manager
Willis Towers Watson
Richardson, Texas
08.2019 - 01.2025
- Advised senior leadership on potential changes or modifications needed for current processes and procedures.
- Created reports on key performance indicators to track progress against objectives.
- Provided guidance, support, and mentorship to junior team members.
- Assigned tasks to staff members based on their skill sets and availability.
- Ensured compliance with company policies and industry regulations.
- Negotiated contracts with suppliers and vendors to secure favorable terms.
- Conducted regular audits of systems and processes to detect any potential issues or risks.
- Monitored daily operations, identified areas for improvement, and created solutions to optimize workflow.
Call Center Manager · Clinical Data Acquisition & Insights
Ciox Health
Irving, Texas
02.2018 - 07.2019
- Provide operational leadership to the Records Retrieval EMR Contact Center, Quality Assurance Team, and Provider Portal including implementation of annual business plan objectives.
- Responsible for the level of service provided to internal customers, physicians, hospital groups and other external customers served by the Contact Center.
- Conduct productivity analysis and efficiency studies. Make recommendations for optimization; and Identify staffing and people development needs.
- Responsible for the financial viability of the Ciox Health Contact Center, including, but not limited to: Plan and maintain operating budget.
- Serve as a resource and provide support to Call Center Supervisors to ensure that all projects remain on track and that yield is in alignment with company goals.
- Build and maintain relationship with internal and external business partners to ensure that departments meet or exceed company’s profit and loss goals.
- Develop weekly action plans to ensure that Sr. Leadership is aware of targets: Cost per transaction, Shrinkage and Overtime Utilization
Manager Access Patient and Support Unit
Cardinal Health
Lewisville, Texas
10.2016 - 07.2017
- Provided guidance and support to supervisors and team leads, quality auditors; indirect supervision of Non-Clinical Care Coordinators and Non-Clinical Case Managers; reviewed request from health care providers resulting in the completion of benefit investigation and prior authorization and appeals and review of patient financial status to determine appropriate patient assistance program.
- Maintained daily receipt of patient cases new or existing, patient and provider service levels standards, staff productivity and adherence to schedules inclusive of Cardinal Health Employees and Vendor Support across multiple states and time zones.
- Assembled project plans and teamwork assignments, directed and monitored work efforts daily, identified resource needs, performed quality review; and escalated quality, timeline issues appropriately.
- Develop and present Quarterly Board Report to all clients supported by program, demonstrating results as it relates to profits and losses, monitoring progress against budget.
- Build and maintained relationship with internal and external business partners to ensure that departments meet or exceed company’s profit and loss goals.
Manager Clinical Operations and Support Unit
Blue Cross Blue Shield of Texas, Oklahoma, New Mexico, Illinois, and Montana-Health Care Service Corporation
01.2008 - 09.2016
- Provided guidance and support to Senior Supervisors and Team Leads, Quality Auditor, Process Consultants, Work Force management specialist and Technical analyst; indirect supervision of Non-Clinical Health Coordinators and Non-Clinical Member care coordinators.
- Responsible for ensuring claims processed timely and ensured proper payments based on policy and based on reimbursement rates.
- Creating and authorizing request for services and member navigation (network steerage) based on plan type and patient geography.
- Ensure all needed technology systems and support for technology systems were in place to receive inbound calls and place outbound calls for Health and Wellness Team and Utilization Management nursing and Non clinical teams. Liaison with technology vendors for the Contact Center to build partnering relationships.
- Identify, design, and activate operational improvements and practices, including: Analyze and modify access and patient through companies Interactive Voice Response System to ensure access to all departments supported by IVR while optimizing service levels.
- Evaluate and improve patient satisfaction based on member/patient feedback.
- Conduct productivity analysis and efficiency studies. Make recommendations for optimization; and Identify staffing and people development needs.
- Maintained daily inventories, membership and provider service levels standards, staff productivity and adherence to schedules inclusive of Blue Cross and Blue Shield Employees and Vendor Support across multiple states and time zones.
- Assembled project plans and teamwork assignments, directed and monitored work efforts daily, identified resource needs, performed quality review; and escalated quality timeline issues appropriately.
- Complied with HIPAA, Diversity Principles, Corporate Integrity, Compliance Program policies and other applicable corporate and departmental policies.
Call Center Supervisor
Genesys Conferencing
Manassas, Virginia
08.2006 - 12.2007
- Analyzed call activity reports and process evaluations, forecasting, planning, and implementing staffing needs; developing modifying and implementing standard operating procedures.
- Created a process focused, principle based environment to encourage the staff to achieve personal success and business results.
- Assured direct reports were functioning as business leaders by setting performance standards and coaching to those standards.
Call Center Supervisor
Pearson Government Solutions/Medicare Prescription Drug Program (Health Care Service Options)
Chester, Virginia
08.2005 - 08.2006
- Coached and developed a team of 15-20 agents. Completed and delivered performance appraisals. Monitored individual and team quality and performance levels.
- Worked closely and effectively with other Call Center Supervisors and members of senior management.
- Assigned departmental tasks, call center activities and maintaining departmental records.
- Provided for accurate and timely submission of employee time and attendance. Responsible for the Brokers Services Desk, ensuring timely replies to inquiries on payments and changes to the plan for state’s serviced.
Provider Customer Advocate
First Coast Service Options Medicare (Parts A&B)
Jacksonville, Florida
12.2003 - 07.2005
- Ensured that providers followed the Medicare program. Ensured CD-9 codes used were in compliance with local and national medical review policies.
- Provided training to provider office staff on topics such as timely and proper submission of claims, how to use Florida Medicare website, and analyzed explanation of benefits to find over and under payments.
Senior Enlisted Advisor, Oral Maxillofacial Surgery Clinic
United States Navy
Okinawa, Japan
08.1989 - 11.2003
- Provided leadership, strategic direction, and administration oversight to various US Naval World-Class Medical Treatment Facilities.
- Provided professional growth and development of Noncommissioned Officers assigned to the command.
Education
BBA - Business Administration and Management
American Intercontinental University
Schaumburg, ILSkills
- Process improvement
- Regulatory compliance
- Contract negotiation
- Performance reporting
- Budget management
- Workflow optimization
References
References available upon request.
Timeline
Sr Operations Manager
Willis Towers Watson
08.2019 - 01.2025
Call Center Manager · Clinical Data Acquisition & Insights
Ciox Health
02.2018 - 07.2019
Manager Access Patient and Support Unit
Cardinal Health
10.2016 - 07.2017
Manager Clinical Operations and Support Unit
Blue Cross Blue Shield of Texas, Oklahoma, New Mexico, Illinois, and Montana-Health Care Service Corporation
01.2008 - 09.2016
Call Center Supervisor
Genesys Conferencing
08.2006 - 12.2007
Call Center Supervisor
Pearson Government Solutions/Medicare Prescription Drug Program (Health Care Service Options)
08.2005 - 08.2006
Provider Customer Advocate
First Coast Service Options Medicare (Parts A&B)
12.2003 - 07.2005
Senior Enlisted Advisor, Oral Maxillofacial Surgery Clinic
United States Navy
08.1989 - 11.2003
BBA - Business Administration and Management
American Intercontinental University
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