Calletta Uthman
Healthcare Professional
St Louis,MO
Summary
Knowledgeable and dedicated customer service professional with extensive experience in Healthcare industries. Dedicated to streamlining operations to decrease costs and promote organizational efficiency. Strong leader and problem-solving team player with an outgoing, positive demeanor and proven skills in establishing rapport with clients. Motivated to maintain customer satisfaction and contribute to company success. Specialize in quality, speed and process optimization. Articulate, energetic and results-oriented with exemplary passion for developing relationships, cultivating partnerships and growing businesses.
Overview
16
16
years of professional experience
Work History
Escalations Lead; Compliance
Molina Healthcare
10.2018 - 10.2023
- Managed a call Que of 200+ incoming Medicaid calls.
- De-escalated High-stress situations effectively, maintaining professionalism under pressure while resolving disputes or conflicts.
- Conducted root cause analysis on recurring issues, identifying areas for improvement and implementing necessary changes.
- Handled escalated calls efficiently, finding satisfactory resolutions for both customers and the company alike.
- Achieved high levels of customer satisfaction by demonstrating empathy, active listening skills, and solution-oriented thinking during interactions with customers facing difficulties resulting in increased loyalty and client retention
- Responded to customer requests for products, services, and company information.
- Participated in regular meetings with management to discuss trends in escalated cases while proposing strategies for addressing common challenges faced by the team.
Customer Care Professional
AllianceRX Walgreens Prime Specialty Pharmacy
05.2018 - 08.2018
- Assist callers from third party copay assistance agencies, Medical Doctor's Office and Patients with medication delivery, approximately 50 calls daily.
- Excel documentation
- Collaborated with team members to improve overall performance, sharing best practices and pooling resources for optimal results.
- Contact Health Plans to verify benefits and bridge the gaps between MD office and Insurance for faster processing of PA's and CD's.
- FCR conference calls between pharmacy and MD for verbal scripts.
- File complaints and escalate to supervisor line when requested.
Benefit Specialist
Benefit Harbor
03.2018 - 05.2018
- Receive Inbound calls from employees wanting information about the benefits being offered through their employment agency (Randstad, RGS, Spherion)
- Give detailed information regarding each benefit offered and enroll or waive all benefits and recap call options for quality assurance
- Explained Aetna Benefit Services, privacy policy, open enrollment dates and requirements for about 30 authorized reps daily.
- Maintained accurate records of all employee benefits transactions, ensuring compliance with federal regulations.
- Counseled employees experiencing life events, guiding them through the necessary steps to update their benefit elections accordingly.
Customer Service Representative
United Health Care
06.2016 - 06.2017
- Managed Inbound calls from policyholders with concerns regarding Benefits enrollment and denied claims
- Performed outbound calls to clients to verify changes and updates
- Recommended services to management by collecting customer information and analyzing customer needs
- Contributed to team effort by accomplishing related results as needed
- Managed heavy call volume.
- Identified and assess customers' needs to achieve satisfaction with about 70 members a day.
Medication Tech/Caregiver
Tesson Heights
05.2015 - 06.2016
- Administered medications throughout the day on a strict schedule for 50-70 residents daily
- Reported observations concerning patient condition, emergency situations or difficulties with medications to the supervising nurse;
- Documented administration of medications per Recover-Care policies
- Provided companionship and emotional support by engaging in meaningful conversations and activities.
- Coordinated transportation and errands to support client independence and mobility.
Certified Nursing Assistant
St. Andrew's (Senior Solutions)
02.2013 - 05.2015
- Monitored vital signs and reported significant changes to nursing staff.
- Supported mobility exercises to enhance patient physical well-being.
- Communicated effectively with healthcare team to coordinate patient care plans.
- Employed infection control protocols to maintain sterile environment.
- Promoted good oral and personal hygiene by aiding patients with shaving, bathing, and teeth brushing.
- Enhanced patient satisfaction by providing compassionate and attentive care in home on a case by case individual basis.
- Checked patient vitals such as temperature, blood pressure, and blood sugar levels.
- Cared for clients in home setting delivering high-quality support to meet needs.
Certified Nursing Assistant
Woodruff Convalescent Center
07.2012 - 01.2013
- Provided patients' personal hygiene by giving bedpans, urinals, baths, backrubs, shampoos, and shaves; assisting with travel to the bathroom; helping with showers and baths
- Assisted with serving meals, feeding patients as necessary; ambulating, turning, and positioning patients; providing fresh water and nourishment between meals
- Monitored vital signs and reported significant changes to nursing staff.
- Supported mobility exercises to enhance patient physical well-being.
- Operated electronic health records system to update patient information accurately on about 10-16 patients a day depending on staffing.
Care Manager
Nazareth Living Center
04.2011 - 01.2012
- Maintained patient stability by checking vital signs and weight; testing urine; recording intake and output information on approx 8-16 residents daily
- Provided patient comfort by utilizing resources and materials; transporting patients; answering patients' call lights and requests; reporting observations of the patient to nursing supervisor
- Documented actions by completing forms, reports, logs, and records
Shift Leader
Shur Sav Market
01.2008 - 01.2011
- Open and closed the store, stock, inventory for needed items, handle customer complaints,
- Operate cash register, bank deposits and safe drops,
- Work shifts when no one else was available
- Trained new employees on company policies and procedures to ensure a seamless onboarding experience.
- Motivated staff through recognition programs, fostering a positive workplace culture and increasing morale.
- Improved team performance with regular feedback sessions and targeted skill development initiatives.
- Led team of 5 through high-demand shifts by implementing streamlined processes and enhancing communication among staff.
Education
Certified Nurse Assistant -
Long Beach Adult School
Long Beach, CA06.2012
High School Diploma -
Normandy Tech
St. Louis, MO05-2004
Skills
- Customer service
- Active listening
- Critical thinking
- Data entry
- Customer relations
- Problem resolution
- Relationship building
- Call center experience
- Computer proficiency
Accomplishments
- Used Microsoft Excel to develop PCP tracking spreadsheets that resulted in faster assignments and removal of OON PCP's
- Created programs that suggested call backs for elderly and alone customers.
- Facilitated FWA meetings where my own successes were highlighted to motivate other teams.
Additional Information
I enjoy finding resolutions to problems. I want to make life easier for those looking for answers and processes to those answers more accessible. To live a life of service is my passion.
Awards
- Top Team Performer, United Healthcare, 03/01/17, Excelling in adherence, attendance, compliance, scheduling, survey scores, and kudos calls. Always willing to assist my co-workers and members with any issues they possess.
- Advocate 4 Me Champion, United Healthcare, 01/01/17, Saving lives by scheduling appointments for our retired members and ensuring they are getting the most out of their health insurance benefits.
Groups
Leet Team (local employee engagement team), United Healthcare, 01/01/16 to 01/01/17, Volunteer yearly projects making blankets and backpacks for the homeless, keeping the morale up for the site by having department meals and idea forums. Other misc engagement projects as we develop them.
Team Lead-Molina Healthcare
- Hard work and dedication to FCR allowed my promotion from CSR to Lead.
- Able to successfully coach and develop team members.
- Monitor workflow to ensure tasks are completed within timeliness standards which are driven by Medicaid and contractual agreements
- Monitors call traffic and works the call Que to assist with getting customers timely service.
- Perform special project assignments from time to time, such as research work and obtaining special authorizations
Timeline
Escalations Lead; Compliance
Molina Healthcare
10.2018 - 10.2023
Customer Care Professional
AllianceRX Walgreens Prime Specialty Pharmacy
05.2018 - 08.2018
Benefit Specialist
Benefit Harbor
03.2018 - 05.2018
Customer Service Representative
United Health Care
06.2016 - 06.2017
Medication Tech/Caregiver
Tesson Heights
05.2015 - 06.2016
Certified Nursing Assistant
St. Andrew's (Senior Solutions)
02.2013 - 05.2015
Certified Nursing Assistant
Woodruff Convalescent Center
07.2012 - 01.2013
Care Manager
Nazareth Living Center
04.2011 - 01.2012
Shift Leader
Shur Sav Market
01.2008 - 01.2011
Certified Nurse Assistant -
Long Beach Adult School
High School Diploma -
Normandy Tech
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