Candice McGee
Operations Executive
Lees Summit,MO
Summary
Performance-driven Vice President with 23 years of experience aligning systems with business requirements, policies and regulatory requirements. Passionate about applying excellent organization and communication skills to manage and lead teams. Results-oriented individual well-versed in interfacing and consulting on business processes to drive results based on sound overall business judgment.
Overview
23
23
years of professional experience
Work History
VP, Operations
Government Employees Health Association (GEHA)
LEES SUMMIT, United States
11.2019 - Current
- Implemented a new structure within Operations to align and create a diverse leadership team and support employee/leader ratios
- Negotiated contracts and led implementation for various Operations strategic partnerships including a new Clearinghouse vendor, workflow tool, ID Card vendor and document storage
- Implemented new enterprise-wide Workflow and Document Storage applications resulting in greater efficiencies across the organization and streamlined processes
- Established and administered annual budget with controls to prevent overages, minimize burn rate and support sustainability objectives.
- Devised processes to boost long-term business success and increase savings levels.
- Worked in matrix management environment with oversight of division level operations directors and managers.
Director, Business Operations
Government Employees Health Association (GEHA)
LEES SUMMIT, United States
04.2016 - 10.2019
- Focused teams on developing innovative and cutting-edge approaches with effective resource allocation and strategic planning.
- Reviewed company's strategic plans and developed departmental goals and standards to support vision.
- Created annual budget and developed comprehensive plan to accomplish company objectives while staying within budget.
- Delegated assignments based on plans, project needs and knowledge of individual team members.
- Promoted energetic atmosphere with purpose to drive improvements in operations for positive member experiences.
Director of Claims & Benefits
Physicians Plus Insurance
Madison, WI
10.2014 - 03.2016
- Manage multiple vendor relationships to retain high effectiveness and efficiency in code editing, subrogation, COB, repricing, and EDI functions
- Monitored team performance, enforcing compliance with corporate claims processes and procedures.
- Investigated, evaluated and adjusted multi-line claims in accordance with standards and laws.
- Determined proper course of action for claims processing.
- Championed insurance claims process by providing expert knowledge and building positive, trusting relationship to support clients during challenging times.
- Established and checked coding procedures, monitored reports and updated internal files.
Application Support & Training Director
Physicians Plus Insurance
Madison, WI
12.2012 - 10.2014
- Supports all functional areas within health plan and serves as a liaison role between systems, end users, IT technical support staff and leadership
- Collaborate with business operations staff to provide timely and accurate system configuration, plan builds, and prioritization of projects
- Collaborated with developers, analysts and project managers to expedite incident resolutions.
- Demonstrated advanced knowledge of software delivery lifecycle and varied delivery methodology.
- Analyzed and troubleshot integration issues related to system configuration, data, maps and workflows.
- Conducted and supported implementation delivery with internal departments.
- Performed quality assurance testing on new software releases for alignment with goals for efficiency and performance.
Education
Bachelor of Science - Business Administration
Warren National University
Skills
Budgeting and forecasting
Risk analysis and management
Project development and life cycle
Contract Management
Employee relations and conflict resolution
Operations management
Business planning
Strategic planning
Cost reduction and containment
Negotiation
Unsurpassed work ethic
Cross-functional communications
Change Management
Accomplishments
- Collaborated with team of 50 in the development of replacing depleting technology with new technology to streamline efforts.
- Reduced operational expenses by [Number]% by streamlining branch operations.
- Promoted to VP, Operations after 3 years with the company.
- Supervised team of 300+ staff members.
- Achieved millions in ROI by introducing RPA and automation technology for claims and operational tasks.
- Implemented $6M project of replacing claims system and insourced 4 departments within a 9 month timeframe.
Affiliations
Trizetto Customer Group (TCG)
Lee's Summit Girls Softball Association (LSGSA)
Lee's Summit CARES - Character Council
Timeline
VP, Operations
Government Employees Health Association (GEHA)
11.2019 - Current
Director, Business Operations
Government Employees Health Association (GEHA)
04.2016 - 10.2019
Director of Claims & Benefits
Physicians Plus Insurance
10.2014 - 03.2016
Application Support & Training Director
Physicians Plus Insurance
12.2012 - 10.2014
Bachelor of Science - Business Administration
Warren National University