Summary
Overview
Work History
Education
Skills
Certification
Timeline
Generic

Charelle Releford

Rockwall,Texas

Summary

Experienced absence management subject matter expert who understands complex business demands and the importance of providing business solutions that exhibit compassion and understanding to reflect a company's culture and objectives. Highly organized and self-motivated professional experienced in project management, absence program development, and process improvement. Skilled in developing and implementing strategies to increase efficiency and performance. Passionate about driving business growth and creating positive work environment.

Overview

18
18
years of professional experience
1
1
Certification

Work History

Associate Director

WTW
12.2020 - Current
  • Create SOWs and Proposals for a variety of projects
  • Lead project management role for designated clients/projects serving as subject matter expert for Absence, Disability Management and Life matters
  • Develop relationships with key service buyers
  • Own and take a lead role in client relationships
  • Conduct operational assessments to efficiently streamline and improve complex program management with considerations for the client's culture, vision, and program objective
  • Conduct policy benchmarking and plan design analysis for plan enhancements and cost-saving measures
  • Lead Contract and Performance Agreement negotiations
  • Collaborate with clients to develop or enhance their time off and return to work strategies
  • Lead and conduct plan marketing, new vendor procurement, and plan implementation
  • Onboard and Mentor newly hired and existing junior colleagues
  • Lead the junior analysts by assigning project roles/responsibilities, and ensuring accountability
  • Conduct review of client deliverable to ensure alignment to client objectives, leverage of optimal services and solutions, and adherence to professional excellence standards
  • Act as a local champion for colleague resourcing and workflow and share best practices across client teams
  • Participate in sales pursuits with a combined H&B team to create cross-LOB sales opportunities.

Life, Absence, and Disability Senior Associate

Mercer
10.2018 - 12.2020
  • Developed intricate benefit plan design and renewal strategies using the most up to date benchmarking data and tools
  • Developed sophisticated absence strategies including PTO and vacation policies to address productivity and overall business performance
  • Drove the development of tools and solutions to address complex client issues managing their absentee workforce
  • Lead successful regional and national marketing initiatives involving renewal and RFP negotiations on behalf of clients for life, accident and disability coverages, including strategies, RFP development, financial analysis, benchmarking, negotiations, and business placement
  • Developed client RFP and renewal reports and presentations, and presentation to client
  • Lead implementation projects for carrier changes or complex design changes
  • Recommended, developed and maintained standard and custom life, absence, and disability reporting/monitoring as needed for clients
  • Assisted with the preparation, completion of peer review process and delivery of clear and concise client-friendly projects
  • Provided financial, contract and/or administrative analysis, and manages portions of projects, including ad-hoc client requests of problemsolving on administrative and operations issues
  • Contributed as a member of the consulting team in developing overall client strategy, interprets and presents benchmark data to client and ensures plan and program changes are properly implemented and embody the client's strategy
  • Effectively communicated latest industry trends to clients based on established benchmarking and survey data
  • Demonstrated project management skills and managed the quality and timeliness of deliverables and delegates to and reviews project work of more junior colleagues
  • Managed internal specialty resources ensuring client deliverables met goals and deadlines D
  • Delegated and reviewed project work of more junior colleagues
  • Maintained accountability for client Life, Absence and Disability accounts and projects
  • Incorporated compliance and professional standards into all work processes including use of templates, client calendar, peer review, and transparency
  • Established effective carrier/vendor relationships to serve clients in benefits procurement and administration
  • Supported financial analysis and review: including data analytics and partnership with actuaries to support funding analysis.

Life, Absence, and Disability Associate

Mercer
06.2015 - 10.2018
  • Supported the life, accident and disability (LAD) benefit product development in terms of designing and evolving the life, accident and disability product offerings, as well as coordinating and managing carrier relationships, managing product-related work streams, and supporting colleagues and employers with implementation
  • Supported development and ongoing refinement of activities related to the scope, marketing materials, sales processes and approach, carrier and employer contracting, compliance activities, and employer decision and implementation guides
  • Supported development and refinement of LAD product offerings and designs, both self-funded and fully-insured
  • Supported clients through marketing, bidding, and implementation activities, as well as ongoing support of LAD program management
  • Supported and lead product implementations with carrier partners, including support of the contracting process and provide ongoing vendor management of the carrier partners, including serving as an intermediary with the carrier relations team and identifying and addressing questions with the carriers, as needed
  • Played a key role in the employer implementations and serve as a resource for client teams supporting employer implementations, including performing user acceptance testing of the website to ensure accuracy in offerings, pricing, and other user experience elements
  • Supported data analysis and analytics (example includes stewardship reporting, claims projections, contribution setting)
  • Utilized internal financial tools to develop self-funded claims projections, set rates and model employee cost-sharing scenarios.

Appeals Specialist

CIGNA Group Insurance
03.2009 - 03.2015
  • Conduct compliance and/or quality reviews and evaluations of adverse claim decisions and provided a summary of review findings, violations, and/or instances of noncompliance with established policies and procedures
  • Analyze and evaluate complex evidence in an impartial manner to ensure the appropriate determination is made in the adjudication of disability and life claim
  • Address problems, controversies, or alleged irregularities in claim processes or benefit payments
  • Work with expert resources (i.e
  • Nurses, Physicians, Vocational Counselors, Vendors, etc.) at each juncture of review
  • Provide interpretation of claims and claim decisions based on contracts and/or policies, benefit payment agreements, and medical circumstances
  • Provide summary report which includes review findings, violations, and/or instances of noncompliance with established policies and procedures
  • Apply appropriate rules based on ERISA standards, contractual guidelines and policy requirements
  • Prepare clear and concise written determinations
  • Proactively communicate with claimants, employers, attorneys, providers and case management team to resolve conflicts involving investigation issues and communicate decisions/rationale for denial/approval
  • Serve as a subject matter expert for conflict resolution of claims, appeals and claims management processes
  • Managed business operation projects and served as primary liaison between client and multiple internal groups to ensure clarity of goals and quality and adherence to deadlines
  • Analyze claims, identify trends, and implement processes to enhance client satisfaction and improve claim management.

Disability Claims Manager III

Long Term Disability
01.2006 - 03.2009
  • Network with claimants and physicians in the management of long-term disability claims
  • Interpreted contractual language and responsibilities as well as managed all claims according to published Quality and Compliance standards
  • Increased productivity by constantly demonstrating management of claim performance to include 95% accuracy on quality reviews
  • Managed business operation projects and served as primary liaison between client and multiple internal groups to ensure clarity of goals and quality and adherence to deadlines.

Education

MBA - Health Systems Management

Texas Woman's University
Denton, Texas
01.2012

Bachelor of Arts - Minor in Health Studies

Texas Woman's University
Denton, Texas
01.2010

Skills

  • Knowledge of Life/AD&D/STD/LTD/LOA plan provisions, contracts, and risk management
  • Analytical Thinking
  • Team Collaboration and Leadership
  • Coaching and Mentoring
  • Advanced Microsoft Office skills - ability to manipulate large volumes of data and macro enabled workbooks in Excel, and PowerPoint
  • Work Planning and Prioritization
  • Detail-oriented with excellent organizational and time management skills with ability to manage changing priorities as needed
  • Key Relationship Development and Management
  • Demonstrating flexibility in prioritizing and completing tasks
  • Critical Thinking
  • Playing a key role in vendor procurement, negotiation, implementation, and optimization activities
  • Superior ability to influence and collaborate with senior management and work across all levels of an organization
  • Decision-Making
  • Project Management and Process Improvement
  • Data Collection
  • Resources Allocation

Certification

  • General Lines Agent, Texas, 2015
  • Life and Health Insurance Counselor, Texas, 2015

Timeline

Associate Director

WTW
12.2020 - Current

Life, Absence, and Disability Senior Associate

Mercer
10.2018 - 12.2020

Life, Absence, and Disability Associate

Mercer
06.2015 - 10.2018

Appeals Specialist

CIGNA Group Insurance
03.2009 - 03.2015

Disability Claims Manager III

Long Term Disability
01.2006 - 03.2009

MBA - Health Systems Management

Texas Woman's University

Bachelor of Arts - Minor in Health Studies

Texas Woman's University

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Charelle Releford