Christopher Cresswell
Jacksonville,FL
Summary
Dynamic leader with extensive experience at Humana, specializing in risk management and process improvement. Achieved substantial cost savings through strategic initiatives while enhancing customer experience. Demonstrated expertise in leading cross-functional teams to ensure regulatory compliance and drive operational excellence. Committed to delivering impactful results that align with organizational goals.
Overview
19
19
years of professional experience
Work History
Associate Director – Consumer Experience
Humana
01.2022 - Current
- Developed proactive risk management programs for Call Center Operations, improving real-time reporting, focusing on value-added outputs, and achieving annual savings while ensuring CMS compliance.
- Managed risk and remediation for Humana’s 4,000+ call center associates.
- Oversaw vendor expansion into three global locations, ensuring compliance with state and CMS regulations.
- Worked closely with cross functional partners including Grievance and Appeals to identify opportunities and drive improvements through strategical mitigation.
- Led a team of up to seven direct reports, including Managers and Senior Professionals.
Associate Director – Business Intelligence
Humana
01.2022 - Current
- Developed a reporting platform for call center metrics (AHT, NPS, Cost Per Call, compliance), increasing NPS by 5 points and reducing AHT by 30 seconds.
- Led a team of analysts, visualizers, scientists, and managers to deliver data-driven operational insights.
- Directed cross-functional teams, strengthening stakeholder relationships and driving solutions for complex issues.
- Provided regular updates to leadership, aligning project timelines and managing risks.
- Led cost-saving initiatives, including first call resolution, member segmentation, and NPS strategy.
Associate Director – Business Process Improvement
UnitedHealthcare
01.2017 - 12.2021
- Developed a compliance platform for tracking member notification misses on provider terms, enabling potential regulatory savings of over $1 million annually.
- Led large-scale, complex initiatives across multiple business lines to enhance processes based on customer feedback.
- Directed cross-functional teams, strengthening stakeholder relationships and driving solutions for complex issues.
- Provided regular executive updates on project progress, alignment, timelines, and risk management.
- Oversaw operational readiness to ensure smooth transitions and effective long-term controls.
Sr. Operations Manager – Provider Data Operations
UnitedHealthcare
01.2017 - 12.2021
- Managed teams executing and updating provider data in the National Database.
- Led quality improvement initiatives, developing audit reporting tools and achieving over $700,000 in national cost savings in 2017.
- Produced executive-level reports on quality performance, project pipeline, planning, and financial impact.
Associate Director – Payment Integrity Training and Development
HMS
01.2016 - 12.2017
- Developed and implemented enterprise-wide training programs, materials, and SOPs.
- Applied CMS and ICD 9/10 Coding Guidelines to create training for nurse and coding reviewers.
- Developed and launched key enterprise policies, including attendance, performance, and remote work.
- Led a project to improve Clinical Review Quality and Appeals, achieving a 7% increase in 12-month rolling metrics and $2.3M annual cost savings.
- Redesigned nursing and coding new hire programs, cutting time to proficiency from 16 to 8 weeks and reducing attrition by 6.2%.
- Led a team of 2 Training Managers, 2 project leads, 3 trainers, and provided dotted-line leadership to 12 additional trainers supporting 600 employees.
Associate Director – Provider Service Rework Reduction
UnitedHealthcare
01.2007 - 12.2016
- Led Six Sigma Black Belts and Analysts to identify and reduce rework drivers across all lines of business.
- Collaborated with internal and external partners on rework initiatives, achieving a 35% reduction in 2016.
- Drove multi-year staff reduction and cost savings programs based on rework and cost analyses.
- Implemented process, tool, and capability changes to increase operational efficiency and effectiveness.
Associate Director - Community and State Provider Call Services
UnitedHealthcare
01.2007 - 12.2016
- Oversaw Operations Managers to drive site-level execution and improve performance of 500+ agents across 8 service centers, supporting 5 million Medicaid members in 23 state plans.
- Managed 4 Project Leads responsible for migration, implementation, and process design for new Community and State contracts in Provider Call operations.
- Served as liaison between Community/State Health plans and the Provider call center, facilitating monthly meetings on metrics, performance, provider complaints, and contract updates.
- Led the offshoring initiative for Provider call operations, overseeing funding, vendor management, and strategic planning.
- Established and managed an Early Warning System to proactively resolve systemic issues, resulting in $2M in savings in 2015.
Education
Master of Business Administration -
Shepherd University
01.2022
Bachelor of Science - Project Management Certification
University of Phoenix
01.2021
Skills
- Risk management
- Process improvement
- Project management
- Regulatory compliance
- Team leadership
- Customer experience
Office Phone
681.252.4159
Degree
MBA
Timeline
Associate Director – Consumer Experience
Humana
01.2022 - Current
Associate Director – Business Intelligence
Humana
01.2022 - Current
Associate Director – Business Process Improvement
UnitedHealthcare
01.2017 - 12.2021
Sr. Operations Manager – Provider Data Operations
UnitedHealthcare
01.2017 - 12.2021
Associate Director – Payment Integrity Training and Development
HMS
01.2016 - 12.2017
Associate Director – Provider Service Rework Reduction
UnitedHealthcare
01.2007 - 12.2016
Associate Director - Community and State Provider Call Services
UnitedHealthcare
01.2007 - 12.2016
Master of Business Administration -
Shepherd University
Bachelor of Science - Project Management Certification
University of Phoenix
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