Christopher Lyles

Dynamic Technical Project Manager with established expertise at Zinnia, demonstrating excellence in project management and cross-functional leadership.. Adept in JIRA and performance management, focused on promoting team collaboration and driving process optimization to deliver remarkable results.

• Owned and Revamped the KPIs, metrics and reporting system to improve performance evaluation of over 50 members of the Case Management team at Policygenius.
• Improved the efficiency of claims audits, adjudication and disputes by partnering with Engineering and Product to automate processes.
• Successfully decreased turnaround times and SLAs of claims and provider disputes by 35% at Oscar Health Insurance by streamlining and automating the triage process for provider disputes and other medical documents.
• Successfully managed teams of Case Managers and Claims Processors in person and remotely. Providing coaching, leadership and a positive culture for the team and company.

Title: Technical Project Manager

• Zinnia, Remote, Technical Project Manager, 08/01/23, Present, Manage overall delivery of the digital projects to realize expected benefits and improvements of Business Operations for both Clients (Delaware Life, Resolution Life, Venerable) & Zinnia. Perform as Scrum Master to support Zinnia Agile project delivery framework and methodology using Jira, Open Air and Microsoft Office., Coordinate with project planning for the Central Intake, Product management, and System teams within Zinnia to ensure their collaboration is provided for completion of projects on time, within budget and with high quality., Collaborate with external client stakeholders and vendors to enhance functionality and capabilities of Digital applications. Leading to the improvement of Zinnia's business capabilities significantly., Ensure delivery processes are efficient and cost effective for Clients and Zinnia to function as a single point of contact for Client delivery and act as an advocate between the delivery teams and the Client.
• Policygenius, New York, NY, Operations Manager, Life Fulfillment Operations, 06/01/20, 08/01/23, Owned Performance Management on the Case Management team., Implemented new metrics including SLA Tracking, and % of work contribution to better track efficiency and speed., Created various benchmarking methods to ensure the measurement of conversion performance could withstand changes in carrier mix and team structure., Hosted monthly meetings reporting on performance of case management for leadership. Highlighting outliers (Both high and low performers)., Created stack rankings during performance review cycles to ensure equal measurements on performance based on our goals & guidelines metrics., Integral to innovating and improving metrics as the business changed., Supervised a team of 30 Case Managers, including two Team Leaders with their own direct reports., Hosted team meetings to provide updates of processes to the CM team., Conducted 1:1s with each direct report as well as skip levels with my Team leads reports monthly to stay updated and get pulse checks on all reports., Provided breaks from the day through trivia and other team building activities to build camaraderie within our remote environment., Instrumental member of the Affinity Group PgBlack leadership team and committee., Created and participated in programming for Black History Month and other celebrations of diversity in the company., Member of the Affinity Group Leadership committee.
• Oscar Health Insurance, New York, NY, Payment Integrity Analyst, Insurance Operations, 01/01/19, 03/01/20, Prevented overpayment on high-risk claims through accurate, compliant, and data analysis. Examined ancillary claims adjustments regarding appeals and facility claims utilizing JIRA and Big Query., Reduced the time to split claims by 30% to 40% through effective collaboration with Engineering and the Claims Product team to enhance tooling and workflows., Increased processes and workflows for communication with providers concerning clinically approved and denied claims., Streamlined communication between providers and Oscar Health Insurance to identify and institute changes using tools such as JIRA and Periscope.
• Oscar Health Insurance, New York, NY, Provider Disputes Team Lead, Insurance Operations, 04/01/17, 12/01/18, Oversaw a team of 10 to 12 claims processor across our New York City and Arizona offices., Owned the processing, communications and resolution of regulatory complaints and disputes from insurance policy owners as well as providers and hospitals., Established quality control measures to guarantee accuracy in workflows and the communication of provider information., Directed Root Cause Analysis for disputed issues and cooperated with teams across the company to resolve issues systematically., Improved triaging of Provider Disputes and Documents by matching disputes to Claims denials, decreasing TAT for disputes by 25%-30%., Oversaw document triaging for the company consisting of disputes, medical records, itemized bills and other documents that were integral for processing claims and providing rulings on disputes.
• Oscar Health Insurance, New York, NY, Claims & Grievances Liaison, 09/01/16, 04/01/17, Formulated workflows and processes to enhance dashboards in JIRA to respond to provider disputes in shorter periods., Utilized JIRA for adjustments and corrections by claims processors and benefits and eligibility teams. Expertly resolved claims adjustments involving dispute resolutions in the Claims Database., Established solutions for questions from members and providers regarding claims, authorizations, and member benefits by handling the most JIRA tickets in the company.
• Oscar Health Insurance, New York, NY, Claims & Benefits Associate, 11/01/14, 09/01/16, Presided as a Liaison between Insurance Operations and Member Services Teams., Escalated problems concerning claims adjudication to the relevant insurance operations team in Oscar's JIRA platform., Collaborated with Insurance Operations to identify and resolve systemic claims issues., Delivered solutions to the Member and Provider services teams regarding claim adjudication., Achieved a leadership role by serving as the Team leader during weekend shifts and supervising 10 to 12 employees during the duration of shifts.