Summary
Overview
Work History
Education
Skills
Timeline
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Denita Baker

Concord,NC

Summary

Results-driven implementation manager with extensive experience in leading and managing multiple implementations simultaneously. Skilled in developing and maintaining project timelines using various databases, consistently achieving high-performance completion rates while closely working with business partners to ensure timely and accurate execution. Expertise includes providing extensive oversight for documentation to streamline setup and preservation processes. Collaborative leader actively partnering with coworkers to promote an engaged and empowering work culture. Documented strength in building and maintaining relationships with diverse stakeholders in dynamic, fast-paced settings.

Overview

27
27
years of professional experience

Work History

Implementation Manager

UnitedHealthcare
01.2022 - Current
  • Audit Sales documents for adherence to quality measures and reporting standards
  • Build and maintain internal and external relationships
  • Facilitate and document implementation meetings and communicate next steps in the implementation process
  • Manage the installation and maintenance of approx. 120 books of business for Medical, Pharmacy, Dental Vision, CDH and Financial Products that includes ASO and fully insured customers
  • Actively participate in cross-functional team projects
  • Research installation issues and develop customer specific resolutions
  • Attend and participate in face out customer meetings and finalist presentations, as required/necessary
  • Facilitate completion of internal and external audits through timeline and plan change submission
  • Mentor new and existing Implementation Managers as required
  • Other duties as required to support the customer implementation process.
  • Managed multiple simultaneous implementations with minimal supervision, demonstrating strong organizational skills and adaptability.
  • Presented project updates to senior leadership, highlighting successes and addressing challenges with proposed solutions, ensuring ongoing support for the implementation team''s efforts.
  • Led a diverse team of professionals in successfully completing complex implementations on time and within budget constraints.
  • Oversaw implementation lifecycle processes based on organizational needs, regulatory requirements, and customer demand.
  • Established effective communication channels between internal teams and external clients to facilitate smooth project execution.

Service Account Manager

UnitedHealthcare
01.2006 - 01.2022
  • Investigate review and resolve claim/benefit issues, for Medical, Pharmacy, Dental Vision and CDH products
  • Ability to understand multiple products and multiple levels of benefits within each product
  • Liaison for high touch customer base to manage first level response and resolution of escalated issues reported by external client (also known as human resources or customer) and internal partners; managing up to 7 clients at once
  • Travel when needed for client support such as; open enrollment, data presentation and cultural training for Medical and pharmacy products
  • Works closely with various internal partners to identify root cause and develop action plans as needed for process improvement
  • Responsible for overall delivery of benefits and services by providing support and guidance to existing and potential customers to ensure continued membership.
  • Increased client satisfaction by building strong relationships and addressing their needs promptly.
  • Conducted regular account reviews to identify areas for improvement and ensure continued success.
  • Established clear communication channels between clients and internal teams, ensuring seamless project execution.
  • Developed customized account plans for clients to help them achieve their business goals.

Customer Service/Claims Specialist (Subject Matter Expert)

UnitedHealthcare
01.1998 - 01.2006
  • Identifies and resolves operational problems using defined processes, expertise and judgment
  • Provides expertise and customer service support to members, customers and/or providers regarding Medical, Pharmacy, Dental, Vision and CDH products
  • Utilize multiple mainframe and software applications to report issues/gaps found while researching payment discrepancies
  • Apply technical skills and analytical skills to identify and address medical facility and client concerns
  • Emphasis is placed on resolving inquiries with benefits, eligibility, customer material requests, physician look-up, authorization, and explanation of benefit statements
  • Provides claim status and explanations effectively and efficiently to agents who reach out for assistance while member or provider is on their other line.

Education

Some College (No Degree) - Health Administration

Southern New Hampshire University
Manchester, NH

Some College (No Degree) - Liberal Arts

Chowan College
Murfreesboro, NC

Skills

  • ISET
  • UNET
  • Microsoft Word
  • Microsoft Excel
  • Qfinity
  • CAMS
  • VCC Desktop
  • Knowledge Central
  • Escalated Tracking System
  • OptumRx
  • Microsoft PowerPoint
  • ACET
  • AXIS
  • Salesforce
  • Variant
  • ICUE
  • OBM
  • Benefit Template Builder
  • CDX IBAAG
  • E-services
  • Requirements Gathering
  • Data Migration

Timeline

Implementation Manager

UnitedHealthcare
01.2022 - Current

Service Account Manager

UnitedHealthcare
01.2006 - 01.2022

Customer Service/Claims Specialist (Subject Matter Expert)

UnitedHealthcare
01.1998 - 01.2006

Some College (No Degree) - Health Administration

Southern New Hampshire University

Some College (No Degree) - Liberal Arts

Chowan College

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Denita Baker