Elsie Peterson

• Analyze complex escalated cases to identify root causes, systemic issues, and trends impacting member experience and operational performance
• Conduct case and call reviews to identify performance trends and coaching opportunities, supporting quality improvement and consistency across teams
• Collaborate cross-functionally across multiple departments and leadership teams to resolve complex escalations, streamline workflows, and improve end-to-end operational efficiency
• Serve as a key point of coordination across departments, ensuring alignment, clear communication, and timely resolution of escalated issues impacting members and operational performance
• Develop and communicate insights to leadership through reporting and analysis, supporting data-driven decision-making and process improvements
• Identify process gaps and recommend corrective actions that improve accuracy, turnaround times, and service quality
• Support departmental training by documenting workflows, reinforcing best practices, and mentoring peers in escalation handling and resolution strategies
• Ensure compliance with CMS, HIPAA, and internal policies while managing high-priority and sensitive escalations

• Managed high-volume, complex escalations, performing in-depth investigations and identifying opportunities for process improvement
• Utilized Power BI and Excel to analyze member trends, generate actionable insights, and support reporting initiatives that improved operational performance
• Selected for the Service Intervention Team (SIT) to reduce repeat callers through data-driven analysis, case reviews, and targeted outreach strategies
• Conducted User Acceptance Testing (UAT) to validate system enhancements, track defects, and ensure operational accuracy and compliance
• Delivered trend reports and process insights to leadership that influenced operational decisions and improved workflow efficiency
• Collaborated cross-functionally across multiple departments to resolve complex issues, reduce repeat escalations, and improve overall process accuracy
• Conducted needs assessments by gathering feedback from members and internal teams to support service improvement strategies

Key Achievements:

• Collaborated with leadership to analyze data trends using Excel and Power BI, identifying performance gaps and generating reports that drove a 15% increase in team efficiency, a 10% reduction in repeat customer inquiries, and a 20% improvement in overall productivity
• Selected for the Service Intervention Team (SIT) based on strong analytical performance; leveraged root cause analysis and data insights to improve processes and enhance member experience outcomes
• Maintained a 96% Net Promoter Score (NPS) by consistently delivering high-quality resolutions and improving service accuracy across complex cases
• Optimized issue resolution workflows by achieving 36-hour turnaround targets on complex case analyses and identifying system and process gaps that led to measurable operational improvements

• Managed high-volume operations and escalations in a fast-paced logistics environment, ensuring accuracy and efficiency
• Analyzed workflows and operational data to identify inefficiencies and implement process improvements
• Audited and verified shipment and inventory data to maintain accuracy and compliance with performance standards
• Generated performance reports and collaborated with cross-functional teams to improve delivery timelines and operational outcomes