Gina Bonsemeyer

• Enhanced team productivity by 9% through the implementation of streamlined processes and effective communication strategies, while reducing staffing requirements.
• Successfully achieved New Mexico Medicaid departmental goals by developing and executing strategic plans and performance metrics; implemented Enlighten automation, resulting in annualized savings of $232K.
• Reduced operational costs via comprehensive process improvement initiatives and effective resource management; consistently exceeded Prompt Pay interest goals, finishing 2023 and 2024 with a five-star rating.
• Improved operational efficiency through data-driven decision-making, leveraging analytics tools to inform strategic development, and established a robust internal quality program and career pathing opportunities for staff.
• Streamlined workflows by identifying and addressing bottlenecks with existing systems, and proactively implementing effective solutions.
• Fostered a strong company culture focused on employee engagement, collaboration, and opportunities for continuous learning.
• Utilized performance data to evaluate operations, target current business conditions, and forecast needs; exceeded unit performance in 2023, achieving a 14% reduction in inventory over 30 days.
• Career Development Leader for New Mexico Women Improving the Strength of the Enterprise (WISE) business resource group.

• Identified underperforming areas and implemented effective process improvements.
• Coordinated, supervised and evaluated work of subordinates and reallocated staff and resources to meet performance requirements.
• Applied strong leadership talents and problem-solving skills to maintain team efficiency and organize workflows to meet any daily demand.
• Analyzed metrics to identify areas of opportunity, drive performance improvements and consistently exceed operational goals.
• Fostered effective communication by providing constructive feedback and sharing knowledge across business lines.
• Mandated policy, procedure and performance adherence for continued and increased operational efficiency and profitability.
• Assessed problems and conflicts and resolved independently.
• Positioned as primary liaison to streamline operations of multiple lines of business within organization.
• Measured effectiveness of customer success by defining operational metrics, tracking systems and reporting to executive team.
• Developed training, task and process guidelines and communicated clear and concise directions to employees.
• Expanded cross-functional organizational capacity by collaborating across departments on priorities, functions and common goals.
• Adjusted job assignments and schedules to keep pace with dynamic business needs, factoring in processes, employee knowledge and customer demands.
• Applied performance data to evaluate and improve operations, target current business conditions and forecast needs.
• Adjusted project plans to account for dynamic targets, staffing changes and operational specifications.
• Maintained tactical control of project budgets and timelines to keep teams on task and achieve schedule targets.
• Planned, executed and controlled assigned projects, ensuring work performed complied with contractual requirements.
• ERT Captain for Albuquerque Service Center.
• Management representative for Service Center Health Champions (Wellness Program).

• Supervise day to day activities; team of 26 direct reports/SR Technicians (on shore) and 134+ Claims Examiners (off shore).
• Line of businesses: NM Business, O65, Centennial Care, Tri-State
• Maintain adequate staffing levels; budget appropriate.
• Organize work load, allocate tasks and daily team work flow for on shore and off shore operators.
• Manage team, individual performance; monthly performance reviews.
• Ensure professionalism and high quality customer service is maintained; Diversity and Inclusion.
• Reports and documents for Senior Managers; team performance.
• Resolution of provider and member inquiries (written and phone inquiries).
• Ensuring DOI inquiries are resolved timely.
• Open and close duties for FSU.
• Recruitment and interview process of new staff.
• Train new staff; identify training requirements of existing staff (on shore and off shore).
• Project management.
• Created efficient work schedules for each team member to maintain deadlines and keep shifts properly staffed.
• Management representative for FSU Health Champions (Wellness Program).
• ERT Captain for FSU.

• Proficient in multiple lines of business and processing situations (examples: BlueCard Host, NM Business, O65, COB, medical necessity review, provider and member inquiries, Medicare, Medicaid, DME, pre-authorizations, Prompt Pay and Medicare Exhaust).
• All manual calculations to apply correct benefits.
• Front end and back end claims adjudication resolution (reports team). BlueCard Host Report Team.
• Maintained inventory to meet cycle time guidelines.
• Blue Chip, Blue Star, Word, Excel, PowerPoint.
• New hire mentor.