Summary
Overview
Work History
Education
Skills
Affiliations
Websites
Work Preference
21
Jessica Lowery

Jessica Lowery

Operations Consultant
8862 Cloister Dr Unit E,SC

Summary

Dynamic Senior Operations Consultant with a proven track record at Allstate Health Solutions, excelling in project management and operational efficiency. Expert in cross-functional team leadership and problem-solving, successfully streamlined processes, enhancing service delivery. Adept at SOP development and fostering collaboration, driving impactful results in Medicare operations.

Overview

16
16
years of professional experience

Work History

Senior Operations Consultant

Allstate Health Solutions
02.2022 - 08.2025
  • Managed Operations for the Medicare Supplement product, focusing on the relationships between customer service, underwriting, sales, claims and the Third-Party Administrator.
  • Escalation management and coordination for resolutions. This includes escalations of issues with our sales team/process, underwriting issues, customer service/billing solutions, and claim issue resolution.
  • Oversaw Third Party Administrator (TPA) relationships, ensuring seamless service delivery and issue resolution for both customer service and claims. Including creation and approval of SOWs for all projects.
  • Verification and approval of TPA invoices.
  • Moderator of multiple interdepartmental meetings including a monthly collaboration meeting including all stakeholders with the Medicare Supp/Over 65 lines of business.
  • Led project management initiatives to streamline processes, resulting in improved operational efficiency, both internally and with the TPA.
  • Participated in projects led by AHS project teams, including use of Asana boards and other project management software.
  • Assisted with responding to all types of Department of Insurance (DOI) Inquiries.
  • SOP management for all Operating Procedures for the Operations team.

Senior Operations Analyst

Palmetto GBA
03.2012 - 02.2022
  • Project management for the PMO office (AVP, VP) for various Medicare contracts. Project management of contract deliverables including the use of Microsoft Project.
  • Acted as a liaison with CMS and Palmetto GBA PMO office for multiple CMS contracts. Acknowledge, track, and respond to inquiries sent from CMS to Palmetto GBA upper management and PMO mailbox.
  • Facilitation/coordination of the System Design Meetings for creation and updates to technical (IT), systems (IS), and other workflow items as required by CMS. Plan meetings and currently working towards the project plans for future contract deployments. This work involves multiple departments within Palmetto GBA using Sprint run deployments. Tracking of all RFC number for work requested.
  • Executive level reporting and strategy writing (technical writing) for multiple Medicare contracts. Creation, collaboration, and editing of reports totaling more than 100 pages.
  • Data analysis of various Medical Review data including but not limited to provider billing patterns, utilization of billing codes and procedures, etc. Advanced data analysis, collection, and presentation for ad hoc reports.
  • Reporting to include annually, monthly, weekly, and daily for internal and external recipients.
  • Coordinate sample selection and provide documentation with the Medical Review Accuracy Contractor (MRAC) regarding Accuracy Review documentation/results for multiple CMS contracts
  • Assistance with data/graphics for proposals, presentations, etc.
  • Manage the QMS 360 (DI) policies and procedures for multiple contracts.
  • Work in FISS for claim record creation for prior authorization contracts.

Customer Service Supervisor\Coordinator

Palmetto GBA
04.2009 - 03.2012
  • Daily, Weekly, Monthly and Annual reporting of data and statistics in a customer service call center
  • Customer Service Operations/Support
  • Data analysis and reporting/monitoring of QC scores.
  • Planning of bi-monthly training sessions to include content creation, verification of attendance and testing, logistics such as dates, times, rooms, attendance schedules for over 150 call center associates
  • Ordering/Procurement and Tracking of Assets.
  • Maintenance of the phone recordings for the IVR line.
  • Creation of presentations for meetings both internally and with customers.
  • Special event planning, travel arrangements and other duties as assigned

Education

High School Diploma -

Lexington High School
Lexington SC
05-1999

Skills

  • Business analysis
  • Program management
  • SOP development
  • Operational efficiency
  • Operations management
  • Project management
  • Cross-functional team leadership
  • Teamwork and collaboration
  • Problem-solving
  • Multitasking
  • Organizational skills
  • Team collaboration

Affiliations

  • Toastmasters

Work Preference

Work Type

Full Time

Work Location

Remote

Important To Me

Work from home optionCompany CultureCareer advancement

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