Dynamic Account Sales Executive with over 20 years at Health Alliance Medical Plans, driving membership growth and enhancing client relationships. Proven expertise in sales strategy and data analysis, successfully managing large accounts and implementing tailored solutions. Recognized for delivering impactful presentations and fostering strong partnerships, ensuring client satisfaction and retention.
Responsible for generating new membership growth and creating product awareness across the Health Alliance Network, centrally based in Illinois. - Territory responsibility: McLean Co. & Southern Illinois.
Maintain and create broker/consultant relationships.
Presenting to prospective employer groups
Overseeing new business implementation
Leading employee meetings and education on all value-added member services.
Client Consultant
Manage/Service 1 large self-funded account, with 10,000 members.
Collaborate with internal teams to manage groups' unique benefit plans and custom claims programs.
Work with the Human Resources team on a daily basis to be a key point of resource for all escalated claims, prior authorization, billing, provider, network, and all other miscellaneous issues.
Lead bi-monthly meetings with consultants, human resources, and key managers of Health Alliance internal teams.
Liaison between the customer, consultants, outside vendors, and all internal departments.
Manage all unique reporting requests from client and work with internal teams to design custom reports to achieve the needed output for clients.
Provide analytics of customer reporting and plan performance.
Facilitate communication and correspondence between employer groups, consultants, and Health Alliance.
Client Consultant
Health Alliance Medical Plans, Inc
Champaign, IL
01.2005 - 01.2021
20+ years of experience in servicing large, fully insured, self-funded, and level-funded clients.
Monitors, analyzes, and reports the activities of competitors.
Works with Communications to create necessary group and member materials.
Manages the daily activities of assigned employer groups.
Responsible for developing a renewal/re-sale strategy and implementing an account service plan for the assigned book of business.
Manages the external aspects of the group renewal process, including handling requests for renewal rates and obtaining product-positioning data; working with the Rating & Underwriting and Retention Managers to determine renewal rates; and delivering and securing renewal rate agreements.
Provides a consultative review of applicable financial, claims, pharmacy, and predictive modeling reports.
Arrange a presentation with the employer group, broker, or consultant to explain the renewal, and with employees to explain the benefits, eligibility, network, and value-added programs.
Works closely with and develops strong relationships with department sales executives to ensure a smooth transition from the sales process of a new account to the service representative and facilitation of the new group implementation process.
Develops strategies with Finance, Utilization Management, and Underwriting to improve cost containment for each group.
Presents reports to appropriate clients, with evaluation, analysis, and trend reporting.
Participates in the development of new products and strategies consistently evaluating market conditions.
Assesses product needs for employers as the economy and market conditions change and works with the Director to develop new products and services.
Serves as the primary interface with consultants hired by the employer.
Assists with the processing of RFPs (Requests for Proposals), making assessments, and advising the RFP coordinator on strategies.
Becomes actively involved in community activities, including health fairs, related to a specific assigned territory by participating in one or more civic organizations.
Participates in State of Illinois meetings, including giving presentations, Q & A sessions.
Establishes and manages relationships with Health Alliance brokers to maintain the flow of large group resale activity.
Client Support Specialist- Self Funded
Health Alliance Medical Plans, Inc
Champaign , IL
01.2004 - 12.2004
Collaborated with other teams within the organization to provide comprehensive solutions for clients.
Performed data entry tasks for client records management.
Investigated unusual or complex customer requests and escalated them as necessary to higher levels of expertise within the organization.
Resolved customer inquiries in a timely manner, exceeding service-level agreements.
Analyzed customer issues to identify root cause and provided appropriate solutions.
Delivered high level of service to clients in effort to build upon relationships for future.
Provided support to the account management and sales team.
Membership Specialist - Lead
Health Alliance Medical Plans, Inc
Champaign, IL
01.2003 - 12.2003
Served as a leader and mentor to six membership coordinators.
Reviewed and updated all process documents related to the daily job functions of the team.
Established training manual for the team.
Provided oversight of daily output and team performance.
Assisted with the individual audit of the team member performance matrix.
Collaborated with the Sales and Account Management team to meet Client deadlines and expectations for enrollment
TPL Coordinator
Health Alliance Medial Plans, Inc
Champaign, IL
01.2002 - 12.2002
Worked with the attorney on negotiated settlement agreements between the company and other liable parties.
Reconciled payments to ensure the accuracy of payments by third-party vendors were correct.
Collaborated with the claims team to ensure the accuracy of claims and amounts due from liable third-party payors.
Managed the relationship between the attorney's office and the company.
Managed data and reporting for all accounts in negotiation.
Premium Billing Lead
Health Alliance Medical Plans, Inc
Champaign , IL
03.1996 - 08.1998
Assisted with the development of internal policies and procedures related to billing.
Provided training to new staff members on billing processes and procedures.
Performed data entry into various software systems related to accounts receivable functions.
Resolved customer inquiries related to billing issues in a timely manner.
Analyzed current billing processes for potential improvement opportunities.
Led team members in resolving complex customer billing disputes.
Created detailed reports on accounts receivable, customer payments and aging summaries.
Communicated regularly with customers regarding outstanding balances or other billing issues.
Leveraged billing systems and tools to prepare and distribute customer invoices based on billing criteria.
Education
Associate of Science - Agricultural Business
Parkland College
Champaign, IL
12-1988
Skills
Sales strategy
Account management
Client relationship management
Data analysis
Customer service
Market research
Presentation skills
Contract negotiation
Implementation planning
Key account management
Affiliations
Hiking , walking , yoga
Landscape and gardening projects
Boating and spending time with family
Reading
Certification
Current State of Il Insurance Producers Lic - Health & Life