Kamara Johnson
Buffalo,NY
Summary
Career oriented individual seeking a new opportunity within a corporate organization to utilize my professional experience, leadership skills and enhance my professional growth.
Overview
24
24
years of professional experience
Work History
Individual Market & Safety Net Supervisor
Univera Healthcare
Williamsville, New York
04.2021 - Current
- SME project lead over multiple change initiatives, i.e., closed loop, OUC resource group, gap tool
- Supervise a team of 25 Customer Service advocates
- Research and resolve a variety of internal and external task including but not limited to claims inquires, enrollment issues, letter request, intakes research, etc
- Coach Customer Service advocates real time, and in one-on-one sessions
- Arrange, present and conduct meetings
- Help with identifying training gaps for staff
- Assist with the development of process and procedures
- Assist workforce with management of Customer Service advocates real time
- Assist with daily statistic reporting and trends
- Assist with conducting interviews for potential new staff
- Assist with capacity planning & budget monitoring
- Arrange training for existing staff.
Government Programs/Individual Market Office Unit Coordinator
Univera Healthcare
Williamsville, New York
06.2015 - 02.2021
- Assist with resolutions for escalated members, and external members via e-mail and phone
- Research and resolve a variety of internal and external task including but not limited to claims inquires, enrollment issues, letter request, intakes research, etc
- Coach Customer Service advocates real time, and in one-on-one sessions
- Attend, present and conduct meetings, and manage our OUC monthly calendar
- Help with refresher training for existing and newly hired staff once on our floor
- Assist with the development of process and procedures
- Assist workforce with management of Customer Service advocates daily statistics
- Assist with daily statistic reporting and trends
- Assist with conducting interviews for potential new staff.
Government Programs/Individual Market Customer Care Advocate
Univera Healthcare
Williamsville, New York
01.2014 - 06.2015
- Assisting members with benefits, membership and enrollment, claims, informational request, etc
- In reference to Medicaid Manage Care, Child Health Plus, Essential Plan, and Individual Market
Medical Intake Coordinator
12.2010 - 12.2013
- Review of infused and injectable drugs performed in home, medical office, or outpatient setting
- Conducts and reviews initial level medication prior authorizations submitted by providers
- Research claims, authorizations, products, and eligibility
- Prepare medical drug cases for nurse team to approve or deny
- Suggest and implement process improvement for the Med Spec Drug unit when identified
- Assist external and internal customers with authorization related inquires
- Distribute and handle department correspondence
- Perform other function as assigned by management
- Assist in preparing and training new hires.
Government Programs Team Lead
08.2005 - 12.2010
- Evaluates procedures and systems utilized to accomplish work processes in accordance with CMS and Medicaid guidelines and standards
- Subject matter expert in areas of Child Health Plus and Medicaid programs
- Managed staff via CentreVu, Capp reports, scorecards, etc
- Generate and manage internal tracking system report weekly, to assure staff is adhering to timelines
- Answer supervisor calls, lead line, and department of social services calls
- Call monitoring, coaching, and mentoring
- Interviewing, also system training to newly hired staff.
Government Programs: Safety Net Representative
03.2001 - 08.2005
- Assisting members and providers with benefits, claims, informational request, etc
- In reference to Medicaid, and Child Health Plus membership and enrollment
- Manually processed CHP applications before deadlines set forth by government guidelines, assisting with enrollment, billing, and claim issues for members.
Member Service Representative
Independent Health
Williamsville, New York
08.2000 - 03.2001
- Customer care center focusing on inquires and member concerns
- Servicing member in changing their doctors, ID cards, member handbooks and provider directories mailings
- Membership and enrollment status.
Education
Erie Community College
Buffalo, NYUniversity of The People
Pasadena, CASkills
- Excellent project facilitation, research, and problem-solving skills, focusing on all relevant details
- Reliable, adaptable, able to learn new systems quickly and take initiative
- Results-driven, effective in planning, delegating, directing, and controlling projects to develop an acceptable solution within deadlines
- PC Software skills include Microsoft Office (Word, Excel, PowerPoint, Access), Teams, Business Manager, CIC, OneNote, Facets, LRSP, Lotus Notes, Care Planner, Vital, Med Impact, Epaces, SIR, Big Box, Outlook, and Care Advance
Trainingeducation
- Thrive Leadership
- Emerging Leaders
- Leadership Essentials
- Developing Your Emotional Intelligence
- Aligned Leadership
- Fail Forward
- Moving People Forward
- Critical Thinking for Better Judgment and Decision-Making
- Dealing with Difficult People
- Creative Thinking
- Erie Community College
- University of the People
- BH HARP
- Strengths Finder 2.0
- Leadership Exploration
Timeline
Individual Market & Safety Net Supervisor
Univera Healthcare
04.2021 - Current
Government Programs/Individual Market Office Unit Coordinator
Univera Healthcare
06.2015 - 02.2021
Government Programs/Individual Market Customer Care Advocate
Univera Healthcare
01.2014 - 06.2015
Medical Intake Coordinator
12.2010 - 12.2013
Government Programs Team Lead
08.2005 - 12.2010
Government Programs: Safety Net Representative
03.2001 - 08.2005
Member Service Representative
Independent Health
08.2000 - 03.2001
Erie Community College
University of The People