Kelly Lanier

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• Managed client accounts, ensuring timely resolution of inquiries and issues.
• Increased client satisfaction by building strong relationships and addressing their needs promptly.
• Cultivated long-term relationships with key stakeholders in assigned accounts, fostering trust and loyalty among clients.

• Lead operational strategy and performance for large-scale Medicare and Medicaid claims operations while ensuring compliance with state and federal contractual requirements, service level agreements, and quality standards.
• Key Contributions
• Directed the design, implementation, and successful launch of a new Pega ER Claims platform that reduced average processing time to under 60 seconds while improving operational efficiency.
• Increased team productivity by 18% while achieving consistent 100% quality review scores across multiple markets.
• Managed enterprise audits including HEDIS, HSAG, ISCAT, PMV, and Ernst & Young reviews, presenting findings and operational results to executive leadership and regulatory agencies to ensure accountability and transparency.
• Developed and implemented operational policies, workflows, standard operating procedures, and training programs that strengthened compliance and enhanced production, quality, and customer outcomes.
• Experience using Tableau and other dashboards, to manage KPIs and operational metrics, and performance analytics to identify improvement opportunities and drive strategic decision-making.
• Lead hiring, coaching, succession planning, performance management, and employee development for direct reports.
• Developed customer service strategies and complaint resolution procedures that enhanced service quality and operational performance across multiple markets.
• Partner with cross-functional leaders to implement enterprise process improvements supporting organizational goals.
• Selected Achievements
• Promoted multiple times into leadership positions based on performance and operational results.
• Selected for Elevance Health Operations Leadership Academy (2023).
• Successfully led transformational process improvements that improved speed, quality, compliance, and productivity across claims operations.

• Managed executive-level mortgage servicing escalations while ensuring regulatory compliance and delivering operational improvements.
• Oversaw complex executive customer cases requiring regulatory compliance and risk mitigation.
• Oversaw complex executive customer cases, ensuring regulatory compliance and mitigating risks to enhance customer satisfaction.
• Produced executive forecasting reports, operational analyses, and performance reporting for senior leadership.
• Produced executive forecasting reports and operational analyses to inform strategic decision-making for senior leadership.
• Supervised and coached team members to ensure operational consistency and adherence to Six Sigma methodologies.
• Key Contributions
• Achievement
• Promoted to Officer in recognition of leadership performance and operational excellence (2013).

• Managed high-volume customer interactions, resolving complex issues to enhance customer experience.
• Identified customer needs, supporting revenue growth through tailored consultative service.
• Maintained high customer satisfaction, consistently meeting operational performance goals.