KELLY MCDONALD
Manassas,VA
Summary
Customer Service/Operations Consultant with exceptional executive leadership experience and a reputation for innovative contact center management. Takes charge of successful large-scale change management implementations that enhance efficiencies and increase growth.
Operations Consultant with a strong background in process improvement and complaint management. Demonstrated ability to lead cross-functional teams, streamline operations, and enhance service delivery, ensuring alignment with organizational goals and customer satisfaction.
Overview
15
15
years of professional experience
Work History
Timecard Review Specialist
MBO Partners
Ashburn, Virginia
05.2025 - Current
- Collaborated with cross-functional teams to streamline review processes and workflows.
- Utilized internal systems to track and document review progress and outcomes.
- Identified areas for process improvements to enhance efficiency in reviews.
- Managed communication between clients and contractors to resolve inquiries efficiently.
- Interacted directly with customers via email, phone, or other communication channels.
Client Care Specialist
MBO Partners
Ashburn, Virginia
02.2025 - 05.2025
- Provided exceptional support to clients through effective communication and problem-solving skills.
- Assisted clients in navigating service options and resolving inquiries promptly.
- Maintained accurate client records using CRM software to ensure efficient service delivery.
Director, Process Improvement
Kaiser Foundation Health Plan
Fulton, USA
10.2018 - 04.2024
- Led a national team responsible for conducting consumer complaint research and investigation in partnership with Grievance and Appeals department in support of Member Services.
- Identified resolution and improvement opportunities, using data gathered through the complaint research.
- Refined executive escalation written summaries to be more actionable for involved parties as well as to provide a clear resolution to the member complaint or issue.
- Identified resolution and improvement opportunities based on data from complaint research to enhance member experience.
- Conducted investigations and provided transcriptions of call recordings for business stakeholders, including legal, compliance, operations and human resources.
- Developed training recommendations for individual staff and addressed systemic issues identified in data review to strengthen team capabilities.
- Restructured team and wrote new job descriptions to better align with the work being performed.
- Created cross-functional team to support multiple service areas in content and process, streamlining operations and enhancing service delivery.
- Managed the Member Service Social Media team responding to member direct inquiries across various social media platforms including Facebook, X, Instagram and Google App reviews. Team provided coverage 7 days a week with a 90% service level for responding within one hour to post or comment, often within 15 minutes. Reviewed over 70 active accounts for Kaiser Permanente as well as public forums for mentions of Kaiser Permanente as part of reputation/and brand management.
Executive Director, MSCC
Kaiser Foundation Health Plan
Fulton, USA
08.2013 - 10.2018
- Led 1 of 4 national contact centers with daily oversight of 600 employees supporting member and provider telephone and email inquiries pertaining to benefits, eligibility, claims, and billing.
- Co-managed national operations for 1800 employees and vendors, ensuring alignment with strategic goals.
- Partnered with regional Health Plan Service Administration Vice Presidents and teams to communicate business updates, operational issues, strategy, negotiate on agreements and ensure implementation of business operational recommendations.
- Contributed to Health Care Reform preparation related to Member Services strategy and facilitated successful implementation.
- Engaged in benchmarking activities with other healthcare organizations, including the Blues, Cigna, and UHG.
- Supported care delivery and administrative services, by identifying process improvement opportunities and implementing initiatives specific to the member and provider experience, including clinical contact center, provider affairs (in and out of network), and national claims administration.
- Implemented first telecommuting agreement with union leadership that increased staffing for peak seasonal volume, reduced staff absenteeism and provided contingency planning for weather and emergencies.
- Presented on Contact Center operations and customer service philosophy to diverse audiences, including vendors and compliance teams, while leading facility operations tours for employer groups and account management leaders.
Operations Manager, MSCC
Kaiser Foundation Health Plan
Fulton, USA
10.2011 - 08.2013
- Managed day-to-day contact center operations and 250 staff, overseeing team managers and support staff while coordinating staffing and hiring processes.
- Achieved all performance metrics and KPIs by coaching and developing team managers, providing adequate management coverage, and overseeing CSR performance management.
- Coordinated regional partnerships during transition of member service contact center functions and staff to national shared service platform.
Senior Manager, Member Services, MSCC and MARS
Kaiser Permanente Mid-Atlantic States
Silver Spring, USA
- Oversaw 145 employees in Member Services Call Center and Medical Centers, ensuring effective resolution of member/provider/customer inquiries on benefits, eligibility, COBRA, HIPAA, claims, billing, and disputes.
- Collaborated with cross-functional departments to enhance business processes for improved efficiency and member-focused service.
- Negotiated with Local 2 OPEIU to foster Labor Management Partnership for union staff.
Manager, Medical Center Member Services
Kaiser Permanente Mid-Atlantic States
Rockville, USA
- Equipped member assistance and resource specialists (MARS) with necessary information, training, and support to effectively resolve member inquiries and issues, collaborating with managers of medical centers (MFAs and PCCLs).
- Collaborated with departments to develop efficient work processes for timely resolution of member issues and identified trends for upstream process improvements, enhancing overall member satisfaction.
- Managed staff of 23, overseeing training, compliance monitoring, performance measures, recruitment, hiring/termination, performance reviews, and setting goals and recognition for team members.
Education
Bachelor of Arts, B.A. - Communications
George Mason University
Fairfax, VASkills
- Executive Leadership
- Process Improvement
- Operational Excellence
- Complaint Management
- Quality Improvement
- Employee Relations
- Cross-functional Collaboration
- Change Management
Timeline
Timecard Review Specialist
MBO Partners
05.2025 - Current
Client Care Specialist
MBO Partners
02.2025 - 05.2025
Director, Process Improvement
Kaiser Foundation Health Plan
10.2018 - 04.2024
Executive Director, MSCC
Kaiser Foundation Health Plan
08.2013 - 10.2018
Operations Manager, MSCC
Kaiser Foundation Health Plan
10.2011 - 08.2013
Manager, Medical Center Member Services
Kaiser Permanente Mid-Atlantic States
Senior Manager, Member Services, MSCC and MARS
Kaiser Permanente Mid-Atlantic States
Bachelor of Arts, B.A. - Communications
George Mason University