Kelly Wensmann

• Managed a team of 10+ Coordinators and motivated employees to be productive and engaged in work.
• Accomplished multiple tasks within established timeframes.
• Maximized performance by monitoring daily activities and mentoring team members.
• Maintained professional, organized, and safe environment for employees
• Cross-trained existing employees to maximize team agility and performance.
• Achieved departmental goals by developing and executing strategic plans and performance metrics.
• Ensured completion of quarterly quality audits, reviewed scores and made recommendations for additional training and provided reporting on quality score trends to leadership
• Enhanced customer satisfaction by resolving disputes promptly, maintaining open lines of communication, and ensuring high-quality service delivery.
• Recruited, interviewed and hired employees and participated in annual merit planning

• Oversaw daily operations of the department, ensuring smooth workflow and timely completion of tasks.
• Applied strong leadership talents and problem-solving skills to maintain team efficiency and organize workflows.
• Developed a process for conducting quarterly quality reviews of formulary exception requests outcomes
• Increased team productivity by implementing efficient workflows and setting clear expectations for staff members.
• Demonstrated commitment to the organization''s core values, leading by example and fostering a culture of excellence.
• Conducted performance evaluations for staff members, identifying areas of improvement and guiding professional development plans.

• Built strong relationships with stakeholders through effective communication, leading to increased trust and collaboration.
• Collaborated closely with executive leadership to develop strategic plans that aligned with the organization''s goals and objectives.
• Developed comprehensive training programs for new employees, resulting in quicker onboarding times and improved overall performance.
• Mentored junior team members, providing guidance on career development opportunities and fostering a supportive learning environment.
• Streamlined project management processes by implementing new organizational tools and techniques.
• Established key performance indicators for departmental goals, enabling more accurate tracking of progress towards objectives and facilitating data-driven decision-making processes.
• Gathered and organized materials to support operations.
• Entered data, generated reports, and produced tracking documents.
• Organized spaces, materials and catering support for internal and client-focused meetings.
• Improved office operations by automating client correspondence, record tracking and data communications.
• Developed internal requirements and standards to minimize regulatory risks and liability across programs.

• Collaborated with other departments within the organization to share best practices and ensure consistent application of policies across all areas of clinical operations.
• Ensured regulatory compliance by diligently tracking documentation and maintaining up-to-date knowledge of industry standards.
• Developed training programs for new staff members, boosting employee retention rates within the department.
• Evaluated existing workflows for opportunities to improve efficiency, resulting in

· Created training materials and trained new teammates

· Identified educational needs of teammates and prepared educational sessions

· Developed formal Policy & Procedures for formulary and formulary exception antibiotics and participated in review and approval process

· Analysis of current operating procedures and recommended changes to improve efficiency

· Participated in establishing specific criteria for formulary exception reviews

· Review and analysis of patient labs, adequacy and trending data, hospital records, and physician progress notes for appropriate usage of medications, dialyzers, acid concentrates and dressings

· Monitored patient information and records to ensure that all documentation is created and maintained accurately and in accordance with HIPAA regulations

· Triaged in-bound calls from facility teammates, doctors and external vendors and provided problem resolutions.

• Provided educational “family night” sessions for Long Term Care facilities regarding Medicare Part D plans
• Solutions designed and implemented
• Created and maintained databases of insurance plans
• Developed system for identifying and tracking unpaid claims
• Created tools to use in resolving pharmacy claim rejections
• Responded to inquiries from customers, nursing staff and doctors regarding benefits, billing issues, prior authorizations and medication inquires
• Month end processes and account reconciliation and collections
• Assisted LTC Residents with complex benefits claims, resolving issues in a timely manner and ensuring satisfaction.
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