Kevin A. FAISON, SR.
Wilmington,Delaware
Summary
Results-driven Director with extensive experience in strategic planning and team leadership at AmeriHealth Caritas. Successfully implemented operational strategies that led to increased efficiency and substantial cost savings. Recognized for innovative problem-solving and effective communication skills that influence key stakeholders and achieve organizational objectives.
Overview
14
14
years of professional experience
Work History
Director, Member, and Community Engagement
AmeriHealth Caritas Family of Companies
01.2017 - Current
- Company Overview: Medicaid
- Responsible for the oversight of multi-state teams (remote/hybrid): Community Educators, Member Advocates, Public Affairs Specialists, Wellness Center Administrators, Customer Service Reps, Managers, and Mobile Wellness Unit
- SME for automating the CRM process, enabling providers to submit forms online
- Business collaboration with senior clinical leaders and executive teams to standardize internal processes/workflows
- $100k in annual operating cost savings through marketing material initiatives
- Spearheaded multiple cost-saving system initiatives while collaborating with Information Systems to automate processes, saving $189k annually
- Forecast and monitor daily call volumes and staffing requirements utilizing CMS (AVAYA) and Workforce Management
- Negotiate cost and contract terms with potential vendors to optimize cost and offered services
- Establish and maintain relationships with elected federal/state officials, DMMA, community-based organizations, local universities/colleges, health providers, and vendors to create health and social initiatives
- Exceeded national standards for call center KPI’s for 2018, 2019, and 2020, respectively
- Four years consecutively attained a 100% Quality rating for both clinical and non-clinical audit reviews
- P & L duties for a $3.8 million annual budget
- Medicare product education for aged-out members by conducting in-person seminars and online meetings
- Clinical and non-clinical consultants for new lines of business (North Carolina, Delaware, and New Hampshire-over 500k enrollees) by providing technical expertise, interviewing/hiring, training, creating, and implementing standard procedures to align with Medicaid contract requirements and enrollees aging into Medicare
- Medicaid
Regional Customer Service Manager
Persante Health Care, Inc.
01.2016 - 01.2017
- Forecasted patient scheduling utilization and required staffing requirements, which resulted in a 15% increase in sales revenue
- Lead thirty-one employees in Customer Service (Call Center)- 1 supervisor, 2 team leaders, 1 Admin, and 27 CSRs
- Administrative oversight of sixty sleep center locations within the Tri-State Region in collaboration with the clinical team
- Scheduled bi-weekly client visits with physician offices and hospitals to determine best practices or to discuss concerns/issues
- Created employee training material and facilitated company-wide training on New Hire and Customer Service Roles
- Provided senior leadership with daily and weekly KPI reports on monthly department metric performance
- Improved customer experience processes and collaborated with IT to enhance patient scheduling and registration software
- Developed and implemented customer service policies and procedures to meet national standardized performance metrics
Supervisor, Member/Provider Services
HIGHMARK Blue Cross Blue Shield Delaware
01.2014 - 01.2016
- Monitored performance and provided leadership to a staff of 55 Customer Advocates and 3 Team Leaders within a call center environment representing the State of Delaware
- Daily management of staff to ensure performance guarantees and established goals were being met
- Assigned as the Plan Management Representative for the State of Delaware and W. L. Gore
- As the Executive Liaison, researched, investigated, and resolved member and provider complaints received from the Senior Executive Office
- Daily contact with Sales/Marketing, Enrollment, Billing, and Claims Unit to resolve group and member issues
- Planned and conducted training for the staff regarding the latest programs and benefits
- I interviewed and hired over two hundred candidates for various positions within member and provider services
Communications Manager, Patient Access (Medical Group)
Christiana Care Health System
01.2012 - 01.2014
- Provided leadership for a newly created department that consisted of 31 employees: Clinical RN Coordinator (Supervisors), Triage Nurses, and Patient Service Reps
- Managed 8 primary medical practice call centers and Endocrinology front desk staff
- Forecasted and monitored daily call volumes using CMS (AVAYA), which assisted with staffing and phone coverage
- Produced daily/monthly productivity reports to senior management
- Created P&P and standardized guidelines for primary care call center staff
- Collaborated with department managers and physicians regarding patient scheduling requirements and SLA performance
- Project Manager for the consolidation of seventeen medical center call centers into one centralized location within the hospital
- P & L duties for a $1.5 million annual budget, which resulted in being under 5% for the years 2012 and 2013, respectively
- Served as the liaison for the medical staff and the call center to address issues around patient scheduling or complaints
- Collaborated with senior clinical leaders to establish and implement triage procedures for call center RNs
Operations Specialist (Emergency Operators)
Christiana Care Health System
01.2011 - 01.2012
- Oversight of Hospital Emergency Operators and Supervisors within a 24/7/365 call center
- Monitored daily call volumes and scheduled staffing based on predicted volumes
- Created and provided daily/monthly productivity reports to the VP of Safety and Emergency Management
- Developed standardized guidelines for primary medical practice call centers, emergency alerts, and hospital operators
- Managed and maintained the paging system for Christiana and Wilmington Hospital
- Coordinated with hospital administrators on enhancements/implementation of emergency code alerts
- Hospital Liaison for issues and/or complaints about medical office staff, physicians, and call center representatives
- Coordinated and implemented Emergency Preparedness protocols for identified emergencies (active shooter, multiple trauma patients, and building closure)
Education
Associate of Science - Organizational Leadership
Wilmington University
New Castle, DE06.2025
Skills
- Customer Satisfaction Enhancement
- Health Insurance (Medicaid, Medicare, and Exchange)
- Customer Service Management & Operations
- Planning/Budgeting/Staffing
- Accounting/Finance/Underwriting
- Policy Writing
- Cost-Reduction Strategies
- Revenue Cycle
- Sales & Margin Improvement
- New Business Implementation
- Operations Management
- Logistical Planning
- Performance Improvement
- Call Center Operations
- Contract Negotiation
- Communication/Marketing
Committees Leadership Programs
- Dale Carnegie Leadership Program-Graduate
- AIM Leadership-Graduate
- Exec Online Leadership-Graduate
- Urban League of Philadelphia Leadership Program-Graduate
- AmeriHealth Caritas Family of Companies: Leading for Leadership Culture (Senior Executive Program) (Mentee)
- Big Brothers/Sisters of Philadelphia
- AmeriHealth Caritas Family of Companies: Building a Mentoring Culture Enterprise Program (Mentor)
- Trauma-Informed Leadership Program- Graduate
- FEMA Certificate (Safety & Emergency Management)
Timeline
Director, Member, and Community Engagement
AmeriHealth Caritas Family of Companies
01.2017 - Current
Regional Customer Service Manager
Persante Health Care, Inc.
01.2016 - 01.2017
Supervisor, Member/Provider Services
HIGHMARK Blue Cross Blue Shield Delaware
01.2014 - 01.2016
Communications Manager, Patient Access (Medical Group)
Christiana Care Health System
01.2012 - 01.2014
Operations Specialist (Emergency Operators)
Christiana Care Health System
01.2011 - 01.2012
Associate of Science - Organizational Leadership
Wilmington University
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