Summary
Overview
Work History
Education
Skills
Accomplishments
Timeline
Generic

Kristen McGuire

Dracut,MA

Summary

Compassionate Care Navigator known for high productivity and efficient task completion. Specialize in patient advocacy, care coordination, and resource management. Excel in communication, empathy, and problem-solving to enhance patient care and support. Committed to streamlining processes for better healthcare outcomes.

Overview

11
11
years of professional experience

Work History

Care Navigator

United Healthcare
10.2022 - Current
  • Provided guidance and support to individuals seeking assistance with navigating the healthcare system for a Medicaid/Medicare Managed Care Organization.
  • Maintained the highest quality of service while working independently in a high-volume, remote call center environment.
  • Drove issue remediation as a single point of contact for high risk members and escalated member issues, and followed through to resolution.
  • Consistently maintained confidentiality while handling sensitive patient information in accordance with HIPAA guidelines.
  • Provided education regarding insurance benefits such as copayments, deductibles, coinsurance amounts.
  • Conducted outreach activities to identify individuals who may need assistance or are at risk of developing health issues.
  • Served as a Development Assistant for a training class of newly hired Care Navigators, and assisted in developing and presenting training materials.
  • Coordinated appointments with primary care providers, specialists, and other medical personnel.
  • Participated in CMS remediation plan for Medicare Medicaid plan test calls.
  • Member experience survey score for 2024 of 96.91%.
  • Three years of CSP Facets experience.

General Manager

Carter’s
01.2016 - 10.2022
  • Directed, trained, and developed a team of 30 associates in 2 diverse stores.
  • Attained and maintained top-ranking results in the sales plan, customer conversion, customer satisfaction, OMNI sales, CTS, and employee retention.
  • Set strategic direction on merchandise and operational execution, ensuring brand standards were met in both locations.
  • Set clear expectations, identified gaps in team performance, and addressed opportunities appropriately.
  • Effectively prioritized time between both stores to meet the needs of each location.
  • Fostered a positive work environment for employees and recognized performance to increase employee engagement
  • Built a talent network through networking and recruiting and developed succession plans in both store locations, resulting in 5 promotions in 7 months.

Store Manager

The Sports Authority
01.2014 - 01.2016
  • Directed, trained, and developed a team of 27 associates in a $5 million store.
  • Developed daily routines and mentor programs to reinforce company best practices, and strengthen service, sales, and merchandise presentation within a store struggling with performance.
  • Achieved a 100% increase in SCALES score in the first 6 months by improving customer satisfaction score, rewards card solicitation, and associate online sales performance.
  • Assessed talent to place associates in positions more suitable to their skill sets, to maximize productivity and development.
  • Achieved an 18% increase in Associate Engagement Survey satisfaction with the Store Manager after the first six months.

Education

English Composition

University of Massachusetts, Lowell
Lowell, MA

Skills

  • Care coordination
  • Insurance education
  • Patient advocacy
  • Patient healthcare navigation
  • Efficient appointment management
  • Customer service
  • Problem solving
  • Team leadership

Accomplishments

  • United Healthcare Employee of the Month September 2024
  • United Healthcare Service Hero Finalist 2024
  • University of Massachusetts Lowell Bands Hall of Fame inductee

Timeline

Care Navigator

United Healthcare
10.2022 - Current

General Manager

Carter’s
01.2016 - 10.2022

Store Manager

The Sports Authority
01.2014 - 01.2016

English Composition

University of Massachusetts, Lowell

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