KRISTIN APP

• Led strategic roadmap for claims capabilities, aligning technology, process, and compliance initiatives with enterprise goals.
• Spearheaded automation and workflow optimization, reducing cycle times and improving accuracy across multiple lines of business.
• Partnered with IT, Operations, and Compliance to deliver system enhancements and ensure regulatory adherence.
• Developed governance frameworks and KPIs to monitor performance, strengthen controls, and enhance customer experience.
• Championed digital transformation initiatives, introducing tools and training programs to build team capability and scalability.
• Reduced claim denials by 5% through implementation of prior authorization and claims workflows, optimizing process design for accuracy and efficiency.
• Delivered cost savings of $2.5 million annually through strategic technology enhancements.

Director of Claim Strategy

Driving enterprise claims strategy, innovation, and operational excellence

• Defined and executed enterprise claims strategy, aligning business objectives with regulatory requirements and customer experience goals.
• Led multi-year transformation roadmap, introducing automation, AI-driven analytics, and digital workflows to modernize claims operations.
• Partnered with senior leadership and cross-functional teams (IT, Finance, Compliance) to deliver strategic initiatives and optimize end-to-end claims processes.
• Developed performance frameworks and governance models, ensuring compliance, quality, and operational efficiency across all lines of business.
• Implemented advanced analytics and predictive modeling, reducing claim leakage and improving fraud detection.
• Achieved measurable impact: Reduced operational costs by $10 million annually through process redesign and technology enhancements.
• Spearheaded innovative approaches to resource allocation and strategic planning, improving scalability and efficiency.
• Leveraged professional networks and industry knowledge to strengthen client relationships and influence industry best practices.

Leading cross-functional teams to deliver strategic and regulatory initiatives for UnitedHealthcare core operations

• Led cross-functional team of Program Managers, driving successful implementation of strategic and regulatory initiatives across UnitedHealthcare Operations & Experience.
• Developed Claim Rules Engine program from the ground up, establishing framework, defining roles, and ensuring alignment with enterprise objectives.
• Managed $60M annual budget with zero overages, ensuring financial discipline and resource optimization.
• Directed design and execution of business transformation initiatives, driving performance improvement, profit optimization, and growth opportunities.
• Monitored program performance and implemented continuous improvement strategies, enhancing operational efficiency and compliance.
• Coordinated efforts across multiple departments, ensuring seamless execution of complex projects from inception to delivery.
• Directed changes to project scope and cost and implemented appropriate change management processes to keep project on track.

• Frontline Support & Resolution
  Resolved an average of 50+ inquiries per day, driving a 20% increase in frontline processing efficiency.
• Claims Subject Matter Expertise
  Implemented process improvements that decreased escalations by 30%, resulting in $500K annual cost savings.
• Team Leadership & Performance Management
  Managed a team of 12 associates, improving SLA compliance from 85% to 97% and optimizing workload distribution for peak efficiency.
• Cross-Functional Collaboration
  Streamlined workflows that cut resolution time for escalated issues by 25%, enhancing operational performance across departments.
• Training & Onboarding Excellence
  Developed training modules that reduced onboarding time by 20% and improved new hire accuracy scores by 15%, strengthening team capability.