Summary
Overview
Work History
Education
Skills
Certification
Timeline
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LISA CHARNETSKI- DOROW

LISA CHARNETSKI- DOROW

New Franken,USA

Summary

Dedicated professional committed to personal growth and continuous excellence in all aspects of work. Passionate about motivating and inspiring others to reach their full potential. Proven track record in effectively managing call center operations, executing projects, leading cross-functional teams, and fostering high levels of engagement. Focus on achieving tangible results and dedicated to developing and leading exceptional teams.

Overview

18
18
years of professional experience
1
1
Certification

Work History

Supervisor UM Administration

Humana
11.2012 - Current
  • Assisted with the implementation of Genesys across our entire department
  • Partnered with various teams on key initiatives, tasks and barriers
  • Also assisted with training other leaders on how to use the different Genesys workspaces to gather data needed
  • Ensured our call metrics report was updated with the new Genesys data
  • Led the department quality program by initiating monthly quality discussions and performing focus audits
  • Additionally, utilized data from quality audits to identify quality trends that steered both process updates and individual coaching sessions
  • Worked closely with the analytics team to define, create and implement quality reporting
  • Analyzing Verint KPI data daily/weekly/monthly to ensure goals are met as well as call forecasting
  • Maintain high levels of performance for call center metrics including: call answer rate, call quality NPSt data and service levels
  • Utilization of Power BI and Tableau reporting to determined trends for quality, side by side and NPSt data as well as call metrics reporting
  • Responsible for the departments hiring strategy; Assisted with the design and implementation of a new training program for the UM Coordinators as well as streamlining the interview/onboarding process
  • Responsible for the staffing model for the IB Contact Center
  • Collaboration with various teams on the implementation of the PAL Questionnaire- we were able to increase the approval rate of authorizations during their initial call instead of cases needing to pend for clinical review- about a 30% approval rate
  • Partnered with our process teams to improve the process for requesting Clinical documentation on pended cases- decreased the request from 3 down to 2 by implementing new processes for our UMAC2 associates
  • Collaboratively manage business processes, documentation, and continuous improvement activities for the IB Contact Center
  • Manage a team of 18+ associates dedicated to high quality of our UM processes; provide clear direction, priority, goals, performance feedback, mentoring and career paths for all personnel, monitor cases for timeliness as well as call monitoring in Verint with a focus on team engagement
  • Reduced staffing administrative costs by $23,000 by working on a lean project to eliminate member calls on weekends
  • Assisted with mentoring various new leaders across Humana by sharing best known methods of leadership
  • Fosters an inclusive work environment that promotes associate engagement and development
  • Handles all portions of performance management including performance evaluations and corrective action plans
  • Responsible for partnering with work force management on operational tasks such as forecasting, daily trends, service level agreements and real time monitoring
  • Hand picked to lead our Medicaid Dual Implementations for CIT
  • Responsible for ensuring project timelines are met and key deliverables are completed timely
  • Collaborating with key stakeholders to ensure processes are updated for new implementations

Front Line Leader Provider Relations

Humana
01.2007 - 11.2012
  • Coordinated and managed the communication plan for large provider terminations – pulling key groups of associates from various departments to develop the communication plan, document the plan, manage the timelines and work with senior leadership on implementation
  • Designed and implemented the Private Fee For Service training program
  • Assisted with the implementation of new software for our department by defining the requirements and testing the system before final implementation
  • Led a project to transition National Ancillary work over to Provider Relations – defined requirements and expectations and helped create procedures
  • Worked with various markets to transition their work over to Provider Relations – created process documents and defined expectations
  • Responsible for partnering with work force management on operational tasks such as forecasting, daily trends, service level agreements and real time monitoring
  • Assisted with developing processes to transition some of our inventory overseas to Manilla
  • Assisted with implementation meetings for National Providers- educated them on Humana processes
  • Responsible for maintaining guidelines for all markets
  • Assisted with the redesign and administration of the Provider Contract Request System – North Star Award
  • Led and managed a team of 25 associates- focused on quality and provider contracting

Education

Associate Degree - Marketing

Northeast Wisconsin Technical College
Green Bay, WI

Skills

  • Excellent written communication skills
  • Excellent oral communication skills
  • Excellent electronic communication skills
  • Excellent interpersonal communication skills
  • Discipline Selection Certified
  • Relationship building
  • Leadership skills
  • Team engagement
  • Problem-solving
  • Analytical skills
  • Investigative skills
  • Organization skills
  • Time-management skills
  • Multi-tasking skills
  • CGX knowledge
  • OneNote knowledge
  • Microsoft Products
  • Genesys knowledge
  • Verint knowledge
  • Workforce management knowledge
  • Call center practices knowledge
  • Emotional Intelligence
  • Lean certification
  • Difficult Conversations training

Certification

Lean Certified

Timeline

Supervisor UM Administration

Humana
11.2012 - Current

Front Line Leader Provider Relations

Humana
01.2007 - 11.2012

Associate Degree - Marketing

Northeast Wisconsin Technical College

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LISA CHARNETSKI- DOROW