Lisa Walseth
Bohannon,VA
Summary
Dedicated, results-driven, educated leader with 25 years of government contracting, and operational experience within various departments. Over 18 years of Medicare experience and 14 years of management experience of which 10 years have been spent overseeing large scale teams with complex systems and multiple workflows. Experience managing staff in remote offices as well as telecommuters. Competent in regulatory interpretation and implementation of processes. Statistical and data analysis experience as well as experience working with scrum teams and prioritizing system solutions. Ability to proactively take action when necessary to seize the utmost performance and improve team efficiency and accuracy.
Overview
15
15
years of professional experience
Work History
Vice President of Operations
Wisconsin Physician Services
Hampton, VA
09.2019 - Current
- Responsible for operational oversight of claims processing, provider certification, recoupment and call center duties which handle more than 6 million lives - over 40 million claims annually for TRICARE East.
- Improved operational efficiency resulting in staffing reductions.
- Earned top tier incentives from the prime for contract performance.
- Delivered expert thought leadership recognized for driving process improvements.
- Set clear goals for managers and implemented systems for measuring results in support of optimal decision making.
- Boosted company profits by optimizing performance strategies and increasing efficiency.
- Developed and deepened relationships with functional leadership to interconnect revenue generation initiatives with day-to-day operations.
- Leveraged analytical, design and implementation skills to offer leadership and support to all operations areas.
- Coordinated work across departments and shared services to keep teams on track with company goals.
Director of Operations
Wisconsin Physician Services
Hampton , VA
07.2018 - 08.2019
- Evaluated operational trends and made proactive strategy adjustments to maintain alignment between performance and objectives for provider certification, claims processing and recoupment teams for TRICARE East.
- Directed training improvements to reduce knowledge gaps and eliminate workforce performance inefficiencies.
- Motivated and supported frontline workers completing work to increase work quality and efficiency.
- Worked closely with other stakeholders to immediately address issues and implement effective solutions.
- Generated reports to assess performance and make adjustments.
- Optimized productivity, streamlined program efficiency, and boosted profitability.
- Assessed team proficiencies, identifying and targeting areas for improvement.
- Forecasted outlook by mitigating operational risk and compiling performance, financial, and headcount data.
- Monitored progress by establishing plans, budgets and measuring results.
- Provided oversight of over 400 employees through coaching, feedback and performance management.
- Conducted staff evaluations and determined promotions and realignments or reductions in workforce.
Manager/Director of Provider Enrollment
Noridian Healthcare Solutions
Fargo, ND
03.2014 - 05.2018
- Primarily responsible for overseeing workload monitoring and performance standards for Medicare Provider Enrollment.
- Supervised three managers and over 200 frontline staff.
- Responsible to initiate process improvements and technology implementation.
- Enforced strong internal controls and compliance programs within operational area.
- Achieved contractual and performance metrics.
- Led the team to increase the percentage of metrics met from 27% to 100% through process improvements and developing an enhanced program for measuring staff production.
- Decreased staffing levels while meeting 100% of performance standards.
- Developed tools and resources to meet application timeliness.
- Meets requirements by developing budgets and working within available funding.
- Implemented Corrective Action Plans to improve processes and meet contract requirements.
- Met 100% on external audits.
Team Leader
Noridian Healthcare Solutions
Fargo, ND
04.2009 - 02.2014
- Responsible for monitoring and meeting Medicare Secondary Payer and Recoupment Team goals.
- Supervised a team of 15-40 staff.
- Provided skills, tools, and training to develop the team.
- Conducted hiring and maintained staffing levels.
- Served as a contact with external stakeholders such as CMS.
- Responsible for managing annual budget requirements.
- Successfully implemented a new contract.
- Met performance expectations by setting expectations for staff and facilitating and coaching them to success.
- Implemented numerous Change Requests.
Quality Improvement Program Analyst
Noridian Healthcare Solutions
Fargo, ND
11.2008 - 03.2009
- Responsible for monitoring effectiveness of quality improvement activities.
- Created quality reports for management responsible for Medicare Business.
- Completed data analysis to measure quality.
- Served as a quality improvement resource to all internal departments, as needed.
- Facilitated an environment that prioritized quality performance.
- Ensured processes are suitable to achieve contractual performance requirements by conducting process improvement reviews.
Education
MBA - Business Management
University of Mary
Fargo, ND03.2018
Bachelor of Science - Business Management
University of Mary
Fargo, ND03.2016
Skills
Analytical Skills
Bid/Proposal Development
Budget Monitoring
Business Process Improvement
Change Management
Coaching/Mentoring
Collaborative Leadership
Continuous Improvement
Government Contracting
Large Scale Management
Operational Efficiency
Quality Improvement
Regulatory Requirements
Timeline
Vice President of Operations
Wisconsin Physician Services
09.2019 - Current
Director of Operations
Wisconsin Physician Services
07.2018 - 08.2019
Manager/Director of Provider Enrollment
Noridian Healthcare Solutions
03.2014 - 05.2018
Team Leader
Noridian Healthcare Solutions
04.2009 - 02.2014
Quality Improvement Program Analyst
Noridian Healthcare Solutions
11.2008 - 03.2009
MBA - Business Management
University of Mary
Bachelor of Science - Business Management
University of Mary
Similar Profiles
Julie GreenJulie Green
Supervisor Technical Claims at Wisconsin Physician ServicesSupervisor Technical Claims at Wisconsin Physician Services
Angelique TurnerAngelique Turner
Receptionist/Medical Assistant at Independent Physician Of WisconsinReceptionist/Medical Assistant at Independent Physician Of Wisconsin
Maalik HillMaalik Hill
Contractor at Wisconsin Physician Service Health Insurance, WPSContractor at Wisconsin Physician Service Health Insurance, WPS