LOUIS D HALL
Charlotte,NC
Summary
Knowledgeable and emotionally intelligent operations leader with 25 years of experience in Customer Relations and Quality Assurance Management, and 5 years of Human Resources Management. As a recognized leader in process improvement and program redesign with budgets exceeding $6.3 million, I am ready to utilize my well-honed servant leader abilities to elevate your program.
Experienced professional with a strong background in technology-related roles. Proficient in software development, system administration, and technical support. Skilled in problem-solving and optimizing performance. Capable of managing projects and collaborating effectively with teams. Committed to continuous learning and staying current with industry trends to contribute to organizational success.
Overview
23
23
years of professional experience
1
1
Certification
Work History
Founder/Operator
REDEEMED ARTS LLC
02.2015 - Current
- Supervised and mentored 6 staff and 15 volunteers, fostering an authentic non-profit environment supporting community relations
- Spearheaded a capital campaign raising over $100,000 for operational costs and building expansion
- Wrote and facilitated workshops and trainings across the United States to 65 to 185 participants
- Reduced operational cost by 35% through effective auditing, the budget sheet reconciliation, and implementing new ADP programs to enhance HR practices
Elementary and High School Teacher
Christian Leadership Arts Academy
09.2025 - 10.2025
- Developed and instructed entrepreneurship coursework for students in grades 6th to 12th
- Developed and instructed visual arts coursework for students in grades Pre-K to 12th grade
- Collaborated with the school head and other instructors in leading the physical education course
Manager of Quality Assurance and Workforce
AUTOMATED HEALTH SYSTEMS
07.2022 - 09.2023
- Developed and implemented the Quality Assurance and Workforce Management plans supporting the 300-agent Medicaid program
- Managed and corrected 27 employees supporting answering 3000 calls per day, and processing 1800 written correspondences
- Developed the internal SharePoint with Power BI and Lists tools, creating real-time metrics tracking, elevating center operation to 7% abandonment, 70% utilization, and increasing client contact to nearly 100,000 per month
- Managed monthly and weekly calibration meetings with internal executive leaders and State Department of Social Services leaders, boosting contract performance by 25% during the first year
Senior Business Analyst/Health Plan Operations
CENTENE CORPORATION
04.2019 - 06.2020
- Drove the analysis of $10mil to $35mil business projects while providing strategies to improve operational efficiencies through effective User Acceptance Testing.
- Evaluated and recommended business solutions to support project managers, program developers, and executive leaders in assessing and understanding customer patterns, enrollment trends, and provider contract history.
- Managed the unification of multiple states' health plan operation changes while leading the project timeline, resulting in 99% health plan expenditures calculation accuracy & 97% contractual implementation accuracy
- Guided the authoring of training tools for business processes & continuous improvement initiatives while creating the corporate Process Owner Standard Operating Procedures guide
Lead Operation Auditor/Provider Contracting and Credentialing
WELLCARE HEALTH PLANS
11.2017 - 04.2019
- Oversaw and directed 20 contract specialists and 4 business analysts in managing proper Audits of Missouri provider contracts and system implementations
- Ensured proper credentialing requirements were obtained and applied to new contract holders before accepting claims for adjudication.
- Managed 20 internal contracting and credentialing agents on proper licensure, certifications, and accreditations processes and procedures, maintaining adherence to Medicaid regulatory, compliance, and policy requirements, yielding $1.5mil first-year Savings
Team Lead, Operations Escalations/ Claims and Contracting
WELLCARE HEALTH PLANS
10.2016 - 11.2017
- Responsible for escalations of 19 jurisdictions for Medicare and Medicaid claims, Pharmacy claims, and all state contracting inquiries.
- Built and managed a cross-functional team of 18 executive escalation experts in performing collaborative root cause analysis, system error triaging, billing and adjudication investigation, and resolving state and federal complaints and grievances.
- Interviewed and directed 20 Florida Medicaid Escalations analysts to investigate internal claims, provider credentialing, and system configuration errors, producing $425k first-year savings and reducing AHCA fraud, waste, and abuse filings by 28%.
- Oversaw the and integration of 24 Standard Operating Procedures and overhauled internal quality control indicators, reducing complaints by 42% and increasing provider contract renewals and member re-enrollments by 40%
Senior Analyst, Provider Account Resolution/Contract Analysis
WELLCARE HEALTH PLANS
10.2015 - 10.2016
- Assisted in the direction of training, certification, and disciplinary actions for 85 team members as related to complaints or inquiries for 19 jurisdictions related to billing configuration, contract language, and claim adjudication.
- Also partnered in the development of an internal Provider Chat program, streamlining communication between Providers and health plans.
- Recommended strategy for an overhaul of operational metrics in determining billing, configurations, and claims adjudication efficiencies, supporting the training, coaching, and development of 85 employees.
- Deterred $875,000 in regulatory fines by investigating billing and contract configuration errors and collaborating in the development of a Provider Chat Platform pilot resource servicing over 15,000 users.
- Steered the cross-functional creation of a 4-week escalations training program and Critical Systems User's Guide for case management efficiency, supporting 525 internal users
Claims Project Control Specialist
WELLCARE HEALTH PLANS
11.2012 - 12.2014
- Managed claim command center projects totaling $6 million, ensuring each of 19 contract holders was adjudicating claims correctly, saving health plans up to $1 billion in liquidated damages per state guideline.
- Coordinated Medicaid and Medicare projects through requirement gathering, milestone creation, process implementation, trend analysis, and systems integration success rate reporting in support of over 350 claim specialists across 18 markets.
- Modified data integrations of Salesforce, SharePoint, and PEGA, yielding 38% process optimization and 18% savings on a $3.6mil to $5.4mil project budget.
- Engineered internal tracking tools for streamlined systems, user performance, and critical error resolution timeline adherence, resulting in a 35% performance improvement
Supervisor of Medicare Call Center Operations
VANGENT INC
02.2008 - 08.2010
- Developed operational metric for 750-person call center while directly managing 30 team leaders through a talent management plan to effectively grow team leaders and senior representatives in their respective succession plans.
- Hired and developed 30 team leaders to manage 720 agents on maximizing call center efficiency based on collaborative analysis of key
Supervisor of Property and Casualty Call Center Operations
ALLSTATE INSURANCE COMPANY
02.2003 - 01.2005
- Steadied employee retention to 91% through onboarding trend assessments, employee journey mapping, execution of customer experience surveys, consistent exit interviews, and employee satisfaction surveys.
- Enacted call center quality and performance measures, reducing costs by 18% while improving member engagement by 53% through detailed audits of through statewide property and casualty accounts
Education
Master of Science - Industrial and Organizational Psychology
Bachelor of Science - Management and Leadership
Skills
- Microsoft Office
- Jira
- SaleForce
- Adobe
- Verint
- Five9
- PEGA
- ZoHo
- AdvancedMD
- Xcelys
- Customer Experience Planning
- Quality Management Planning
- Process Redesign Execution
- Human Resource Management
- Operation Budget Forecasting
- Change Management Oversight
- Talent Acquisition Initiative
- Project and Program Management
- Quality assurance
- Medicaid compliance
- Operational auditing
- Business analysis
- Project management
- Process optimization
- Change management
- Team building
- Effective communication
- Strategic planning
- Conflict resolution
- Employee training
- Team leadership
- Ethics and integrity
- Team engagement
- Recruitment and hiring
- Entrepreneurial leadership
- Talent acquisition
- Staff management
- Performance assessments
- Strategic thinking
- Entrepreneurial and innovative
- Operations management
- Negotiation
- Client engagement
- Contract negotiation
- Business planning
- Customer focus
- Process improvements
- Business administration
- Customer acquisition
- Organizational structuring
- Visionary leadership
- Contract management
- Policies and procedures development
- Start-up operations
- Quality control planning
- Employee motivation and performance
- People and culture
- Policies and procedures
- Team collaboration
Certification
Six Sigma Black Belt
Timeline
Elementary and High School Teacher
Christian Leadership Arts Academy
09.2025 - 10.2025
Manager of Quality Assurance and Workforce
AUTOMATED HEALTH SYSTEMS
07.2022 - 09.2023
Senior Business Analyst/Health Plan Operations
CENTENE CORPORATION
04.2019 - 06.2020
Lead Operation Auditor/Provider Contracting and Credentialing
WELLCARE HEALTH PLANS
11.2017 - 04.2019
Team Lead, Operations Escalations/ Claims and Contracting
WELLCARE HEALTH PLANS
10.2016 - 11.2017
Senior Analyst, Provider Account Resolution/Contract Analysis
WELLCARE HEALTH PLANS
10.2015 - 10.2016
Founder/Operator
REDEEMED ARTS LLC
02.2015 - Current
Claims Project Control Specialist
WELLCARE HEALTH PLANS
11.2012 - 12.2014
Supervisor of Medicare Call Center Operations
VANGENT INC
02.2008 - 08.2010
Supervisor of Property and Casualty Call Center Operations
ALLSTATE INSURANCE COMPANY
02.2003 - 01.2005