Job Search Status
Open to workDesired start date: 2 weeks notice
Open To Work
Hi, I’m
Malcolm Haymes
Winder
Work Preference
Summary
Dynamic and ethical professional with over a decade of experience in utilization management. Expertise in training teams and fostering collaboration has led to significant improvements in patient care and operational efficiency.
Overview
16
years of professional experience
Work History
Elevance Health
Utilization Management Representative III
05.2015 - Current
Job overview
- Analyzed utilization data to ensure compliance with healthcare regulations and policies.
- Facilitated interdisciplinary meetings to enhance patient care plans and optimize resource allocation.
- Reviewed prior authorization requests for clinical appropriateness and adherence to guidelines.
- Trained staff on utilization management protocols, improving team efficiency and knowledge retention.
- Reduced wait times for essential services by effectively managing utilization review caseloads and prioritizing urgent requests.
- Promoted a culture of collaboration and teamwork, fostering an environment that encouraged open communication and shared learning among colleagues.
Wipro Technologies
Team Lead
09.2014 - 01.2015
Job overview
- Cultivated a supportive environment for junior team members, encouraging skill enhancement and effective knowledge transfer.
- Analyzed project performance metrics to identify areas for strategic enhancement.
- Developed training materials to support onboarding of new team members effectively.
Wipro BPO
Team Lead
01.2010 - 06.2014
Job overview
- Cultivated an environment of knowledge sharing by mentoring junior team members and supporting their skill advancement.
- Implemented process improvements that reduced turnaround time for project milestones.
- Served as a role model for the team by demonstrating commitment to excellence, professionalism, and adherence to company values at all times.
- Trained team members in critical methodologies required for successful task execution.
- Maintained professional demeanor by staying calm when addressing unhappy or angry customers.
Education
University of Tennessee Chattanooga, TN
Bachelor of Science from Theater
08-2005
University Overview
Skills
- Problem-solving skills
- HIPAA compliance
- Professionalism and ethics
- Claims processing
- Insurance verification
- Utilization review
- Microsoft office
Timeline
Utilization Management Representative III
Elevance Health
05.2015 - Current
Team Lead
Wipro Technologies
09.2014 - 01.2015
Team Lead
Wipro BPO
01.2010 - 06.2014
University of Tennessee
Bachelor of Science from Theater