Summary
Overview
Work History
Education
Skills
Timeline
Generic

Matthew T. Griffith

Franklin Township,OH

Summary

Dynamic, results-oriented professional poised for leadership with a strong focus on performance-driven outcomes. Proven expertise in optimizing operations and fostering team collaboration to achieve organizational objectives, resulting in significant improvements in efficiency and productivity. Recognized for reliability and adaptability in navigating evolving challenges while consistently maintaining high standards of excellence. Committed to driving innovation and cultivating a culture of continuous improvement, ensuring team success in an increasingly competitive landscape.

Overview

20
20
years of professional experience

Work History

Supervisor; Operations – Call and Claim Plan Advisor

United HealthCare, Inc., Cincinnati, OH
Cincinnati, OH
04.2019 - Current
  • Implemented strategies to guide and develop a team of 12 senior plan advisors, focusing on data-driven insights from KPIs to maximize productivity and elevate team effectiveness.
  • Directed and coordinated activities of staff and physicians across hospital groups to maintain high standards of care and operational efficiency.
  • Achieved alignment of staff performance goals through bi-weekly assessments, ensuring plan advisors remain on track. Delivered annual performance reviews for each plan advisor, driving accountability and development.
  • Monitored and documented individual performance while providing coaching and counseling to plan advisors to sustain team results.
  • Achieved a significant increase in team call quality from 86.5% in 2024 to 97.5% currently.
    Realized an improvement in team claim quality (payment accuracy) from 77.2% in 2024 to 99.6% currently.
  • Exhibited outstanding technical expertise and responsiveness in coaching, reflected in a 100% direct report survey score for 2024 and 2025.
  • Responsible for developing my Team members by providing information, educational opportunities and potential growth opportunities. In addition, I respond to Team members seeking assistance and provide a course of action. I analyze and respond to inquiries from members and providers and supervise and direct specific work activities for my Team daily.
  • Responsible for maintaining an exceptional level of customer service, productivity and quality of work performed by my Team daily. I also participate in developing, refining and implementing unit policies and procedures.
  • Played a key role in unit budget preparation by delivering data-driven insights and leveraging KPI dashboards and scorecards to drive shared accountability and optimize Team performance against budget objectives.
  • Worked with Plan Sponsors/Groups on benefit design, plan changes, renewals, compliance and best practices.
  • Responsible for resolving network contract disputes with providers. This process involves working heavily with UHC provider relations support Team and individual providers disputing allowable amounts on claims.
  • Partner with numerous internal and external stakeholders to achieve Group PG’s and support provider relationships.
  • Also responsible for interviewing and recommending new Plan Advisor hires in collaboration with HR.
  • Highly skilled as it relates to network development, contracting methodology, negotiations and payments with providers across the U.S.
  • Championed customer satisfaction and retention initiatives while maintaining unwavering commitment to high ethical standards and responsible stewardship.
  • Served as subject matter expert on HIPAA regulations, ICD-10 coding, Medicaid, Medicare and ACA compliance, ensuring adherence to industry standards and regulatory requirements.
  • Functioned as subject matter expert for RFP development, partnering with Account Executives to strengthen proposals and support new business growth.
  • Demonstrated strong autonomy and strategic judgement in resolving complex operational challenges across Medicare, Medicaid and employer-sponsored programs, Plans and Policies.
  • Seven years’ experience processing medical claims, in-depth review of healthcare Policies and benefits and over four years’ experience leading a dedicated Team of Sr. Plan Advisors responsible for calls and claims processing.
  • Promoted to Senior Plan Advisor in 2021. Promoted to Team Lead in 2022. Promoted to Supervisor in 2024.
  • Firm: The largest publicly traded healthcare organization in the U.S.

Claims Resolution Analyst

Acosta Sales and Marketing Inc., Cincinnati, OH
Cincinnati, OH
06.2017 - 03.2019
  • Utilized proprietary systems, reporting tools, contracts and Standard Operating Procedures (“SOP”) manuals to research and resolve assigned claim and invoice denials. Served as the lead point of contact for clients, including major grocery chains and retail partners.
  • Resolved complex claims issues for large grocery clients, enhancing the efficiency of rebate and coupon programs.
    Validated and investigated invoices, contracts, and supporting documents, resulting in successful reprocessing of claims previously categorized as invalid, denied, or pending.
  • Firm: One of the largest privately held Sales and Marketing firms in the U.S.

Consultant

RVK, Inc., NYC, NY
NYC, NY
02.2010 - 12.2016
  • Responsible for the completion of all client-related projects including, but not limited to, asset allocation studies, domestic, international and emerging market equity, fixed income and alternative investment manager research, style analyses, Investment Policy creation and revisions, Mean Variance (“MVO”), Mean Benchmark (“MBO”) and efficient portfolio analysis.
  • Act as primary Investment Advisor and key point of contact with clients and coordinate with other Senior Consultants core investment philosophies and economic theory regarding portfolio construction, implementation, monitoring and fiduciary best practices.
  • Gathered and presented Capital Market Research and provided updates to our institutional clients on how macroeconomic factors such as changes in interest rates, fiscal and monetary policies, political dislocation, economic growth and unemployment are impacting their portfolios on a regular, on-going basis.
  • Responsible for meeting with and presenting portfolio performance to some of the largest and complex Boards and Investment Committees in the U.S.
  • Recommended investment action to Pension Plans and High Net Worth Plans as macroeconomic conditions change.
  • Promoted from Associate Consultant to Consultant in 2014.
  • Firm: Top 10 general investment consulting firm in the U.S. serving DC, DB and Endowment Plans among others

Director – Investments; Office of the Chief Investment Officer

New York Life Insurance Company, NYC, NY
NYC, NY
02.2006 - 01.2010
  • Responsible for the on-boarding of all investment options for NY Life’s Variable Annuity insurance products. The product line consisted of 125 mutual and hedge funds with $20 billion of assets (as of 03/31/2010).
  • Due diligence reporting on both existing and new Variable Annuity funds. Due diligence consisted of detailed analysis regarding firm history and background, firm and fund assets under management and changes to firm AUM, manager/team skill assessment, research capabilities, investment process, portfolio risk and style drift analysis. The due diligence function sought to assess peer and benchmark performance, standard deviation analysis, Sharpe, Sortino and Information Ratio analyses.
  • Responsible for meeting with all portfolio managers who managed money on behalf of NY Life’s Variable Annuity products. Meetings were intended to get an in-depth understanding of the investment process, philosophy and risk management of the fund to present to internal product managers and senior members of NY Life’s Investment Committee.
  • Supervised 2 junior analysts.
  • Firm: the largest mutual life insurance company in the U.S. with over $150 billion in assets

Education

Master of Business Administration - Finance

Iona University

Bachelor of Science Degree - Economics, Finance

State University of New York College at Oneonta

AI in Healthcare: From Strategy to Implementation

Harvard University
Cambridge, MA
09-2026

Skills

  • Coaching and guidance
  • Results driven
  • Team leadership
  • Service excellence
  • Claims resolution
  • AI powered performance
  • People management
  • Supervisor excellence
  • Established leader
  • Goal oriented

Timeline

Supervisor; Operations – Call and Claim Plan Advisor

United HealthCare, Inc., Cincinnati, OH
04.2019 - Current

Claims Resolution Analyst

Acosta Sales and Marketing Inc., Cincinnati, OH
06.2017 - 03.2019

Consultant

RVK, Inc., NYC, NY
02.2010 - 12.2016

Director – Investments; Office of the Chief Investment Officer

New York Life Insurance Company, NYC, NY
02.2006 - 01.2010

AI in Healthcare: From Strategy to Implementation

Harvard University

Bachelor of Science Degree - Economics, Finance

State University of New York College at Oneonta

Master of Business Administration - Finance

Iona University

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Matthew T. Griffith