Summary
Overview
Work History
Education
Skills
Timeline
Generic

Michael Anderson

Saint Louis,MO

Summary

  • Flexible, seasoned leader with expertise in Customer Service and Claims management
  • Competent and resourceful manager in healthcare who excels in coordinating operations, monitoring all aspects of performance against SLA's, staff recruitment and retention.
  • Thrive in fast paced environment, always guiding teams through change management.
  • Excel at managing daily operations with frequently changing priorities.
  • Skilled escalation contact for clients, providers and members, always while maintaining the highest level of customer satisfaction. Notable Accomplishments
  • Managed multiple Pharma operational sites, driving consistency and high performance.
  • Vice President requested my relocation to assist with turning around the Pharma Ops department.
  • Successful in reorganizing departments, 'managing up' leader performance and in turn driving exceptional performance against critical KPI's and contractual obligations.
  • Responsible for driving down call center turnover rate by 20 percent in two years.
  • Successfully implemented and drove multiple operational improvements in claims, leading to better reporting and workload management.

Seasoned Operations Manager and talented leader with 25 years of experience applying exceptional planning and problem-solving abilities toward enhancing business plans and day-to-day activities. Results-driven and resilient in developing teams while improving processes and increasing productivity. Bringing solid understanding of industry trends, excellent communication skills, talent for spotting areas in need of improvement and implementing changes with strategic approach.

Overview

23
23
years of professional experience

Work History

Operations Manager - Pharmaceutical

Rx Outreach
02.2016 - 09.2018
  • Managed day to day operations of data entry, phone pharmacy, and customer service representatives
  • Provided mentoring and coaching to supervisors, leads, and representatives
  • Reported data of all operational metrics to senior leadership weekly
  • Lead interviewer to attract and retain staff with goal of providing exceptional customer service
  • Effectively evaluated performance and capacity to meet all standards of the organization.

Customer Service/Claims Supervisor

Lumeris/Essence Healthcare
10.2018 - 05.2024
  • Managed inbound and outbound customer service representatives
  • Provided mentoring and coaching to all front-line staff
  • Owned critical reporting and data, communicating key data to leadership daily
  • Interviewed and hired employees and managed all aspects of payroll processing
  • Evaluated performance and communicated expectations to all customer service staff
  • Assisted with escalated client, member or provider issues, driving swift resolution.
  • Built talented teams of 30 claims administrators dedicated to timely and compliant resolutions.

Senior Lead Account Manager

Express Scripts, Inc.
06.2012 - 01.2015
  • Managed a team of account managers, supporting and mentoring the team
  • Daily interactions with clients, providing rapid issue resolution
  • Accountable for new business operations and implementation activity
  • Facilitated internal and external meetings with multiple clients and staff members
  • Participated in Quarterly Business Reviews and audits as needed
  • Monitored service trends and reporting to clients
  • Partnered with Sales, IT, Operations, and Quality to execute on key client deliverables
  • Built and maintained critical client relationships to grow business and upsell product lines.
  • Streamlined communication between clients and internal teams for efficient problem-solving and project execution.

Call Center Manager - St. Louis/Orlando Operations

Express-Scripts
05.2001 - 05.2012
  • Effectively managed daily operations of the Call Center for Healthbridge and the Pharmaceutical division
  • Led and motivated a direct staff of 9 supervisors and an indirect staff of 150 customer service/insurance verification representatives, providing frequent feedback on performance and areas for development
  • Managed the satellite offices in Indianapolis, Indiana and Lake Mary, Florida
  • Participated in implementations for new patient assistance programs and lines of business
  • Represented department on strategic projects, task forces and committees for operational improvement initiatives
  • Assisted senior management in developing/implementing strategic processes to meet service goals
  • Selected by executive management to be the project leader for key program changes
  • Managed relationship with key external clients resulting in key strategic initiatives
  • Participated in client audits and business review visits
  • Effectively worked cross functionally with internal business units (specifically Account Management, Implementation, Training, and Production) to continuously deliver quality service and to exceed clients' expectations
  • Led implementation of call monitoring quality program and audit process to ensure client service standards were met
  • Workforce management focused, often shifting staff to address call volumes in multiple queues
  • Analyzed program data and provided digestible information to account management
  • Worked with Director to develop and manage annual budget, including merit/bonus recommendations and expense control
  • Acted as liaison with HR/Recruiting, scheduled job fairs, and interviewed internal and external candidates for open positions
  • Led quarterly department focus groups to identify opportunities to improve service and increase employee satisfaction.
  • Proactively identified opportunities for process improvement, leading initiatives that resulted in increased productivity and reduced costs within the call center operation.
  • Managed budgetary responsibilities while maintaining adequate staffing levels, securing necessary resources without compromising operational efficiency.

Education

Credits earned towards Associate Degree with Goal to obtain BA Degree -

UMSL University
St Louis, MO

Some College (No Degree) -

University of Missouri - St Louis
St Louis, MO

Skills

  • Problem-Solving
  • Team Leadership
  • Operations Management
  • Customer Service

Timeline

Customer Service/Claims Supervisor

Lumeris/Essence Healthcare
10.2018 - 05.2024

Operations Manager - Pharmaceutical

Rx Outreach
02.2016 - 09.2018

Senior Lead Account Manager

Express Scripts, Inc.
06.2012 - 01.2015

Call Center Manager - St. Louis/Orlando Operations

Express-Scripts
05.2001 - 05.2012

Credits earned towards Associate Degree with Goal to obtain BA Degree -

UMSL University

Some College (No Degree) -

University of Missouri - St Louis
Michael Anderson