Summary
Overview
Work History
Education
Skills
Languages
Timeline
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Michelle Leto

Tyler,TX

Summary

Operations Executive with 20+ years of experience leading multi-site operations. Professional business leader prepared for challenges of Senior Manager role. Combines deep understanding of business operations with commitment to driving team success and achieving significant results. Renowned for adaptability in dynamic environments and collaborative approach to problem-solving, leveraging keen analytical and decision-making skills.

Overview

13
13
years of professional experience

Work History

Senior Manager | Client Operations HP Benefits

CVS Health
06.2022 - Current
  • Oversight management Client Benefits
  • Leading complex implementations – Medicaid, Medicare, Commercial
  • Oversight of operational measures for Government Programs
  • Provided strong leadership to enhance team productivity and morale.
  • Led cross-functional teams to achieve project milestones and deliver high-quality results.
  • Established strong relationships with clients and stakeholders, ensuring long-term partnerships and repeat business.
  • Collaborated closely with peers from other departments to drive organizational success jointly as one cohesive unit.
  • Improved team performance by providing comprehensive training and fostering a collaborative work environment.
  • Mentored junior staff members for skill development and career progression within the organization.
  • Implemented and developed operational standards, policies and procedures.
  • Achieved operational excellence by streamlining processes and implementing best practices.
  • Balanced competing priorities efficiently while maintaining focus on critical tasks requiring immediate attention.
  • Conducted performance evaluations, compensations and hiring to maintain appropriate staffing requirements.
  • Increased customer satisfaction with timely project deliveries and seamless communication.
  • Executed appropriate staffing and budgetary plans to align with business forecasts.
  • Reviewed and analyzed reports, records and directives to obtain data required for planning department activities.
  • Consistently met or exceeded annual performance targets set by senior leadership.
  • Boosted team member productivity by enhancing performance monitoring and instituting motivational approaches.
  • Spearheaded change management efforts for seamless adoption of new systems or processes among employees.
  • Evaluated hiring, firing, and promotions requests.

Senior Manager | Coram Regional Admissions

CVS Health/Coram
09.2021 - 06.2022
  • Oversight management, Regional Admissions Team
  • Cross-functional oversight, 59 pharmacies
  • Improved team performance by providing comprehensive training and fostering a collaborative work environment.
  • Reduced costs, optimized resource allocation, and improved efficiency in managing projects.
  • Managed large-scale projects and introduced new systems, tools, and processes to achieve challenging objectives.
  • Implemented and developed operational standards, policies and procedures.
  • Conducted performance evaluations, compensations and hiring to maintain appropriate staffing requirements.
  • Reviewed and analyzed reports, records and directives to obtain data required for planning department activities.
  • Managed budgets effectively, achieving financial objectives while maintaining strict control over expenditures.
  • Evaluated hiring, firing, and promotions requests.
  • Improved team productivity by implementing agile methodologies, reducing project completion times and enhancing collaboration.

Senior Manager | HP Account Management

CVS Health
08.2018 - 09.2021
  • Leading complex implementations – Medicare and Medicaid
  • Cultivated relationship with a complex Health Plan Client
  • Manage a team of 28 Account Managers
  • Led cross-functional teams to achieve project milestones and deliver high-quality results.
  • Established strong relationships with clients and stakeholders, ensuring long-term partnerships and repeat business.
  • Improved team performance by providing comprehensive training and fostering a collaborative work environment.
  • Managed large-scale projects and introduced new systems, tools, and processes to achieve challenging objectives.
  • Mentored junior staff members for skill development and career progression within the organization.
  • Implemented and developed operational standards, policies and procedures.
  • Achieved operational excellence by streamlining processes and implementing best practices.
  • Demonstrated exceptional adaptability in navigating complex situations or rapidly changing environments with ease.
  • Conducted performance evaluations, compensations and hiring to maintain appropriate staffing requirements.
  • Increased customer satisfaction with timely project deliveries and seamless communication.
  • Implemented innovative solutions to overcome challenges, leading to enhanced productivity levels.
  • Executed appropriate staffing and budgetary plans to align with business forecasts.
  • Reviewed and analyzed reports, records and directives to obtain data required for planning department activities.
  • Championed process improvement initiatives that led to significant cost savings without compromising on quality standards.
  • Consistently met or exceeded annual performance targets set by senior leadership.
  • Drove adoption of new technology solutions, modernizing operations and improving operational efficiency.
  • Streamlined internal processes for financial reporting, ensuring accuracy and compliance with regulatory standards.
  • Enhanced team performance with regular coaching sessions, focusing on individual strengths and areas for improvement.

Manager | HP Account Management

CVS Health
09.2015 - 08.2018
  • Accountable for Account Management/Client Support including overall customer satisfaction
  • Managed team of 20 professionals
  • Spearheaded cross-functional initiative to achieve Prior Authorization Process Improvement
  • Rolled out launch of new Health Plan Client Support Team
  • Health Plan Lead for numerous cross-functional SWAT Teams, responsible for streamlining processes and procedures
  • Responsible for Operational and Administrative tasks
  • Developed and maintained positive interdepartmental relationships
  • Escalation point for complex inquiries
  • Lead RDS Workgroup, reorganizing/streamlining processes
  • Responsible for training New Hire Account Managers on several departmental functions.
  • Hiring Manager ensuring department success

Sr. Account Manager

CVS Health
09.2012 - 09.2015
  • 1st Chair, Government Account.
  • Responsible for Operational and Administrative aspects, Trending and Member Claim issues
  • New Program Implementation coordination
  • Ad hoc Reporting, Plan Design coordination and management
  • Project Management for Business Service Requests and Project Request Forms
  • HBO Presentations, and Audit Coordination
  • Develop operational initiatives in alignment with the account goals and objectives by promoting new products Escalation point for complex inquiries
  • Sales and Clinical Operations
  • Additional responsibilities: Benefit Administration, Eligibility, Customer Care, Finance, Underwriting, Pricing, Legal, Auditing, Marketing, Communications, Retail, Mail, and Specialty Pharmacy Operations
  • Developed long-lasting client relationships by providing exceptional customer service and support.
  • Analyzed data on client behavior patterns to inform future account management strategies, resulting in higher retention rates.
  • Performed effectively in self-directed work environment, managing day-to-day operations and decisions.
  • Gained customer trust and confidence by demonstrating compelling, persuasive and composed professional demeanor.

Education

Bachelor of Science -

Southwestern Assemblies of God University
Waxahachie, TX
05.1986

Skills

  • Medicare and Medicaid operations
  • Process Improvement
  • Strategic Planning
  • Project Management
  • Government Benefits
  • Risk Mitigation
  • Pharmacy Benefit Management
  • Operations Management
  • Cross-functional team coordination
  • Data-driven decision making

Languages

Spanish
Native or Bilingual

Timeline

Senior Manager | Client Operations HP Benefits

CVS Health
06.2022 - Current

Senior Manager | Coram Regional Admissions

CVS Health/Coram
09.2021 - 06.2022

Senior Manager | HP Account Management

CVS Health
08.2018 - 09.2021

Manager | HP Account Management

CVS Health
09.2015 - 08.2018

Sr. Account Manager

CVS Health
09.2012 - 09.2015

Bachelor of Science -

Southwestern Assemblies of God University

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Michelle Leto