Peter Heddles
Elkmont,AL
Summary
Accomplished Operations Manager with a proven track record at West Corporation, enhancing efficiency and optimizing processes through expert data analytics and effective operations management. Skilled in leading cross-functional teams and driving organizational change, significantly improving key performance indicators and stakeholder relations.
Overview
29
29
years of professional experience
Work History
Senior Business Process Analysts
Optum Insight
01.2023 - Current
- Designed and developed multiple levels of reporting for management and directors to provide insight into operational key performance indicators
- Review productivity and quality trends impacted by scoring among the teams, identified variances, and implemented initiative-taking solutions to mitigate risk
- Built database scripts and created unique business tools using excel to assist with managing execution of Quality taskings
- The analyses generated helped optimize turnaround times for additional coaching, identify gaps in processes, and incorporate feedback from operational, financial and QA reports, to improve performance
- Created Standard Operating Procedures and Job Aid controls the technical processes within the organization
Supervisor, Medical and Clinical Operations
Optum Insight
Franklin, USA
01.2013 - 01.2023
- Manage multiple projects during tenure
- HCC Medicaid, ACA, RACCR, Commercial projects and Computer Aided Coding projects
- Designed reports utilizing SQL, Excel, Access, and Tableau
- Reporting created were utilized to track inventory and production trends
- Train and mentor new supervisors with daily reports and responsibilities
- Manage team workflow to avoid possible negative impacts for stakeholders
- Participated in continued training above required courses
- Manage the production team by utilizing reporting and HR policies to ensure legal compliance, production goal and employee interactions
- Built database scripts and created unique business tools utilizing excel to assist with managing inventory and deadlines
- Assisted in identifying gaps in coding processes, and incorporate feedback from operational, financial and QA reports, to improve performance
- Authorized training manuals/job aids to support supervisors and the personnel assigned to their teams
- Created Standard Operating Procedures and Job Aid controls the technical processes within the organization including Chart Operations
Operations Manager – United Health Care Call Center
West Corporation
Huntsville, USA
01.2006 - 01.2013
- Manage a team of two hundred individuals for an inbound telephone call center for healthcare insurance claims and benefits
- Monitored customer quality goals and investigated issues with customer inquiries, complaints regarding customer service, and provider surveys
- Trained customer service agents in corporate protocols for job duties adding interpersonal and people soft skills
- Designed and implemented monthly, quarterly, and yearly reports for departmental key performance indicators
- This was utilized in senior staff and client presentations
- Worked with management and IT to review and implement new software to include innovative programs and potential new clients
- Managed departmental budget including headcount, forecasting, payroll, and overtime allotment
Insurance Support Representative - Consultant
Huntsville Hospital
Huntsville, USA
01.2006 - 12.2006
- Hired to address AR dates
- Upon hiring date, the AR dates were at 190 days; within 5 months AR dates decreased to 42 days
- Which resulted in increased efficiency while driving increased revenue to the organization
- Assisted with the design and implementation of processes to support the new Code Tracking and Billing software roll out, reducing data entry errors causing rework, and medical claim refiling
Customer Service Supervisor
Blue Cross Blue Shield of Nebraska
Omaha, USA
01.1996 - 12.2005
- Managed multiple cross functional teams focused on customer service
- Call Center
- Written inquiries
- State Grievances
- State compliance
- Identified, investigated, and resolved customer inquiries related to benefit claims and approvals
- Trained new and existing employees on contract language for records handling and positive conflict resolution
- Oversaw compliance team to ensure state mandated grievance laws were followed and timely responses were provided for customer appeal cases
- Tracked, analyzed, and reported error types to include administrative errors potentially impacting financial liability
- Managed departmental budget including headcount, forecasting, payroll, and overtime allotment
Education
B.A. - Education
Iowa Western Univeristy
Council Bluffs, IA01.1996
Skills
- Efficiency Enhancement
- Enterprise resource planning
- Process mapping
- Requirements gathering
- Business analysis
- Data analytics
- Operations management
- Business continuity planning
- Gap analysis
- Collaborative Stakeholder Relations
- Business process reengineering
- Business case development
- Cross-functional team leadership
- Organizational change management
- Key performance indicators
- Service level agreements
- User acceptance testing
- Program management
References
Available upon request.
Timeline
Senior Business Process Analysts
Optum Insight
01.2023 - Current
Supervisor, Medical and Clinical Operations
Optum Insight
01.2013 - 01.2023
Operations Manager – United Health Care Call Center
West Corporation
01.2006 - 01.2013
Insurance Support Representative - Consultant
Huntsville Hospital
01.2006 - 12.2006
Customer Service Supervisor
Blue Cross Blue Shield of Nebraska
01.1996 - 12.2005
B.A. - Education
Iowa Western Univeristy
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