Summary
Overview
Work History
Education
Skills
Awards
Timeline
Generic

Sandra Smithson

Cold Brook,NY

Summary

Improve Operational Service & Delivery | Deliver Strategic & Operational Planning. Present monthly root cause trending across products to drive 35% improvement on complex issues. Driving knowledge transfer with clear actions. Motivated leader proven to meet commitments, facilitate and drive projects, leading diverse teams under aggressive timelines. Diligent with proven ability to manage and lead teams effectively. Successfully implemented process improvements that enhanced operational efficiency and team productivity. Demonstrated strong problem-solving and communication skills to drive team success.

Overview

21
21
years of professional experience

Work History

Operations Manager

MetLife Insurance
Oriskany, NY
01.2012 - 01.2025
  • Managed Long Term Disability, Short Term Disability, Absence Management, Life Claims, Waiver, Accidental Health, Critical illness, Dental and coordination of Workers Compensation claims.
  • Prevent risk following ERISA guidelines.
  • Deliver customer commitments and high-quality claim decisions to include knowledge of actions by team and provide appropriate coaching and performance management to address discrepancies.
  • Manage team operating costs.
  • Build on process improvement with analysis of trending.
  • 80% improvement in claim processing with development of claim capture template.
  • Developed reporting with new web-based system to capture required State Regulation data.
  • Developed Quality Assurance controls for State Specific requirement resulting in 96% accuracy across team.
  • Full people management responsibilities, including hiring, terminations, promotions, performance and compensation, training and development.
  • Handle State Insurance Department filings, complaints and calls.

Unit Leader

MetLife Insurance
Oriskany, NY
01.2004 - 01.2012
  • Managed Short Term and Long-Term Disability, Absence Management for National accounts and Small Market accounts.
  • Work with customers to negotiate, arbitrate, and resolve issues, concerns and expectations regarding, process, service and performance guarantees.
  • Manage Risk and performance assigned to team and claim block consisting of over 1,000 open active files.
  • Project lead to include working with customer on Return-to-work efforts.
  • Present monthly results to customer showing trending and action items for improvements.

Supervisor/Trainer/Call Center

United HealthCare
Oriskany, NY
  • Medical coverage to include ICD9 and ICD10 coding.
  • Training 90 associates and leading associates to success.
  • Handling incoming irate callers for medical claims.

Education

High School Diploma - Online management learnings

Mohawk High School

Skills

  • Process improvement
  • Service Delivery
  • Strategic Operational Delivery
  • Inventory Management
  • Schedule Management
  • Collaborative Problem Solver
  • Manage Operating Cost
  • Manage Risk and Compliance (ERISA)
  • Performance Management
  • Customer Service

Awards

  • Center Stage, Top giver in recognition
  • Top score, For team engagement

Timeline

Operations Manager

MetLife Insurance
01.2012 - 01.2025

Unit Leader

MetLife Insurance
01.2004 - 01.2012

Supervisor/Trainer/Call Center

United HealthCare

High School Diploma - Online management learnings

Mohawk High School

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Sandra Smithson