Shamika Watts
Kansas City,MO
Summary
Motivated program supervisor adept at accomplishing program objectives through effective staff training and supervision. With demonstrated track record of achievement. Offering top-notch abilities in communication, relationship building and process improvements along with remarkable skill in creating and implementing programs of all sizes. Prepared to apply several years of experience in program operations.
Overview
11
11
years of professional experience
Work History
Program Supervisor
AssistRx
Overland Park, KS
02.2023 - Current
- Makes necessary changes in staffing based on day of week and other anticipated events
- Monitors productivity of customer service representatives and generates reports
- Monitors individual, team, and call center results to identify and act on both positive and negative performance trends to ensure attainment of revenue goals and performance targets
- Monitors service calls to observe employee demeanor, technical accuracy, and conformity to company policies
- Answers questions and recommends corrective services to address customer complaints
- Provides communication and follow up to ensure representatives are fully informed of all new information related to products, procedures, customer needs and company related issues, changes, or actions
- Determines work procedures, prepares work schedules and expedites workflow
- Studies and standardizes procedures to improve efficiency of direct reports
- Maintains collaboration among workers and resolves grievances
- Prepares composite reports from individual reports by direct reports
- Performs other related duties as assigned by management
- Directly supervises all employees within the Patient Solutions Program(s)
- Carries out supervisory responsibilities in accordance with the organization's policies and applicable laws
- Responsibilities include interviewing, hiring, and training employees; planning, assigning, and directing work; appraising performance; rewarding and disciplining employees; addressing complaints and resolving problems
- Managing a team of 60+ agents.
Supervisor, Care Navigation
Bright Health
Kansas City, MO
11.2019 - 12.2022
- Assist Care Navigation Reps with day-to-day processes
- Improve customer service by evaluating and re-designing processes and interactions
- Establish and communicate call center metrics and service levels to direct reports
- Monitor and analyze report results; implement changes as needed
- Monitor real time call volume
- Manage aux usage, monitor attendance to guarantee phone coverage
- Train, coach, counsel, and discipline employees; conduct one on one weekly/monthly individual and team meetings
- Conduct mid-year and yearly reviews
- Develop the department’s customer service procedures, policies and standards; handle customers’ escalations, investigate customer complaints; find solutions
- Participate in interviewing and hiring of incoming candidates
- Implementation of plans, processes, and procedures
- Working on escalated calls or emails
- Assisting Appeals and Grievances with finding INN providers/facilities
- Working closely with Appeals and Grievances on High priority cases
- Managing a team of 15+ employees.
Lead Medical Advocate
Aetna
Overland Park, KS
10.2018 - 11.2019
- Respond to and resolve on the first call, customer service inquires and issues by identifying the topic and type of assistance the caller needs such as benefits, eligibility and claims, financial spending accounts and correspondence
- Educate customers about the fundamentals and benefits of consumer-driven health care, guiding them on topics such as selecting the best benefit plan options, maximizing the value of their health plan benefits and choosing a quality care provider, filing and following up on appeals and grievances and advising of the status of appeals and grievances
- Taking Escalation calls, Sending/Receiving escalated emails
- Filing and following up on the status of Appeals and Grievances.
Consumer Services Specialist
UMB
03.2018 - 09.2018
- Taking inbound calls for members inquiring on balance inquiries, credit card inquires and fraud/ dispute claims.
- Interact with customers over the phone by accessing multiple systems in order to answer a variety bank related questions, provide information, resolve problems and cross sell appropriate products.
- Continue learning and maintaining skills through classroom training, self-paced online learning and the review of regular department communications.
- Performance will be measured based on call quality, talk time, cross sale success rate and demonstration of target competencies with monthly incentive opportunity.
- Other duties as assigned.
Medical Advocate
United Healthcare
07.2016 - 10.2017
- Respond to and resolve on the first call, customer service inquires and issues by identifying the topic and type of assistance the caller needs such as benefits, eligibility and claims, financial spending accounts and correspondence
- Educate customers about the fundamentals and benefits of consumer-driven health care, guiding them on topics such as selecting the best benefit plan options, maximizing the value of their health plan benefits and choosing a quality care provider
- Contact care providers (doctor’s offices) on behalf of the customer to assist with appointment scheduling or connections with internal specialists for assistance
- Assist customers in navigating uhc.com and other UnitedHealth Group websites while encouraging and guiding them towards becoming self-sufficient in using these tools
- Filing and following up on the status of Appeals and Grievances.
Fraud Specialist II
US Bank
Overland Park, KS
11.2013 - 07.2016
- Conduct thorough investigations of potential fraud cases, including gathering evidence, analyzing transactional activity, interviewing relevant parties, and documenting findings
- Collaborate with peers, internal departments, and law enforcement as necessary to investigate and resolve fraud cases
- Analyze transactions and other data sources efficiently to identify potentially fraudulent activities while maintaining high standards of quality
- Prepare and file Suspicious Activity Reports (SARs) in accordance with internal policies and procedures and the Bank Secrecy Act (BSA) and other regulatory requirements
- Become proficient in multiple different bank systems and Microsoft applications and research open-source intelligence to gather data and information to assist in fraud investigations
- Write clear and concise narratives to describe the summary of the fraud investigations so that an outside reader can understand the investigation findings
- Ensure SARs are complete and accurate and reported timely
- Maintain a comprehensive understanding of SAR filing guidelines, regulatory expectations, and stay updated on changes in fraud trends
Education
High school or equivalent -
Central Senior High School
01.2009
Skills
- Written and Verbal communication
- Conflict resolution
- Mentorship
- Time management
- Interpersonal skills
- Adaptability/ Client adaptability
- Reporting
- Integration
- Team Management
- Management
- Agility and Flexibility
- Strategic Planning
- Project Coordination
- Process Improvements
- Reporting Requirements
Accomplishments
- Superstar Supervisor award 2024
- Nominated within first 6 months of employment for value award
Timeline
Program Supervisor
AssistRx
02.2023 - Current
Supervisor, Care Navigation
Bright Health
11.2019 - 12.2022
Lead Medical Advocate
Aetna
10.2018 - 11.2019
Consumer Services Specialist
UMB
03.2018 - 09.2018
Medical Advocate
United Healthcare
07.2016 - 10.2017
Fraud Specialist II
US Bank
11.2013 - 07.2016
High school or equivalent -
Central Senior High School