Sharon Carter

Accountable for fully insured and self-funded customers in the 51-5000 employee commercial segment

• Manage over 150K members and 350 customers with medical, pharmacy, stoploss and ancillary products
• Exceeding retention budgets 8 of 9 years while achieving rate targets and cross selling products
• Cultivate strong relationships with brokerage firms and customers
• Partner with brokers and customers by analyzing data and reviewing program and network options
• Ability to influence and solve complex situations both internally and externally
• Foster collaboration with internal operations to continuously improve process and customer satisfaction
• Create proactive customer facing activities, templates and communications for account management team
• Developed high-performing teams by providing mentorship, guidance, and opportunities for professional growth.
• Established a culture of continuous improvement by fostering open communication channels and empowering employees to voice their ideas.

• Managed over 60K members and 400 self-funded cases in 51-500 employee commercial segment
• Developed renewal strategies driving retention and earnings result
• Built new processes for renewal delivery timeline to better manage workload, high volume and broker needs
• Exceeded retention results, top 20% of peer group and achieved Presidents Circle
• Developed high-performing teams by providing mentorship, guidance, and opportunities for professional growth.

• Managed over 28k members and 3,000 cases in Washington and Alaska including Association business
• Responsible for strategic direction of 2-99 segment to ensure net growth, persistency and profitability objectives are met in a rapidly changing environment
• Prior companies PacifiCare & Network Health Plan acquired by UnitedHealthcare
• Ensured compliance with relevant industry regulations by establishing thorough documentation processes and adhering to best practices in all aspects of small business management.

• Lead, implemented and deployed national and regional initiatives in thirteen markets, with over 1.4 million members that enabled the sales teams to increase sales and retention. Deployed Multi Choice product in four health plans leading to over 20,000 new members
• Developed, refined and streamlined policies and procedures to improve the performance of sales, account management and sales operations. Participated in cross-functional teams that improved California persistency by 20% over previous year results.
• Streamlined processes between sales, underwriting and installation in Arizona and Washington leading to fewer handoffs and a decrease in quote, underwriting and case installation turn around time

• Partnered with regional management and cross functional areas including product, pricing, underwriting, sales, finance, marketing and regulatory to develop programs, processes and operational efficiencies to ensure success of market objectives around profit, growth and retention strategies
• Developed business strategies to replicate the California General Agent service model to support the decision to sell business direct. The new model includes a multi carrier quoting tool, broker bonus program, continuing education program, no fee Cobra/PTP/FSA administration, broker service unit and a restructured sales service model
• Analyzed market trends to inform product development and sales strategies.

• Responsible for development and maintenance of all commercial products in Washington and Oregon executing a product strategy that evolved from a niche HMO to a broad product portfolio including PPO, SDHP, EPO, HDHP, PEAT Association resulting in exceeding profit and membership targets by over 150%.
• Refined the small group strategy by building the first Washington PacifiCare association/trust - PEAT enabling the company to compete in a market with 50% of the small group segment in associations and is now the leading product sold in Washington.
• Launched UnitedHealthcare products and services into the marketplace after having worked through acquisition filings, product selections, rating methodologies, processes and training
• Implemented innovative solutions to solve complex problems, resulting in increased productivity and streamlined operations.

• Led multiple projects to support the company business plan for Commercial and Medicare products including counties expansions and exits, process improvements and implementation of state and federal mandates

• Reviewed and responded to member appeals regarding benefit determinations, claims payments, and services issues

• Authorized inpatient and outpatient services per plan criteria, including maintaining documentation of files, correspondence and medical director reviews