Tammy Schultz
Milwaukee,WI
Summary
Strategic and results-oriented leader with over 20 years of experience in call center operations within the health insurance and managed care industries. Expert in driving business growth, developing high-performing teams, and implementing cost-saving process improvements. Adept at provider network development, contract negotiations, and managing third-party vendors. Proven track record in achieving operational excellence and enhancing customer satisfaction with both member and provider lines of business.
Overview
29
29
years of professional experience
1
1
Certification
Work History
Business Owner
T & C Consulting
12.2022 - Current
- Consulted with customers to assess needs and propose optimal solutions.
- Delivered exceptional results under tight deadlines by prioritizing tasks effectively and delegating responsibilities appropriately throughout the team.
- Trained and motivated employees to perform daily business functions.
- Increased client satisfaction by implementing innovative business strategies and streamlining processes.
- Optimized workflow by analyzing operational data and implementing process improvements.
- Performed statistical analyses to gather data for operational and forecast team needs.
- Spearheaded community outreach efforts to enhance brand awareness among local customers and stakeholders.
- Fostered an inclusive workplace culture that valued diversity, collaboration, and continuous learning.
- Interacted well with customers to build connections and nurture relationships.
- Handled problematic customers and clients to assist lower-level employees and maintain excellent customer service.
- Assisted in recruiting, hiring and training of team members.
- Trained and guided team members to maintain high productivity and performance metrics.
- Observed each employee's individual strengths and initiated mentoring program to improve areas of weakness.
Member Services Department Manager
Common Ground Healthcare Cooperative
03.2023 - 07.2024
- Day to day operational oversight of Member Services with direct leadership of operational, project, training and quality specialists as well as all member services representatives
- Partner closely with Chief Administrative Officer to ensure overall department and business success
- Rebuilt and reshaped department to achieve KPI goals during Open Enrollment and going forward
- Manage, analyze, improve and maintain service procedures, policies, goals and standards that align with service and employee experience goals
- Ensure quality review and coaching programs analyze greatest number of contacts with least efforts and most meaningful analysis
- Coordinate onboarding of new hires to include facilitation of recruitment, access, and onboarding to ensure those candidates with best skill and cultural alignment receive a positive and successful onboarding experience
- Provides leadership, development, and coaching to staff that provides supportive environment; build and maintain success plans across roles
- Serve are a voice of staff and voice of members
- Consistently demonstrating a passion and aptitude for supplementing high touch service with innovation self- service options that customers desire
- Modeling the organizational culture and values including transparent reflection and celebrations
- Implementation of virtual operations for business continuity plan that ensures goal attainment
- Proven track record of success in development of front-line staff and leaders
- Ensure effective and consistent communication throughout the team, encourage feedback and customer insight to enhance the customer experience
- Identify and instill best practices, processes and systems and drive a continuous improvement environment in the contact center.
- Collaborated with other departments to ensure seamless coordination in achieving company-wide objectives.
- Improved customer satisfaction rates through attentive service, prompt issue resolution, and continuous process improvements.
- Maintained a professional work environment by addressing conflicts proactively and fostering open communication among staff members.
- Established clear performance expectations for staff members which led to increased accountability.
- Evaluated employee performance fairly and accurately, rewarding hard work while addressing areas needing improvement.
- Implemented cross-training initiatives for employees, increasing overall departmental knowledge and versatility.
- Enhanced department efficiency by streamlining processes and implementing time-saving strategies.
- Optimized scheduling practices to ensure adequate staffing during peak business hours without sacrificing employee satisfaction or budgetary constraints.
- Introduced new methods, practices, and systems to reduce turnaround time.
- Led a team of professionals to consistently achieve or exceed performance targets.
- Managed projects efficiently from inception to completion ensuring timely delivery within budget constraints.
- Reduced process bottlenecks by training and coaching employees on practices, procedures, and performance strategies.
- Maintained positive customer relations by addressing problems head-on and implementing successful corrective actions.
- Recruited, interviewed and hired employees and implemented mentoring program to promote positive feedback and engagement.
Provider Relations Manager
Humana
08.2005 - 03.2023
- Day to day responsibilities include quality interactions with providers nationwide negotiating contracts, process improvement and efficiency improvement in way we do business
- POC for all vendors in call handling, provider data updates, provider grievances and CMS audits
- Provider Issues resolution and relationship management with large facilities throughout US
- KPI attainment of department goals at 99% for 5 years and running
- Given STAR Award for project management
- Of outreach to hurricane affect providers after hurricane Micheal
- Implementation of misroute provider call reduction project to save 15k monthly
- IT project execution of automation of CRM case from incoming emails
- Revenue saving 1.5 million over 2 years
- Selected out of 50,000+ employees to attend pilot program training at Disney Institute to unveil Perfect Experience annual summit
- Then, MC and facilitator for 2000+ attendees for PX Summits
- Creation and execution of Coaching for Results (CFR) to raise NPS score by 17%
- Lean project established to create CFR database results to track and graph associate performance
- Avaya phone switch implementation
- New Humana systems roll outs of CRM, CCP, Single point, APEX, P@AG, Mentor and CIS
- Start-up of offshore vendor program for 'Provider Simplicity' project
- Manage 3rd party vendor, Zelis, for employer group claims processing
- Growth revenue doubled during tenure
- Primary player in provider communications for HEDIS / Star rewards and call handling with providers
- Communication project implementation during AEP
- Created and administered department SharePoint site
- Development of significant provider processes call handling guide for each of 27 market offices in US and Puerto Rico to create reduction in AHT by 220 seconds
- Corporate mentor and facilitator for new leaders
- Put into practice Provider Self Service Contracting (PSSC) web tool to reduce call volume by 12%
- Revamp quality program and creation of quality form and database for trend tracking.
- Provided exceptional support to healthcare providers during times of transition or crisis, resulting in minimal disruption to patient care delivery and maintaining high levels of satisfaction among partners.
- Developed comprehensive reports highlighting trends and performance metrics of providers, enabling informed decision-making at all levels of management.
- Served as a liaison between healthcare providers and internal departments such as claims processing or customer service, facilitating effective resolution of any issues that arose during day-to-day operations.
- Improved provider satisfaction through the development and implementation of targeted training programs for staff on provider policies and procedures.
- Promoted a culture of continuous improvement within the provider relations team, regularly soliciting feedback from healthcare providers and incorporating suggestions into strategic plans.
- Developed standard operating procedures for the provider relations department, leading to increased efficiency and consistency across all functions.
Account Manager
Imperial Supplies
01.2004 - 01.2005
- Develop area regional territories for nationwide distributor of small maintenance parts
- Daily maintenance and touch base of clients
- Meet and exceed new business and overall sales quotas by 5% month over month for 8 months.
- Increased client satisfaction by building strong relationships and addressing their needs promptly.
- Managed a diverse portfolio of accounts, ensuring timely communication and effective problem resolution.
- Conducted regular account reviews to identify areas for improvement and ensure continued success.
- Used analytical skills to track and report on account performance metrics, providing insights for future growth opportunities.
Senior Account and Operations Manager
APAC Customer service
01.1996 - 01.2004
- POC for all aspects of several inbound teleservices' programs on remunerative accounts for Blue Cross Blue Shield Association, New Jersey, Alabama and California
- Implementation and development of new processes and procedures on fast-paced new technology, product knowledge- based accounts as stated above
- Develop monthly, quarterly and annual budgets and forecasts
- Contract negotiations & KPI attainment
- Complete understanding of claims, benefits, precertification’s, and Medicare programs within health insurance client
- Reporting, statistical information, and trend projections for the past, present and future for clients and staff, based on marketing information and historical data
- Manage and train processes for performance improvement and support operational development on upper management and entry management positions
- 350 employees with 25+ direct reports on several multi-faceted programs
- Develop and maintain relationship as point of client contact for internal and external information
- Identify growth potential within existing programs and improve performance
- Attained highest bonus payout for growth performance
- Monitor Quality Assurance and Data Processing for continuous process improvements.
Education
Associate of Arts - Radio And Television Broadcasting
Brown Institute
Minneapolis, MN05.1992
Skills
- Strategic Leadership
- Business Development
- Operational Excellence
- Change Management
- Relationship Building
- Stakeholder Management
- Quality Assurance & Compliance
- Value Initiatives
- Project Management
- Process Improvement
- Team Development & Coaching
Work Availability
monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
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Timeline
Member Services Department Manager
Common Ground Healthcare Cooperative
03.2023 - 07.2024
Business Owner
T & C Consulting
12.2022 - Current
Provider Relations Manager
Humana
08.2005 - 03.2023
Account Manager
Imperial Supplies
01.2004 - 01.2005
Senior Account and Operations Manager
APAC Customer service
01.1996 - 01.2004
Associate of Arts - Radio And Television Broadcasting
Brown Institute
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