Whitney Kemp
Schwenksville,PA
Summary
Talented professional considered knowledgeable leader and dedicated problem solver. Brings 25 years of valuable expertise to forward company objectives. Attentive to detail with experience in coordinating projects, programs and improvements.
Overview
33
33
years of professional experience
Work History
Medicare Compliance Advisor
Cigna-HealthSpring
06.2022 - 11.2023
- Built and maintained relationships with clients to provide ongoing support.
- Facilitated communication and collaboration between departments to help business function smoothly.
- Managed annual CMS Readiness Checklist process to ensure the Plans readiness for the new benefit period by reviewing attestations for completeness.
- Coordinated with Business areas to maintain performance data for Compliance scorecards.
Senior Field Trainer
Cigna-HealthSpring
05.2020 - 06.2022
- Provided coaching and mentoring to employees.
- Trained and mentored 75 new personnel hired to fulfill various roles.
- Developed lesson plans, instructional materials and written practice tests for Medicare Appeals Analysts, Up Skill/Conversion and Regulatory training courses.
- Facilitated virtual, in-person and blended learning sessions.
- Established and maintained quality control standards.
- Analyzed and evaluated training effectiveness and program outcomes.
Project Management
Aetna, Inc.
01.2016 - 05.2020
- Responsible for leading and managing all aspects of a project and program which includes planning, coordination, and development as well as implementation while prioritizing work, resources and time
- Ensures the end results of the project and business operations meet Aetna’s objectives and that all deliverables and due dates are met
- Tracks progress and communicates project status on a regular basis to all impacted parties
- Responsible for providing input on business plans to achieve business goals
- Proactively leads assigned project by creating project timeline, identifying key milestones and additional resources needed to successfully complete the work
- Assists with the management of internal relationships, processes and performance which includes working relationships external providers and vendors
- Negotiates to obtain additional resources
- Completed quality audits for Medicare complaints
Supervisor Medicare Complaints & Appeals
Aetna, Inc.
09.2012 - 01.2016
- Managed team of 15-20 analysts
- Conducted team meetings to disseminate information updates on internal Policies and Procedures as well as CMS regulation updates
- Monitored team and individual performance by reviewing reports
- Participated in CMS audits of Grievance universes
- Built strong functional teams through formal training, diverse assignments, coaching, mentoring and other development techniques
Manager Precertification Call Center
Aetna, Inc.
11.2008 - 09.2012
- Managed 4 Supervisors and a Call manager
- Communicated performance and productivity expectations and helped balance workload to achieve site operational goals
- Responsible for the overseeing the operations of the call center that operated 24 hours ,7 days a week
- In Bound call operators responsible to take calls from members and providers to obtain prior authorization for medical care
- Achieved Employee Opinion Survey results Employee Engagement Index = 89% favorable; Diversity Index = 89% favorable; Manager Effectiveness Index = 94%
- Served as an I-9 Champion for Blue Bell location
Customer Service Supervisor
Aetna, Inc.
11.2000 - 11.2008
- Managed team of 15-20 employees
- Disseminated information in a variety of mediums to ensure employees were provided the most current and up to date policies and procedures
- Maintained tracking for employees performance such as Quality, Schedule adherence, Attendance and Average Handle Time
- Complete scorecards, document behaviors, complete observations of performance, and analyze areas of strength and opportunities
- Participate in Provider network calls to address any issues regarding the Provider Call Center such as education on specific work flows or system usage i.e
- Strategic Contract Manager
- Collaborate with departments that directly impact the level of service we provide to the Provider community
- Serve as back up to Manager in their absences by handling escalated matters addressing service issues, planning daily strategies to meet Call Center key performance measures (calls and correspondence), analyzing lost time and creating a common understanding of the effects on the business on local and national levels
Customer Service Trainer
Aetna, Inc.
06.1998 - 11.2000
- Instructed new hire employees in understanding Health insurance
- Trained new hire Customer Service Representatives on all Aetna systems required to field calls, utilize online reference tools and effective assist customers
Customer Service Representative
Aetna, Inc.
03.1993 - 06.1998
- Served as single point of contact for American Express account
- Fielded 60-75 calls per day coverage questions, explaining claim determinations
Claim Processor
Aetna, Inc.
11.1990 - 03.1993
- Adjudicate claims including Medical, Dental, Medicare secondary & Flexible Spending Accounts
Education
High School Diploma -
Reading Senior High School
Reading, PA06.1984
Skills
- Leadership
- Productivity Improvement
- Risk Management
- Project Tracking
- Project Planning
- Compliance Monitoring
- Staff Management
- Communication
- Team Management
- Collaboration
- Data Driven Decision Making
- Critical Thinking
- Resource Development
- Training and Facilitation
- Application of Industry Policies and regulations
- Building Consensus
- Employee Engagement
Timeline
Medicare Compliance Advisor
Cigna-HealthSpring
06.2022 - 11.2023
Senior Field Trainer
Cigna-HealthSpring
05.2020 - 06.2022
Project Management
Aetna, Inc.
01.2016 - 05.2020
Supervisor Medicare Complaints & Appeals
Aetna, Inc.
09.2012 - 01.2016
Manager Precertification Call Center
Aetna, Inc.
11.2008 - 09.2012
Customer Service Supervisor
Aetna, Inc.
11.2000 - 11.2008
Customer Service Trainer
Aetna, Inc.
06.1998 - 11.2000
Customer Service Representative
Aetna, Inc.
03.1993 - 06.1998
Claim Processor
Aetna, Inc.
11.1990 - 03.1993
High School Diploma -
Reading Senior High School
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