Kim Jones

Experience

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  Aetna

  Jan 1992 - Jun 2003

  Case Implementation/Project Manager

  Administered transitioning the Prudential HealthCare medical and dental business over to Aetna paper and systems. Assisted in converting more than 7.8 million medical and dental members from PHC to Aetna products and systems. Member of Regional Conversion Team responsible for managing and tracking lapse process. Coordinated all systems terminations for groups (straight and converted cases). Managed and distributed EIB (Electronic Issue Brief) request for Case Install generic accounts. Mentored new hires in Case Installation department. Managed full implementation of New Issues, Add Issues and major/complex plan changes and re-rates. Acting in conjunction with sales to obtain plan details from clients needed to install new cases. Oversaw all work, produced by the functional areas and managed any impacts or issues. Welcomed clients and communicated installation objectives. Maintained CITRS reports and conducted training for Account Management team. Responsible for implementing new employer groups (end-to-end) with medical, life and dental benefits. Customer Service liaison for new and existing clients (90-days post implementation). Conducted product and system training for new and existing employees. Developed relationships with Brokers and General Agents. Back-up resource for Account Managers, Rate Calculators and Underwriting. Managed underwriting for small group (AB1672) cases. Generated monthly and year-to-date logs and spreadsheets for all new cases sold. Show less

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  UnitedHealth Group

  Jun 2003 - May 2014

  Client Migration Manager

  Project Manager managing Renewal Rights transitions (Renewal Rights Entity-RRE). Fresh Start (Pharmacy) project member assisting with transitioning over 12 million UHC commercial pharmacy members and data sets from Medco to OptumRx. Tracking and monitoring the migration activity by wave for all UHG clients and their membership. Working various system reports in Migration Management Tool (MMT). Administer activities for Fresh Start daily command center calls. Managed, monitored and tracked daily IRAAD submissions. Lead, supported and managed the designated Acquisition or Alliance Partner for the United Platform initiatives to assure accurate and efficient migration and implementation of existing business cases on the Legacy platforms for front-end business set-up with minimal disruption. Implemented national initiatives that have a direct impact to customer implementation or migration. Facilitated readiness calls with internal partners. Key contact for all functional areas regarding readiness issues. Analyzed project impact and status. Member of Business Process Support Team (BPST) working closely with products, implementation management, and client implementation. Responsible for the coordination and completion of projects across various functional areas. Provided subject matter expertise, input to business requirements, policy & procedures, and Job Aids as needed for line staff. Responsible for conducting impact analysis, project management, writing process documents and newsletter articles related to new product/program, and system enhancements. Headed process change initiatives and administered front-end helpdesk inquiries. Reviewed current processes/programs, performed needs assessment and developed project plans. Developed communication and training related to project outcomes and coordinated implementation. Responsible for end-to-end business process activities creating, controlling and improving business processes. Show less

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  Health Insurance Company

  May 2014 - now

  Sr. Implementation/Project Manager (National Accounts)

  Manage/Administers the end-to-end installation of assigned National accounts. Build client structure,billing set up, eligibility collection, data base loading, ID cards, preparation of plan materials such as administrative documents and customer education materials. Provides implementation support to assigned National accounts by responding to inquiries or resolving issues of concern. Identifies areas of opportunities as well as process improvements throughout multiple processes and act upon changes needed. Facilitates timely case installation from end to end in partnership with business partners and downstream operational areas. Manage turnaround time frames based on metrics set for each functional area. Facilitate internal/external meetings.Maintains effective communication between Sales/clients/customers and internal downstream partners to ensure excellent customer service is provided at all times. Participates in projects related to area of operation. Mentor to new and/or existing employees on basic processes. Show less