David Grant is a Director in the Insurance Industry. He is a Strategic Thought Leader in Workflow Enhancement, BPI (busi...
DAVID B GRANT, M.A. Aurora, CO 80016 * 303-905-8816 *
[email protected] ARCHITECTING SUPERIOR CLAIMS PROCESSING SOLUTIONS PROVEN TO CONTAIN COSTS AND DRIVE PROFITABLE GROWTH Strategic Thought Leader in Workflow Enhancement, BPI (business process improvement), and Business Development
__________ ACHIEVEMENT SUMMARY __________ Overview: Focal point for national claims processing, post-disability return-to-work programming, operations management, and ROI analytics. For Cigna: Generated the transition maps that guided Great-West Healthcare's integration. Designed executive reporting dashboards for senior decision-makers. Developed and deployed claims processing and return-to-work best-practices while enhancing work-flow management. For Great West: Led major operational reengineering initiatives which: improved audit programming, disability case management & claims administration (including tax admin.), and ERISA and State compliance at multi-million dollar annual values. Increases in responsibility reflect several outstanding operations and business development contributions.
__________ CAREER HISTORY __________ CIGNA GROUP INSURANCE/ GREAT-WEST HEALTHCARE, Greenwood Village, CO
1997 - 2011
Cigna began integrating Great-West Healthcare Group Life & Disability book of business in April 2008. The operation acquisition was completed in July 2010. Great-West Healthcare was a division of Great- West Life and Annuity Insurance Company CIGNA CLAIMS SOLUTIONS AND BUSINESS DEVELOPMENT STRATEGIST (Aug. 2010-Jan. 2011)
Overview: Championed national accounts in delivery and follow up, implementation and ongoing service delivery, partnering in the role of Claim Organization Subject Matter Expert to those leading the steps of the process from Sales, Implementation, Account Management and Claims Team. REGIONAL CLAIMS MANAGER (April 2008-July 2010) Overview: Led streamlining and consolidation initiatives. Project managed acquisition integration while leading efficiency improvement initiatives for the claims unit. Served as subject matter expert for the full processual life cycle covering Group life insurance, LTD/STD (long- and short-term disability) claims and Group medical underwriting. Scope: As claims manager, directed a team of 5 unit managers (claims, Group Life, disability tax, LTD and STD, Group Medical underwriting, 1099 provider Maintenance Support), each with a staff of 2-12 professionals. Oversaw all aspects of claims administration, operations, compliance, and return-to-work and vocational rehabilitation program development. Achievement Highlights
Metrics--Consistently outperformed company targets of 99% accuracy for claims administration and customer service satisfaction (as measured by internal and external auditors). Transition Management--Project Manager for Cigna's integration of Great-West Healthcare Group Life and Disability claims and Group Life Medical Underwriting operations. Met all schedule and budget targets while running the department seamlessly. Business Development and Customer Service--Mediated interests between sales and claims departments to present dynamic finalist proposals. Provided potential and current customers with contract claim and administration advice, which enhanced customer retention and new business acquisition. GREAT-WEST GROUP LIFE AND DISABILITY CLAIMS OPERATIONS MANAGER (1998-2008) GROUP LIFE MEDICAL UNDERWRITING MANAGER (2004-2010) 1099 PROVIDER MAINTENANCE SUPPORT MANAGER (2006-2009) REHABILITATION SPECIALIST (1997-1998)
DAVID GRANT, PAGE 2
Overview: Steady increases in scope accorded on the basis of outstanding issue resolution
accomplishments. Served as Claims Organization subject matter expert; provided BPI guidance to Sales, Implementation, Account Management, and Claims teams. Led process standardization initiatives for LTD/STD, Disability Waiver and Group Life policy administration. Owned department claim procedures and compliance integrity. Scope: Directed up to 40-55 professionals (claims processors, auditors, unit managers, administrative personnel, and medical underwriters). Administered $3-$6 million budgets for three costs centers (claims, underwriting, 1099 support). Constantly led national strategic initiatives to improve claims and customer service unit performance. Achievement Highlights
Metrics--Developed a comprehensive claim audit program that resulted in 99%+ financial and procedural accuracy results for the 2000-2009 period. BPI--Established and implemented claims adjudication and call management policies and procedures that significantly improvement cost management. Developed and implemented a comprehensive and dynamic reengineering of the 1099 Provider Maintenance Support unit. The changes implemented to the operations procedures resulted in the company establishing IRS compliance and avoiding potential fines exceeding $1 million dollars. Business Development--Continuously explored new ways to provide service that consistently exceeded expectations of consumers and policyholders while increasing corporate transparency at all decision-making levels. Operations/M&A Leadership--Coordinated responses to over 30 Department of Insurance audits; in each case, incurred no fines or penalties. Primary business manager for two life/disability claim acquisitions by the healthcare division; simultaneously led streamlining and integrating initiatives while consolidating locations. Served as IT resource and contact point for all claims aspect of FACETS, the new claims administration system; Coordinated various systems tests to ensure accuracy of data. Directed the case management and vocational rehabilitation vendor and services program resulting in focused and successful return to work and stay at work outcomes. Professional Development--Mentored over 10 junior managers and professionals, the vast majority gaining promotion. Generated comprehensive medical underwriting manuals. Developed the enterprise-wide audit program to ensure industry standard procedures and compliance. INTRACORP, Denver, CO
1986 - 1997
Managed care subsidiary of Cigna. DISTRICT MANAGER (1991-1997) REHABILITATION SUPERVISOR (1988-1991) REHABILITATION SPECIALIST (1986-1988) FT. LOGAN MENTAL HEALTH CENTER, Denver, CO
CLINICAL THERAPIST
1982 - 1986
__________ PROFESSIONAL DEVELOPMENT __________ Education: Master of Arts in Rehabilitation Counseling (1982) and Bachelor of Science in Rehabilitation &
Related Services (1979), University of Northern Colorado, Greeley. Accreditation: Certified Rehabilitation Counselor 1990-2000. International Claims Association Life
Claims Committee delegate 2005-2007
