Kankanampati Krishnaveni

• A UnitedHealth Group Company), Hyderabad Process – RxCCR (Central Client Repository), Managed a team of 25- 35 people Most of them are Seniors and most tenured in the process (7-8 Years).
• In This pandemic situation Virtually managing the Team since.
• Ensure all deliverables are met and implement operations management frame work.
• Plan and execute capacity through managing resources and performance and thereby meet Bussiness related metrics.
• Maintain strong client relationship by meeting results, providing accurate and on time reporting, and meeting all commitments and deliverables.
• Accountable for client satisfaction in area of responsibility, against service level agreement, and ensures achievement of key performance indicators (like TAT, quality, production, Efficiency, Utilization etc.)/project milestones.
• Initiate and promote continuous improvement programs across sphere of influence.
• Provide guidance in the development of training curriculum for Operations personnel and approve individual training plans.
• Providing regular performance feedback and giving frequent formal and informal coaching sessions.
• Manage escalation process and ensure client satisfaction in issue resolution.
• Coach and help develop team members; help resolve dysfunctional behavior.
• Building and maintaining an effective Team environment.
• Schedule work for team and Coordinate with the Team to identify process improvement opportunities.
• Identifying areas of development and formulating individual development plans to achieve performance parameters within team.
• Monitored employee performance and enacted improvement plans, coordinated disciplinary actions or provided rewards.
• Established open and professional relationships with team members which facilitated communication, quickly resolving issues and conflicts.
• Forecasted business needs and scheduled employees to meet expected demands.
• Assisted established management staff with operational oversight, business development and process improvement strategies.
• Aligned team actions with company policies and industry standards.

• Managed team workload to reach production targets.
• Assigned various tasks to group members according to skills and experience to achieve maximum productivity.
• Developed process improvements and offered actionable solutions to correct recurring issues.
• Used advanced features of Microsoft Office to complete necessary reports for senior management review.

• Managing process quality for a span of 50- 100, mostly people who work on identifying discrepancies between medical records and billed services for complex and high value claims by identifying Up-coding, Unbundling, Duplication, and Misrepresentation of services.
• Administrative responsibilities as assigned. Handle sensitive information appropriately (HIPAA) and act in a fair and honest manner consistent with the company's code of conduct.
• Understand and implement the quality framework to ensure all deliverables are met.
• Understand and help implement operations management frame work.
• To maintain strong client relationship by meeting results, providing accurate and on time reporting, and meeting all commitments and deliverables.
• Accountable for client satisfaction in area of responsibility, against service level agreement, and ensures achievement of key performance indicators (like TAT, quality etc)/project milestones.
• Initiate and promote continuous improvement programs across sphere of influence.
• Provide guidance in the development of training curriculum for Operations personnel and approve individual training plans.
• Negotiating solutions, and anticipating/handling critical work situations.
• Providing regular performance feedback and giving frequent formal and informal coaching sessions
• Create an environment oriented to trust, open communication, creative thinking and cohesive team effort.
• Lead by setting a good example (role model) - behavior consistent with words.
• Assure that the team members have the necessary education and training to effectively participate on the team.
• Recognize and celebrate team and team member accomplishments and exceptional performance.
• Identifying solutions to improve the process and sharing best practices within the team.
• In absence of manager always handle the team with all sorts of managerial responsibilities
• Marked charts and graphs to record results and prepared and delivered presentations, training and briefings required by contract.
• Collaborated with senior management and business line management to identify and prioritize new concepts for development and launch.

• Devoted special emphasis to punctuality and worked to maintain outstanding attendance record, consistently arriving to work ready to start immediately.
• Quickly learned new skills and applied them to daily tasks, improving efficiency and productivity.
• Analyze benefit requests and secure all necessary data to ensure appropriate implementation based on applied logic of RxCLAIM (by SXC) pharmacy claim adjudication system.
• Work with Clinical Pharmacy to implement formulary updates and clinical programs in the pharmacy claim adjudication system.
• Develop client specific implementation plans and manage implementation processes in accordance with department protocol.
• Run queries out of the RxCLAIM adjudication system to secure all necessary information to implement plan requests.
• Develop and run macros in RxCLAIM to implement plan requests.
• Perform claim testing to ensure accurate claim adjudication.
• Maintain acceptable and appropriate quality levels and production turnaround times (TAT)
• Adhere to all documentation standards within the department.
• Assist with the development of process improvements for the department.
• Research and respond to all claims processing inquiries of Client Management, Clinical, and other internal department.

• Directed and controlled various benefit programs, including 401K, medical, dental and vision packages.
• Analyze benefit requests and secure all necessary data to ensure appropriate implementation based on applied logic of RxCLAIM (by SXC) pharmacy claim adjudication system.
• Run queries out of the RxCLAIM adjudication system to secure all necessary information to implement plan requests.
• Develop and run macros in RxCLAIM to implement plan requests.
• Perform claim testing to ensure accurate claim adjudication.
• Maintain acceptable and appropriate quality levels and production turnaround times (TAT)

Job Profile of previous roles: In Bits-Pilani Hyderabad Campus:.

• Worked as Project Research Scholar for 2 projects.
• One project was under the Guidance of Dr.
• Rajkumar Banerjee Scientist E1 of Lipid Science Technology Division, Indian Institute of Chemical Technology (IICT), and
• The other one was under the guidance of
• Dr.Suman Kapur, Dean, Research and Consultancy and Shri B.
• K.Birla and ShrimatiSarla Birla Chair Professor, Department of Biological Sciences, BITS- Pilani.
• Gathered, arranged and corrected research data to create representative graphs and charts highlighting results for presentations.
• Validated incoming data to check information accuracy and integrity while independently locating and correcting concerns.
• Completed exhaustive research into ETHANOLIC EXTRACT OF MANGIFERA INDICA SEED KERNEL AMELIORATE VISCERAL FAT VIA IMPROVEMENT IN LIPID METABOLISM IN HIGH FAT DIET INDUCED OBESE MICE using databases, physical records and digital resources.
• Gathered and organized information for research purposes.
• Wrote research papers, reports, reviews and summaries regarding the experiment.

PUBLICATIONS:

1. Publish a paper in the Journal of Pharmacy Research from Bits-Pilani related to “ETHANOLIC EXTRACT OF MANGIFERA INDICA SEED KERNEL AMELIORATE VISCERAL FAT VIA IMPROVEMENT IN LIPID METABOLISM IN HIGH FAT DIET INDUCED OBESE MICE”. Journal of pharmacy Research 2012,5(10),4974-4978

2. Published a paper in Journal of Pharmacy Research related to “entitle “EVALUATION OF ANALGESIC ACTIVITY OF ROOT EXTRACTION OF TALINUM PORTULACIFOLIUM”. Journal of pharmacy Research 2012, 5(8),4100-4102.

Involved procuring, dispensing, indenting drug, Educating and Training patients.

• Ran and presented public seminars to educate local residents about diabetes and heart disease.
• Dispensed medications and communicated with prescribers regarding therapeutic incompatibilities.
• Worked with automated dispensing systems and other pharmacy automation systems as required by department.
• Collaborated with colleagues, technicians and leading pharmacists in effective prioritization and filling of orders.
• Communicated potential issues and reactions to specific medications for patients ranging from children and teenagers to adults and geriatrics.
• Monitored ordering of pharmacy medication stock to maintain streamlined inventory and low overhead.
• Conducted blood pressure screenings and counseled patients on hypertension.
• Assisted patients with over-the-counter medication recommendations and responded to questions concerning drug interactions.
• Taught patients how to use medical devices such as glucose meters and oximeters.
• Supervised work of pharmacy clerk and technicians to optimize service quality and productivity.