Verenise Zermeno
La Habra,CA
Summary
I am a people-focused professional driven to create positive business impact through continuous improvement and strategic problem-solving. With a strong background in leadership, team building, and communication, I excel at guiding teams to overcome challenges and deliver results. I thrive on building meaningful relationships, fostering collaboration, and implementing solutions that drive growth. Passionate about empowering others and exceeding goals, I combine analytical thinking with practical execution to help both people and business succeed.
Overview
6
6
years of professional experience
Work History
Member Experience Manager
VIVIO
01.2023 - Current
- Improved individual KPI attainment by 18% in the first year through targeted coaching, QA audits, and structured feedback practices.
- Increased QA compliance by 15% via refresher trainings, call calibrations, and enhanced scoring criteria.
- Reduced escalations by 22% by standardizing escalation pathways and member resolution scripts.
- Assisted in the hiring and onboarding process by screening candidates, coordinating training, and supporting new hire integration.
- Assisted in developing workflows, creating SOPs, and enhancing ticket management processes to support operational efficiency and consistency.
- Collaborated with Operations, Clinical, Product, and Engineering teams to support pharmacy and benefit implementation launches with zero service interruptions during go-live.
- Prioritized, tracked, and validated system defects using Jira, accelerating resolution cycles and enhancing member experience.
- Built and maintained reporting dashboards for QA, SLAs, and volume trends used by leadership for resource planning and decision support.
- Managed payroll, schedules, and PTO requests for 15+ employees with 100% compliance against payroll deadlines and internal policies.
Member Experience Supervisor
VIVIO
01.2022 - 01.2023
- Managed a team of 15, fostering a positive and motivated work environment while consistently meeting client expectations.
- Monitored employee performance and safety, implementing retraining programs to correct issues and optimize productivity.
- Established and communicated clear goals, aligning team efforts and promoting collaboration and accountability.
- Coordinated with internal departments to streamline operations and maximize efficiency across production and administrative functions.
- Analyzed member feedback to identify trends, driving improvements in service offerings and operational processes.
Team Lead
VIVIO
01.2021 - 01.2022
- Coached team members on job-specific techniques, improving efficiency and performance
- Mentored new hires, providing guidance on best practices, company policies, and delivering exceptional customer service.
- Managed team schedules, approved time-off requests, and ensured adequate coverage for all shifts.
- Drove positive organizational change through strategic thinking, innovative solutions, problem-solving, and consistent leadership.
- Oversaw opening and closing procedures and monitored shift transitions to ensure smooth operations and business success.
Care Concierge Representative
VIVIO
01.2020 - 01.2021
- Prior Authorization Processing: Accurately reviewing and submitting requests for medical services, procedures, and prescriptions to insurance providers.
- Insurance Verification & Eligibility: Confirming member coverage, benefits, and deductible status to ensure proper authorization.
- Medical Terminology Knowledge: Understanding clinical terms to interpret provider requests and patient records correctly.
- HIPAA Compliance & Patient Confidentiality: Maintaining strict adherence to privacy laws and organizational policies.
- Data Entry & Documentation Accuracy: Recording authorization requests, call notes, and member information with precision.
- Time Management & Multitasking: Managing high call volumes while ensuring accurate, timely processing of requests.
- Workflow Optimization: Identifying inefficiencies and implementing process improvements to increase team productivity.
- Escalation Management: Recognizing complex cases and routing them appropriately to ensure timely resolution.
- Provided exceptional customer service, addressing inquiries and resolving issues promptly.
- Collaborated with staff members to enhance customer service experience and exceed team goals through effective client feedback.
- Exceeded monthly performance metrics consistently, contributing to the success of the call center operations.
- Cross-trained and provided backup support for other departments within the company.
Education
Associates - Applied Science
Bryan University
Rogers, AR01.2015
Skills
- Healthcare Operations Member Experience Team Leadership Coaching & Development Training & Onboarding Hiring & Candidate Screening Workflow Development SOP Creation Ticket Management Systems Jira QA & Call Monitoring KPI Reporting Escalation Management Cross-Functional Collaboration Implementation Support Workforce Management
- Adaptability
Accomplishments
In 2023, I was honored with the 'Leading Through Change Award' for my contributions during the company’s startup phase. This recognition reflected my ability to navigate uncertainty, guide teams through evolving processes, and implement solutions that supported both operational growth and employee engagement. It underscored my commitment to leadership, adaptability, and driving positive outcomes during times of change.
LANGUAGES
English: Fluent
Spanish: Fluent
Timeline
Member Experience Manager
VIVIO
01.2023 - Current
Member Experience Supervisor
VIVIO
01.2022 - 01.2023
Team Lead
VIVIO
01.2021 - 01.2022
Care Concierge Representative
VIVIO
01.2020 - 01.2021
Associates - Applied Science
Bryan University