
Kimberly Pope
Critical Care Enrollment Specialist
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About
Driven and empathetic business operations professional with more than 18 years of experience supporting insurance enrollment, patient scheduling, healthcare technology implementations, operational training, and cross-functional stakeholder engagement within UnitedHealthcare and Optum. Proven track record of managing complex enrollment processes, collaborating with members and internal business partners, and resolving operational challenges across the healthcare continuum. Recognized by peers and management for exceptional information retention.
Experience leading customer onboarding, insurance enrollment initiatives, change management efforts, workflow optimization projects, and process improvements driven by customer feedback and evolving industry requirements. Demonstrated ability to uphold federal compliance standards while improving operational efficiency and enhancing customer experiences. Skilled in building strong stakeholder relationships, managing competing priorities, and delivering successful outcomes in fast-paced healthcare environments.
Expertise includes EDI enrollment processes, payer operations, healthcare workflows, member scheduling, operational support, training, and large-scale team collaboration.
Experience
Critical Care Enrollment Specialist at UnitedHealthcare/ UMR (2025 – Present)
- Promoted care management programs to members, driving engagement and averaging 3 to 8 accepted appointments daily.
- Synthesize information from multiple systems and resources to help members make informed healthcare decisions and address complex health concerns.
- Partnered with cross-functional teams and business partners to resolve member issues, coordinate solutions, and improve service outcomes.
- Ensured accurate documentation and record maintenance while adhering to HIPAA, organizational policies, and federal compliance requirements with 100% accuracy.
- Navigated sensitive member interactions with empathy and professionalism, fostering trust while maintaining confidentiality and regulatory compliance.
- Selected as a Culture Ambassador, supporting employee engagement initiatives, strengthening team collaboration, and promoting organizational values.
Senior Electronic Data Enrollment Analyst at UnitedHealthcare/ Optum (2007 – 2025)
- Research and resolve complex member eligibility, enrollment, and benefits issues. Had extensive knowledge of payer processing procedures for hundreds of different insurance programs.
- Consistently month over month had 100% customer satisfaction, often receiving perfect score.
- Worked with multiple ticketing systems including Salesforce, Vantage, and SAP.
- Multi-tasked daily taking an average of 25 incoming customer calls, while still performing other duties such as contract processing, and payer follow-ups.
- Was a part of multiple acquisitions and business merger projects. Within 17 years, I was a part of 10 acquisitions and mergers. Help integrate systems between the organizations.
- Was part of a team of 7 people that continually increased enrollment processing numbers, using automation, and adjusted processing times taking into consideration quarterly changes.
- Performed weekly follow-ups on an average of 1000 contracts per week using phone, email, and website checks.
- Took calls and chats for multiple lines of business simultaneously. Providing enrollment services for small physician offices to large nationally recognized hospital systems.
- Coordinated onboarding activities and provided training, coaching, mentoring, and knowledge transfer for new hires and existing staff, both onshore and offshore.
- Collected information, documented findings, tracked issues, and coordinated solutions across multiple business areas. Often working up to 20 customer cases per day, while still taking customer calls, and performing follow-ups on customer contracts.
- Showed initiative by volunteering for projects related to process improvement with other teams.
- Built strong partnerships across departments. Worked closely with Payer Implementations, other Support teams, Developers, and managers from other teams, to develop new lines of business and resolve complex customer issues.
Assistant manager at Carlos O’Kelly’s Mexican Cafe (1999 – 2007)
- Participated in startup operations for a new restaurant location.
- Coordinated recruitment, interviewing, onboarding, and training of newly hired employees.
- Managed employee schedules and operational readiness activities.
Education
Master of Arts in Organization Communication – University of Dubuque (2015)
Bachelor of Arts in Double major: Business and Philosophy – Loras College (2004)
