Kristine Shiroma
Gloucester
Summary
Dynamic professional with extensive experience at UnitedHealthcare, excelling in client representation and analytical reasoning. Proven track record of enhancing provider satisfaction and fostering collaborative environments. Adept at managing complex caseloads and delivering exceptional service, ensuring timely resolutions and strong stakeholder relationships. Committed to continuous improvement and effective communication.
Professional advocate with legal knowledge and strong analytical abilities. Proven track record in client representation, legal research, and case management. Adept at collaborating with teams to achieve desired outcomes, adaptable to evolving needs. Skilled in negotiation, communication, and conflict resolution. Reliable and results-driven with focus on delivering impactful solutions.
Overview
25
25
years of professional experience
Work History
Senior Provider Advocate , Account Manager
UnitedHealthcare
10.2016 - 05.2025
- Worked effectively with fellow team members to coordinate effective solutions to any question or concern.
- Delivered friendly service and offered expert support in every interaction.
- Established trusting relationships with clients by maintaining open lines of communication throughout the entire representation process.
- Managed complex caseloads with diligence, prioritizing tasks to ensure timely resolution of cases.
Senior Provider Relations Representative
Neighborhood Health Plan
04.2008 - 10.2016
- Enhanced provider satisfaction by addressing concerns and resolving issues in a timely manner.
- Coordinated site visits for potential network partners, showcasing the value-adds and benefits of joining the company''s provider network.
- Organized various educational events to promote understanding of policies and procedures among providers.
- Provided exceptional customer service to providers during the credentialing process, ensuring a smooth experience for all parties involved.
Injury Claims Unit Manager
Progressive
06.2000 - 11.2008
- Developed strong relationships with key stakeholders such as policyholders, agents, attorneys, vendors, which facilitated smoother claim resolutions.
- Coordinated resources during high-volume or catastrophic events for efficient deployment of the claims team.
- Built an inclusive and supportive work environment that encouraged collaboration, innovation, and continuous learning within the claims unit.
- Fostered a culture of accountability within the unit by setting clear expectations and providing constructive feedback on performance evaluations.
Education
Masters Public Health Administration - Public Health
University of Massachusetts, Amherst
Amherst, MA01-2020
Bachelor of Science - Psychology
Arizona State University
Tempe, AZ05-1996
Skills
- Document review
- Analytical reasoning
- Resolution management
- Client representation
Timeline
Senior Provider Advocate , Account Manager
UnitedHealthcare
10.2016 - 05.2025
Senior Provider Relations Representative
Neighborhood Health Plan
04.2008 - 10.2016
Injury Claims Unit Manager
Progressive
06.2000 - 11.2008
Masters Public Health Administration - Public Health
University of Massachusetts, Amherst
Bachelor of Science - Psychology
Arizona State University
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