HEALTHCARE OPERATIONS LEADER
I’m Patrice Chance, a healthcare operations leader with 15+ years across Medicare Advantage, Medicaid and CHIP, and commercial plans. I’ve launched two health plan contact centers, managed a $13M budget as a Director, and led service technology from IVR self-service to AI agent assist. Every regulatory review I’ve led since 2018 has had zero contact center deficiencies.
Open to Director-level healthcare operations and AI-enabled service transformation roles · Remote or Houston opportunities.
LEADERSHIP AT A GLANCE
Prior Director experience · Universal American, 2008–2014
Business leadership: I have led an RFP, negotiated a knowledge-platform contract, partnered on a Business Associate Agreement, coordinated technology and operations teams through testing and launch, and supported regulatory readiness and employer-client issue resolution.
Lines of business: Medicare Advantage · Medicaid / CHIP · Commercial, including fully insured and self-funded plans.
I participated in member fairs at Memorial Hermann Health Plan and Baylor Scott & White Health Plan. At Baylor Scott & White, I served on the Member Advisory Board representing contact center operations, meeting quarterly with members to discuss call trends, opportunities for improvement and ideas for better service.
This experience brought member perspectives into operational discussions alongside service data.
Ascension / Dell Children’s Health Plan · 2022–present
Manager, Customer Service Operations · Led the contact center build-out for approximately 60,000 STAR, CHIP and CHIP Perinate members; Genesys Cloud operations; zero-deficiency HHSC and URAC reviews.
Scott & White Health Plan · 2018–2022
Workforce Development Manager · FirstCare integration, knowledge redesign (quality 82% → approximately 94%), training and engagement.
Memorial Hermann Health Plan · 2014–2018
Manager, Customer Service Operations · Built the contact center from the ground up: design, launch training, backup BPO, QA and workforce planning; partnered on an approximately $20M budget.
Universal American · 2008–2014
Director, Customer Service Operations & Training · $13M budget, Nanorep RFP and contract, global BPO training, three CMS onsite audits.
01 / MY APPROACH
Healthcare operations is where strategy becomes someone’s experience.
My leadership begins with one question: Who are we here to serve? Members need access to care and clear answers. Providers need dependable support. Employees need the knowledge, tools, and confidence to do their work well.
Before any transformation project, I ask: What problem are we trying to solve? I listen to the people affected, examine the current process, and use data to understand the root cause. That understanding guides the solution, the definition of success, and how we measure progress.
I set clear priorities, align cross-functional partners, and establish ownership for execution. My work spans contact center operations, workforce development, client relationships, regulatory readiness, and service technology—balancing quality, capacity, compliance, and financial performance.
B.A. in Business Management
American Public University System
CAREER IMPACT
Selected outcomes from health plan operations, service transformation and regulatory readiness.
Memorial Hermann · Ascension / Dell Children’s Health Plan
2Built Memorial Hermann’s contact center from the ground up, including floor plan, launch training, QA, workforce planning and a backup BPO. Then led the contact center build-out for Dell Children’s Health Plan, covering hiring, training, knowledge management and QA guidelines.
Ascension / Dell Children’s Health Plan · 2025
+10%Recommended adult and new-member outreach through executive client MCO report-card workgroups. Partnered with Quality, Care Management and Provider Relations on outreach that contributed to a 10% increase in adult wellness visits.
Ascension / Dell Children’s Health Plan · 2025
+30%Analyzed provider survey feedback, identified claims escalation as a major concern and partnered with Claims leadership on a clearer dispute-escalation process. Service improvements helped deliver a 30% increase in provider satisfaction, with 100th-percentile results in key survey categories.
Memorial Hermann · Scott & White · Ascension / DCHP
ZeroLed contact center readiness, prepared agents and leaders for auditor interviews, and partnered with Compliance on audit preparation.
Zero contact center deficiencies in each listed review.
Memorial Hermann · 2016–2017 / Scott & White · 2020–2021
25% / 35%Provider IVR self-service resolved approximately 25% of provider calls at Memorial Hermann and 35% at Scott & White without agent contact, supporting claim-status, eligibility and prior-authorization inquiries.
At Memorial Hermann, I led requirements, call flows, testing, training and launch using the existing Cisco platform, partnering with Cisco and MH IT on delivery. The IVR connected to Facets; Scott & White’s solution connected to its internal CRM.
I monitored agent versus IVR volumes daily, including IVR-to-agent transfers and calls resolved in self-service, and produced monthly reports with quarterly and annual averages.
MH reporting covered August–December 2016 following launch and 2017; Scott & White reporting covered 2020 and 2021. Percentages are approximate reported results across those periods.
Memorial Hermann Health Plan · 2014–2018
$300KRedesigned Medicare Secondary Payer / Coordination of Benefits processes to deliver $300K in net improvement.
Memorial Hermann Health Plan · 2014–2018
−20%Redesigned provider service workflows and portal processes to reduce provider call volume by 20%.
Memorial Hermann Health Plan · 2014–2018
−10% / −15%Established an escalation unit that reduced member grievances by 10% and provider complaints by 15% in its first quarter.
Scott & White Health Plan · 2018–2022
82% → ~94%Led the SupportPoint knowledge redesign, separating member and provider content. Overall service quality rose approximately 12 percentage points, and internal compliance audits moved from monthly to quarterly.
Universal American · 2008–2014
13–15 → 7–9Redesigned Medicare training and workflows, reducing average handle time from 13–15 minutes to 7–9 minutes.
PEOPLE, QUALITY & EXECUTIVE INFLUENCE
Retained 70% of my original team since joining Ascension / Dell Children’s Health Plan in 2022. Employees hired in 2024 and 2025 also remain. Developed team members who advanced into supervisor and team-lead roles.
At Universal American, I created a “Who Wants to Be a Trainer?” development challenge. Over three months, two selected participants chose topics, developed materials and quizzes, and trained staff. One subsequently advanced to supervisor and the other to trainer.
At Memorial Hermann, I developed a supervisor who advanced to Call Center Manager in the scheduling department. At Scott & White, a trainer advanced to manager and a supervisor advanced to trainer.
Built the QA program for Memorial Hermann’s new contact center, with six QA auditors reporting directly to me. Designed the scorecard around issue resolution, member satisfaction, information accuracy and regulatory requirements.
I bring this understanding of audit principles, evidence and accountability to how I approach AI implementation and oversight.
Participated in DCHP executive client workgroups on MCO report-card performance and recommended adult and new-member outbound outreach. Used provider survey analysis to engage Claims leadership in improving dispute escalation.
My role connects service data and frontline experience with cross-functional decisions about member access and provider support.
ANALYTICS & AI-ENABLED SERVICE
My progression spans provider self-service, quality governance, knowledge management, analytics and AI-assisted tools.
I lead operational requirements, testing, training and adoption, and establish ownership for ongoing use. My experience with audit readiness informs how I approach accuracy, human escalation and accountability in AI-enabled service.
Led the RFP, Business Associate Agreement and contract negotiation for a new knowledge platform, then ran a two-week pilot, training and handoff to knowledge analysts. Adopted quickly, at lower cost than the prior platform.
Developed an approximately 90-question evaluation covering conversational IVR, chatbots, agent assist, automated QA and Facets/CRM integration. Addresses ownership, customization limits, hidden fees, and one- and three-year cost models.
Built a Tableau dashboard used by my leadership team to monitor Facets task status, call trends and FCR. Developed monthly Member and Provider reporting on top-five call drivers and changes in counts and percentages.
Organized monthly survey data in Excel and used AI assistance to create an FY26 Member and Provider CSAT dashboard.
Operations run on Genesys Cloud for call handling, workforce management and quality auditing.
Created and deployed a healthcare learning and team-engagement platform using generative AI to support development and content creation. Connected scenario practice, assessments, team challenges, friendly competitions and leader reporting with learner progression and completion controls. Includes Medical Literacy, Understanding Providers and Understanding Claims courses.
Privacy-conscious learning design: Developed training materials, screenshots, and learning activities using fictional scenarios, with no sensitive member information.
Visit PurposeKin ↗Designed and configured a Jotform FAQ assistant around frontline information needs. Coordinated testing and team training, established content maintenance ownership and used unanswered questions and agent feedback to improve coverage.
Tested with two supervisors, a lead and two CSRs; agent questions in team chat dropped substantially.
Read the implementation case →Developed a repeatable communication workflow using Google Sheets, Slides and Apps Script, supported by generative AI during development. Built PDF preview generation, reviewer approval and scheduled distribution steps for email and team chat.
Structured content ownership and approval connect automation with human review.
My planning frameworks address call-reason analysis, appropriate use cases, core-system dependencies, human handoff, vendor responsibilities and ongoing monitoring. Conversational IVR and agentic AI remain design frameworks, building on my production experience with rules-based IVR.
LEARNING & WORKFORCE DEVELOPMENT
Two examples of how I translate operational judgment into practical guidance for teams and leaders.
AI-ASSISTED IMPLEMENTATION DEMO · 90 SECONDS
Concept and AI-assisted video created by Patrice Chance. I created this educational demonstration to show how healthcare operations expertise shapes conversational AI workflows—from understanding the caller’s need and verifying identity to checking authorized claim records and transferring unresolved billing questions to a representative.
My approach connects clear instructions, reliable information, and human support to the people we serve.
AI-generated presenter and characters in a simulated member call. This demonstration illustrates workflow design; it does not depict a live production system.
LEADERSHIP DEVELOPMENT DEMO · 100 SECONDS
I created this coaching demonstration to show how leaders can balance empathy with workforce capacity. I close with guidance on schedule alternatives when staffing, projected call volumes and service levels allow.
Listen with care. Explore practical options. Keep service coverage in view.
AI-assisted training video created by Patrice Chance, featuring AI-generated characters in a simulated coaching conversation.
RESUME & EXECUTIVE PORTFOLIO
Explore my healthcare operations experience, leadership approach, and selected transformation projects.
PDF · 2 PAGES
Career experience, leadership strengths, and measurable service and business outcomes.
PDF · 8 PAGES
My leadership philosophy and case studies in provider experience, workforce development, knowledge management, and service technology.
LET’S CONNECT
Open to Director-level healthcare operations and AI-enabled service transformation roles, with a preference for remote or Houston opportunities.
The best way to reach me is a LinkedIn message. Please include the organization and role you have in mind.
Message me on LinkedIn ↗