Jennifier Gensler

I am a Senior Grievance Consultant and Analyst with hands-on experience leading small teams to meet productivity and quality targets in high-volume health plan operations. I oversee 3–5 analysts, mentor on time and queue management, and conduct weekly touch bases to drive performance improvements.

I consistently maintained a combined regulatory and non-regulatory score of 92% while managing coverage determinations, appeals, POA/AOR documentation, weekend triage, and case assignments. My background includes senior resolution work supporting pharmacies, members, customer care representatives, and pharmacy helpdesk on claims, prior authorizations, escalation/de-escalation calls, and member education.

I am proficient with PeopleSafe, Microsoft Office suite, Citrix, Avaya/Five9, Verint, MARx and various case management and pharmacy claims tools. I seek roles where I can continue coaching teams, ensure compliance and quality, and advance into broader management responsibilities within a collaborative healthcare environment.