lucywaithaka84
About Candidate
I’m Lucy Waithaka, an experienced professional with over 16 years of expertise leading teams, managing projects, and delivering exceptional customer experiences. My career has spanned healthcare, insurance, and corporate operations, but the common thread has always been problem-solving, building strong relationships, and driving results.
I’ve successfully led large-scale projects, introduced systems that improved efficiency, and recovered significant organizational losses. At the same time, I’m passionate about customer care—ensuring that clients and partners feel supported, valued, and confident in the services they receive.
I thrive in dynamic environments where collaboration, innovation, and resilience are key. Whether it’s managing complex projects, negotiating partnerships, or mentoring teams, I bring a mix of strategic thinking, empathy, and a results-driven mindset.
I’m excited to apply my skills across industries—whether in operations, customer experience, project management, or stakeholder engagement—to create meaningful impact and help organizations achieve their goals.
Location
Education
A multidisciplinary program combining the study of human behavior with strategic communication. Developed expertise in psychological principles such as cognition, motivation, and social interaction, alongside advanced skills in interpersonal, organizational, and media communication. Trained in research methods, conflict resolution, and audience engagement, with a strong focus on applying psychological insight to improve communication effectiveness, leadership, and client relations.
Licensed by the Nursing Council of Kenya, with a strong medical foundation and extensive experience across healthcare and insurance sectors. Skilled in delivering holistic patient care, conducting clinical assessments, and administering treatments while ensuring compliance with professional standards.
Beyond clinical practice, I have applied my nursing and psychology background to health insurance operations, including medical claims management, provider relations, and fraud prevention. This unique blend of frontline healthcare and corporate insurance expertise enables me to bridge patient needs with organizational goals, ensuring both quality care and operational efficiency.
Kenya Registered Midwife (KRM), licensed by the Nursing Council of Kenya, with experience in maternal healthcare and insurance operations. Skilled in safe delivery practices, patient education, and applying clinical expertise to medical claims management and provider relations.
Work & Experience
•Define priority geographies and customer segments with clear market-level engagement plans aligned to access, quality and goals.
•Achieve top-line revenue growth in priority markets to support 2026 corporate mandate targets through increased client retention and new client wins driven by active provider market engagement as mutually defined with book of business commercial leadership
•Develop the capabilities of commercial teams for sales enablement and client retention through deploying structured provider market engagement across book of business and for priority markets, integrating health segments levers.
•Oversees client retention initiatives, proactively addressing client needs, resolving issues, and ensuring high levels of satisfaction with provider services
•Ensure seamless collaboration through embedment in market forums between front-office commercial activities and back-office provider operations. This goal involves two-way thought leadership- both 1. Monitoring market trends, client feedback, and competitive dynamics to inform provider strategy & enhance commercial effectiveness, and 2) preparing & delivering presentations, proposals, and reports that highlight the Health Organization’s value, outcomes, and differentiators
•Strengthen cross-team collaboration and engagement to inspire our people, elevate everyday employee experiences, and attract and retain top talent.
•Develop, implement and manage strategic provider management relationships regionally.
•Ensure the achievement of operational objectives and maximize value creation for the company (Cost reduction, customer relationship initiatives, and operational improvements).
•On boarding of new health providers and conducting target educational programs.
•Manage day-to-day operations and relationships with healthcare providers.
•Support a true culture of relationship management and provider centricity.
•Continuous improvement and maintenance of provider communications channels taking into consideration local cultural practices.
•Proactive participation on marketing and communication campaigns and activities adjusting those to the local nuances. Attend corporate client presentations.
•Ensuring delivery of 5-star customer experience through close partnership with providers.
•Directed operations and provided leadership to all aspects of provider management and claims processing which included clinical vetting and payment.
•Developed clinical protocol for management of claims mainly in Kenya, Uganda, South Sudan and Malawi.
•Played a leadership role in evaluating and strengthening internal controls and mitigating risk exposure to promote efficiency.
•Collaborated with senior managers to execute change management, corporate strategies, business development plans and organizational development initiatives that led to results.
•Confirmed empanelment of providers and member education is done to providers and clients.
•Ensured provider reconciliation and payments to providers was done as per standards and offered vetting guidance to claims analysts and negotiated for discounts on paid claims.
•Supervised claims analysts to ensure performance and compiled monthly performance reports.
Efficiently handle all claims and settle within the stipulated time.
Vetting of all claims and had a rejection rate of 5% every month saving the company money.
Identify trends in healthcare cost saving methods.
Ensure that all claims' documents are archived in relevant system.
Promptly attend to customer’s queries.
Ensure that all rejections and returns are back to the provider within 30 days of receipt.
Prepare various claims analysis reports for clients and manage consumption.
Register and process all reported claims and advise clients on supporting documents.
To receive and acknowledge all customer correspondences
Triaging patients in mass casualty incidents.
Assessing patients and coming up with a diagnosis and intervening on site.
Giving prehospital care to patients with emergencies like myocardial infarction, angina, hypoglycemia, convulsions, fever, tachycardia’s, obstetric cases, hyperglycemia, shock, hypothermia, drowning patients etc.
Resuscitating patients on site and stabilizing them before taking them to the hospital.
Dressing and suturing wounds on accidents scene to prevent bleeding before taking them to the hospital.
Transferring patients between hospitals critical and stable patients.
Actively participating in major disaster scenes in the country.
Making sure proper documentation is done for patient.
Safely implementing nursing intervention and procedures in the care of the patient
Actively participating in resuscitation team in delivering emergency care to the critically ill
Triaging patients and tracking them accordingly.
Facilitating admissions accordingly to the wards
Demonstrate a spirit of inquiry to internal and external customers
Demonstrate exquisite foresight in anticipating emergency cases and planning to meet the needs of the patients in saving their lives
Demonstrate mastery of technical skills
