Amanda Bombich
Parrish
Summary
Seasoned Operations Manager and talented leader with 20 years of experience applying exceptional planning and problem-solving abilities toward enhancing business plans and day-to-day activities. Results-driven and resilient in developing teams while improving processes and increasing productivity. Bringing solid understanding of industry trends, excellent communication skills, talent for spotting areas in need of improvement and implementing changes with strategic approach.
Overview
24
24
years of professional experience
1
1
Certification
Work History
Operations Manager, Utilization Manager
Highmark Inc
10.2018 - Current
- Spearheaded multiple projects and initiatives, demonstrating expertise in multitasking
- Defined and achieved departmental goals by expertly overseeing staff, executing strategic plans, and evaluating outcomes
- Pioneered and introduced optimized standard operating procedures, streamlining workflows to boost productivity
- Championed the creation and 24/7 accessibility of innovative utilization management tools
- Actively engaged in Agile practices and contributed to focused workgroup discussions
- Provided clear direction to staff, setting benchmarks, and regularly evaluating performance metrics
- Offered hands-on coaching, guidance, and developmental opportunities, while maintaining standards for disciplinary actions
- Oversaw critical HR functions, including recruitment, termination, and recognition, ensuring alignment with organizational vision
- Fostered a culture of excellence, pushing teams to surpass utilization management objectives through strategic engagements and leadership activities
- Mentored direct reports to achieve unparalleled performance and ensured strict adherence to regulatory standards
- Uphold stringent quality and customer service norms while addressing challenges proactively and championing system advancements
- Instituted high-performance benchmarks, emphasizing best practice implementation
- Drafted and executed actionable strategies, driving improvement and compliance with key accreditation standards such as NCQA, CMS, DOH, and DOI
- Established symbiotic collaborations across departments, fueling improvements in processes and patient care
- Extracted insights from clinical data analyses and articulated findings to senior management
- Fostered inter-departmental relationships, ensuring superior care delivery standards
- Conducted regular efficiency assessments, providing expert recommendations for a streamlined, cost-effective operational approach
- Engaged in Agile methodologies, enhancing project efficiency and adaptability
- Contributed to focus workgroups, fostering collaboration and innovative problem-solving
- Supervised operations staff and kept employees compliant with company policies and procedures.
- Empowered employees to take ownership of their responsibilities, leading to increased accountability and improved performance outcomes.
- Conducted regular performance reviews, identifying areas for improvement and developing action plans to address them.
- Led hiring, onboarding and training of new hires to fulfill business requirements.
- Developed and maintained relationships with external vendors and suppliers.
- Enhanced customer satisfaction by establishing clear communication channels and addressing concerns promptly.
- Established positive and effective communication among unit staff and organization leadership, reducing miscommunications, and missed deadlines.
- Analyzed and reported on key performance metrics to senior management.
- Facilitated smooth collaboration between departments through clear communication channels.
- Achieved higher employee retention rates by fostering a positive work environment and providing opportunities for professional growth.
- Developed and implemented strategies to maximize customer satisfaction.
- Handled staff training initiatives aimed at upskilling the workforce to meet dynamic industry demands.
- Directed initiatives to improve work environment, company culture or overall business strategy.
- Developed strong relationships with vendors, resulting in better pricing and improved service quality.
- Spearheaded process improvements, resulting in increased productivity and reduced operational costs.
- Increased profit by streamlining operations.
- Analyzed data trends to identify potential bottlenecks in operations workflow, implementing strategies to mitigate risks accordingly.
- Implemented quality control systems to boost overall product consistency and reliability.
- Led successful change initiatives, ensuring seamless transitions during organizational restructuring efforts.
- Assisted in recruiting, hiring and training of team members.
- Trained and guided team members to maintain high productivity and performance metrics.
- Interacted well with customers to build connections and nurture relationships.
- Tracked employee attendance and punctuality, addressing repeat problems quickly to prevent long-term habits.
- Observed each employee's individual strengths and initiated mentoring program to improve areas of weakness.
- Reported issues to higher management with great detail.
- Cultivated and strengthened lasting client relationships using strong issue resolution and dynamic communication skills.
- Maintained up-to-date knowledge of industry trends, regulations, and guidelines, contributing to the continuous improvement of utilization management practices within the organization.
- Enhanced patient care by conducting thorough utilization reviews and coordinating with healthcare providers.
- Collaborated with interdisciplinary teams to develop effective care plans tailored to individual patients'' needs.
- Analyzed data from utilization reports, identifying patterns and opportunities for cost savings without compromising patient care quality.
- Served as a liaison between clinical staff, administrative personnel, and external stakeholders for all matters related to utilization management, facilitating clear communication across all parties involved.
- Provided training and mentorship to new team members, fostering a collaborative work environment focused on achieving departmental goals.
- Streamlined approval processes for medical procedures, ensuring efficient and timely patient care.
- Conducted comprehensive audits of medical records to ensure compliance with regulatory requirements and best practices in healthcare management.
- Coordinated with other department leaders to align utilization management initiatives with broader organizational goals and objectives.
- Evaluated the performance of remote and in-house utilization review teams, providing feedback and guidance to drive continuous improvement efforts.
- Developed internal policies and procedures related to utilization management, resulting in improved efficiency throughout the department.
- Identified gaps in service delivery and recommended improvements to optimize resource utilization and quality of care.
- Optimized resource allocation by conducting regular assessments of staffing levels and workload distribution within the department.
- Maintained positive customer relations by addressing problems head-on and implementing successful corrective actions.
- Maintained professional demeanor by staying calm when addressing unhappy or angry customers.
- Established team priorities, maintained schedules and monitored performance.
- Evaluated employee performance and conveyed constructive feedback to improve skills.
- Defined clear targets and objectives and communicated to other team members.
- Assisted in organizing and overseeing assignments to drive operational excellence.
- Cultivated positive rapport with fellow employees to boost company morale and promote employee retention.
- Established performance goals for employees and provided feedback on methods for reaching those milestones.
Utilization Management Registered Nurse
Cigna Healthcare
01.2005 - 10.2018
- Led clinical operations in Medical Management Utilization Review and Prior Authorization
- Served as the primary clinician for several client accounts
- Recognized as a Subject Matter Expert (SME) in federal and state regulatory compliance for prior authorizations
- Demonstrated in-depth knowledge of various insurance products
- Proficient in multiple operational systems across different business lines
- Spearheaded dental review authorizations under medical plans
- Conducted prior authorization assessments for elective procedures and surgeries, leveraging nursing expertise and established guidelines
- Partnered with physicians to ensure optimal patient outcomes
- Collaborated with cross-functional teams to boost daily productivity
- Directed multiple projects and addressed unique client requirements
- Managed data analytics, including Excel report generation and outlier analysis
- Honored with multiple Cigna Champion & Cigna Everyday Awards
- Directed Employee Action Committee initiatives, coordinating events that fostered community engagement and enhanced workplace morale
- Utilized critical thinking skills to prioritize nursing interventions based on patients'' acuity levels and individual needs.
- Conducted thorough patient assessments to identify changes in condition, promptly notifying physicians and initiating appropriate interventions when necessary.
- Collaborated with interdisciplinary teams to develop comprehensive treatment plans for complex patients with multiple comorbidities.
- Facilitated patient transitions between different levels of care, ensuring continuity of services and minimizing disruptions in treatment plans.
- Followed all personal and health data procedures to effectively comply with HIPAA laws and prevent information breaches.
- Participated in evidence-based practice project implementation, nursing competency development and nursing simulation activities.
- Led teams in driving successful patient outcomes by prioritizing standard of care and best practices.
- Reported findings to quality departments after conducting routine restraint audits and worked with team to devise corrective actions for deficiencies.
Facility Nursing Supervisor RN
Trinity Health System
08.2015 - 11.2016
- Oversaw and coordinated nursing teams, optimizing direct patient care
- Conducted analyses of nursing and ancillary operations to enhance patient care and maximize staff efficiency
- Prioritized emergency procedures and swiftly reallocated personnel during crisis situations
- Collaborated with Nursing Directors and the Vice President of Nursing to define and enact the department's philosophy and goals
- Served as the primary point of reference for staff, elucidating the department's philosophy, standards, and policies
- Oversaw staff scheduling and resource allocation
- Discussed patient care and treatment with care team members to optimize intervention plans and care delivery.
- Promoted interdisciplinary collaboration by fostering strong relationships with physicians, therapists, and other healthcare professionals.
- Contributed to positive team dynamics as an approachable supervisor who actively listened to concerns from both patients and nurses.
- Mentored new nursing staff members to promote adherence to established best practices and foster professional growth.
- Answered questions and addressed concerns from employees via email, phone and in person.
- Followed all HIPAA rules and regulations regarding patient confidentiality.
- Delegated tasks and provided leadership for weekend and holiday staffing of nurses and support personnel.
- Provided direct nursing care to patients when personnel was short-staffed.
- Ensured compliance with regulatory standards through regular audits of documentation, policies, and procedures.
- Improved patient satisfaction scores by addressing concerns promptly and ensuring consistent delivery of high-quality care.
- Maintained a safe environment for patients, visitors, and staff by enforcing infection control measures and risk management strategies consistently across the unit.
- Educated patients and families on treatment procedures and answered questions for thorough home care plans.
- Optimized resource utilization with careful allocation of equipment, supplies, and personnel based on patient acuity levels.
- Coordinated nursing care for patients and participated in patient and family education.
- Confidently directed overall operation of nursing services and patient care.
- Facilitated smooth transitions between shifts through clear communication of pertinent patient information during handoffs.
- Supervised, directed, and motivated high-quality performance from nursing staff.
- Conducted routine facility inspections, identifying areas needing improvement and eliminating hazards posed to staff and residents for continued compliance with associated regulations.
- Monitored and inspected staff processes to eliminate hazards posed for both residents and staff while ensuring continuous compliance with regulations.
- Collaborated with interdisciplinary teams for comprehensive patient care plans, resulting in better health outcomes.
- Administered medications via oral, IV, and intramuscular injections and monitored responses.
- Collaborated with physicians to quickly assess patients and deliver appropriate treatment while managing rapidly changing conditions.
- Educated patients, families and caregivers on diagnosis and prognosis, treatment options, disease process, and management and lifestyle options.
- Developed strong relationships with patients'' families, providing emotional support while addressing concerns or questions about care plans.
- Improved patient outcomes by providing high-quality nursing care and implementing evidence-based practices.
- Educated patients on disease management and self-care techniques, promoting lifestyle changes for improved health.
- Managed care from admission to discharge.
- Served as a liaison between physicians and patients'' families to facilitate clear communication regarding treatment options and progress updates.
- Provided direct patient care, stabilized patients, and determined next course of action.
- Investigated and independently resolved complaints from staff, physicians, and patients by leveraging clinical judgment and unit management expertise.
- Established and maintained effective communication with staff, physicians and community organizations to promote high quality patient care.
- Communicated with patients, ensuring that medical information was kept private.
- Coordinated discharge planning efforts with social workers, case managers, and other multidisciplinary team members for smooth transitions posthospitalization.
- Managed complex cases of critically ill patients, ensuring optimal treatment plans were executed effectively.
- Utilized advanced clinical skills such as wound care management or IV therapy administration, leading to faster recovery times for patients treated under my supervision.
- Aligned nursing goals with department objectives to enhance overall performance metrics within the healthcare facility.
- Administered medications and treatments as prescribed by physicians.
- Communicated with healthcare team members to plan, implement and enhance treatment strategies.
- Educated family members and caregivers on patient care instructions.
- Documented treatments delivered, medications and IVs administered, discharge instructions, and follow-up care.
- Evaluated patient histories, complaints, and current symptoms.
- Followed all personal and health data procedures to effectively comply with HIPAA laws and prevent information breaches.
- Used first-hand knowledge and clinical expertise to advocate for patients under care and enacted prescribed treatment strategies.
- Managed patients recovering from medical or surgical procedures.
- Offered exceptional care and support to individuals recovering from acute incidents and dealing with chronic conditions.
Staff Registered Nurse
Heritage Valley Health System - Beaver
05.2001 - 08.2008
- Served as a Staff Nurse for mother and baby units, attending to post-op gynecology patients; responsibilities included patient assessments, administering oral and injectable medications, treatments, patient education, and collaborating with physicians and other staff
- Gathered patient health data through interviews and observation, documenting data in electronic records.
- Verified patients had information necessary for ongoing care, providing guidance on diagnoses, management of medications, and prevention methods.
- Implemented appropriate interventions based on assessment findings which resulted in improved symptoms management.
- Streamlined workflow processes within the nursing unit to maximize efficiency while maintaining exceptional patient care standards.
- Collaborated with physicians to develop comprehensive treatment plans tailored to individual patient needs.
- Educated patients on disease prevention and management strategies, empowering them to make informed decisions about their health.
- Served as a strong advocate for patients'' rights, ensuring that their needs were met in accordance with ethical guidelines and regulatory requirements.
- Mentored new nurses as they transitioned into practice, providing guidance and support to promote professional growth.
- Participated in quality improvement initiatives aimed at enhancing overall patient care delivery within the organization.
- Facilitated smooth transitions of care for patients by effectively communicating with other healthcare providers.
- Conferred with physicians to discuss diagnoses and devise well-coordinated treatment approaches.
- Coordinated appropriate use of resources, such as equipment and supplies, to ensure availability when needed.
- Collaborated with physicians, pharmacists and therapists to deliver quality, evidence-based care.
- Developed and implemented individualized patient care plans for optimal outcomes.
- Educated patients, families and caregivers on diagnosis and prognosis, treatment options, disease process, and management and lifestyle options.
- Coordinated patient discharge planning to provide post-discharge patient care, promoting healing and recovery.
- Documented treatments delivered, medications and IVs administered, discharge instructions, and follow-up care.
- Managed patients recovering from medical or surgical procedures.
- Communicated with healthcare team members to plan, implement and enhance treatment strategies.
- Educated family members and caregivers on patient care instructions.
- Monitored patient reactions after administering medications and IV therapies.
- Evaluated patient histories, complaints, and current symptoms.
- Provided skilled, timely and level-headed emergency response to critically-ill patients.
- Conducted ongoing monitoring and evaluations of behaviors and conditions, and updated clinical supervisors with current information.
- Implemented care plans for patient treatment after assessing physician medical regimens.
- Used first-hand knowledge and clinical expertise to advocate for patients under care and enacted prescribed treatment strategies.
- Explained course of care and medication side effects to patients and caregivers in easy-to-understand terms.
- Followed all personal and health data procedures to effectively comply with HIPAA laws and prevent information breaches.
- Offered exceptional care and support to individuals recovering from acute incidents and dealing with chronic conditions.
- Promoted patient and family comfort during challenging recoveries to enhance healing and eliminate non-compliance problems.
- Equipped patients with tools and knowledge needed for speedy and sustained recovery.
- Facilitated therapeutic communication, conflict resolution and crisis intervention by redirecting negative behaviors and helping patients regain or improve coping abilities.
- Performed frequent checks on life support equipment and made necessary adjustments to preserve optimal patient conditions.
- Observed and documented patient factors such as diets, physical activity levels, and behaviors to understand conditions and effectively modify treatment plans.
- Delivered high level of quality care to diverse populations while overseeing patient admission and triaging based on acuity and appropriate department admission.
- Led prenatal and breastfeeding classes at the facility
- Functioned as a Staff Nurse for the Cardio-Pulmonary unit and post-op gynecology patients, handling patient assessments, medication administration, treatments, and physician collaboration
- Delivered specialized care to Open Heart and PTCA patients
- Performed various nursing interventions such as wound dressing, vital sign monitoring, and specimen collection.
- Implemented medication and IV administration, catheter insertion, and airway management.
- Administered medications via oral, IV, and intramuscular injections and monitored responses.
- Monitored patients' conditions and reported changes in physical presentation, appearance, and behavior to discuss treatment with physicians.
- Assessed physical, psychological, physiologic, and cognitive status of patients.
- Consistently maintained accurate documentation of all relevant information related to patient progress, treatments administered and other pertinent data.
- Provided emotional support for patients and families during difficult times, helping them navigate the healthcare system with compassion and understanding.
- Increased patient satisfaction by consistently delivering high-quality nursing care with a focus on empathy, communication, and professionalism.
- Participated in staff meetings and continuing education programs to stay current on best practices and maintain licensure requirements.
- Promoted teamwork and collaboration with interdisciplinary teams for optimal patient care planning and implementation.
- Achieved timely medication administration by utilizing effective time management skills and prioritizing critical tasks.
- Precepted student nurses and oriented new hires, providing guidance and mentorship when teaching on hospital policies, emergency procedures, and nursing best practices.
- Worked within interdisciplinary health care team to develop, implement and make adjustments to patient care plans, individualizing strategies, and methods to improve health and meet recovery goals.
- Directed patient care by initiating and following through with plan of care, continuing care, and discharge instructions.
- Managed elements of patient care from admission to discharge or transfer to other units.
- Trained new nurses in proper techniques, care standards, operational procedures, and safety protocols.
- Identified patient care requirements by establishing personal rapport with patients and families.
- Effectively prioritized assignments, executing care based on each patient's relative condition and delegating tasks to available personnel deliver safe and efficient care.
- Assisted in the training of nursing students during clinical rotations, fostering an environment conducive to learning and skill development.
Education
Master of Science - Strategic Leadership
Elizabethtown College
Elizabethtown, PA12-2026
Bachelor of Science - Nursing
Kent State University
Kent, OH01.2017
Bachelor of Science - Nursing
Drexel University
Philadelphia, PA06-2012
Associate of Science - Nursing
Kent State University
East Liverpool, OH05-2001
No Degree - Certificate of Practical Nursing
Jefferson Technical College
Steubenville, OH01.1992
Skills
- Good Communication
- Strong Attention to Detail
- Strong Work Ethic
- Data Analytics
- Problem-solving
- Team leadership
- Operations management
- Customer service
- Operations monitoring
- Operational efficiency
- Decision-making
- Employee relations and conflict resolution
- Planning and implementation
- Staff training
- Staff management
- Inventory management
- Management
- Project management
- Operations oversight
- Policies and procedures implementation
- Performance monitoring
- Employee motivation
- Staff development
- MS office
- Maintaining compliance
- Goal setting
- Interpersonal communication
- Client relationships
- Inventory control
- Workflow optimization
- Strategic planning
- Process improvement
- Schedule management
- Performance management
- Regulatory compliance
- Process improvements
- Organizational management
- Superb time management skills
- Invoice processing
- KPI tracking
- Retail operations management
- Unsurpassed work ethic
- Data management
- Incidents management
- Cross-functional collaboration
- Cross-functional communications
- Data analysis
- Performance reporting
- Process flows
- Cross-functional communication
- Process improvement strategies
- Performance evaluations
- Data evaluation
- Change management
Accomplishments
- Used Microsoft Excel to develop inventory tracking spreadsheets.
- Supervised team of twenty-two staff members.
- Collaborated with key stakeholders in the development of medical necessity algorithm for prior authorization reviews.
- Collaborated with key stakeholders in the development of Out-of-Network provider requests.
Certification
- Certified Managed Care Nurse (CMCN)
- Six Sigma Certification White Belt
- Basic Life Support Certification (BLS)
Locations
- Parrish, Florida
Hobbies and Interests
- Utilization Management
- Registered Nurse
- Traveling
- Volunteer Work
Languages
English
Full Professional
Spanish
Elementary
Timeline
Operations Manager, Utilization Manager
Highmark Inc
10.2018 - Current
Facility Nursing Supervisor RN
Trinity Health System
08.2015 - 11.2016
Utilization Management Registered Nurse
Cigna Healthcare
01.2005 - 10.2018
Staff Registered Nurse
Heritage Valley Health System - Beaver
05.2001 - 08.2008
Master of Science - Strategic Leadership
Elizabethtown College
Bachelor of Science - Nursing
Kent State University
Bachelor of Science - Nursing
Drexel University
Associate of Science - Nursing
Kent State University
No Degree - Certificate of Practical Nursing
Jefferson Technical College
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