Amanda Williams
Rosemount,MN
Summary
Visionary healthcare leader with 15+ years of experience driving transformation in health services strategy, utilization management, and clinical operations across Medicare, Medicaid, and Commercial lines of business. Proven track record designing and optimizing scalable programs that deliver measurable improvements in member outcomes, quality of care, cost containment, and regulatory compliance. Adept at leading large cross-functional teams, building strategic vendor and provider partnerships, and aligning clinical innovations with enterprise growth goals. Expertise spans program design, operational execution, value delivery, and strategic advisory for executive stakeholders.
Overview
17
17
years of professional experience
1
1
Certification
Work History
Director, Utilization Management
UCare
Minneapolis, MN
10.2023 - Current
- Lead strategic redesign and operational oversight of Utilization Management (UM) across physical and behavioral health for 75+ staff. Partner with executive leaders to align UM programs with enterprise goals for affordability, regulatory compliance, and care quality.
- Consolidated UM functions into a unified model, enhancing collaboration and increasing program agility.
- Decreased authorization turnaround times by 50%, improving member and provider satisfaction.
- Implemented letter automation, resulting in 94% operational efficiency gains.
- Act as strategic liaison with vendors, compliance, and clinical leadership to ensure enterprise alignment and regulatory readiness.
Director, Clinical Operations
UCare
Minneapolis, MN
11.2020 - 10.2023
- Directed strategic operations for clinical services, with oversight of budget, staffing, vendor performance, and quality outcomes.
- Ensured alignment with enterprise priorities across Commercial and Government lines of business.
- Developed and scaled standardized models for staffing, onboarding, and performance across clinical teams.
- Championed continuous improvement initiatives that optimized workflows and reduced service delays.
- Delivered value-driven care strategies for diverse populations.
- Fostered a high-performance team culture, improving retention and internal promotion rates.
UM Program Development Manager
HealthPartners
Bloomington, MN
11.2018 - 11.2020
- Directed the design, launch, and optimization of enterprise-wide UM programs.
- Served as a clinical SME across major, cross-functional initiatives.
- Achieved $1M+ in cost savings via process redesign and resource reallocation.
- Launched new roles and workflows, increasing operational efficiency by 70% within six months.
- Presented data-driven recommendations to executive leadership to close strategic performance gaps.
Supervisor, Utilization Management
HealthPartners
Bloomington, MN
10.2015 - 10.2018
- Led a team of 12 clinical staff in daily UM operations, with a focus on compliance, productivity, and quality assurance.
- Maintained 98.9% regulatory compliance across all managed programs.
- Collaborated with internal medical directors and executives to execute cost-effective care strategies.
- Improved reimbursement processes for non-contracted providers, enhancing accuracy and timeliness.
Utilization Management Review Specialist
HealthPartners
Bloomington, MN
09.2014 - 10.2015
- Initiated workflow changes that improved accuracy, cutting delays in case review.
- Supported quality audits and regulatory reporting to ensure program compliance.
Senior Utilization Management Specialist
Blue Cross Blue Shield of Minnesota
Eagan, MN
09.2008 - 08.2014
- Spearheaded initiatives to improve UM workflow efficiency, documentation accuracy, and staff training across the department.
- Created detailed SOPs and user guides that enhanced onboarding and staff productivity.
Education
Master of Business Administration (MBA) -
Concordia University
St. Paul, MNBachelor of Science in Nursing -
South Dakota State University
Brookings, SDSkills
Health Services Strategy & Design
Clinical Program Innovation
Utilization & Case Management Leadership
Population Health & Affordability Initiatives
Regulatory Compliance & Accreditation (NCQA, CMS) Provider Engagement & Reimbursement Strategy Cross-functional Executive Collaboration
Vendor Oversight & Value Delivery
Talent Development & Team Optimization
Data-Driven Performance Improvement
Websites
Personal Information
Awards
- President’s Award for Leadership Excellence – Recognized for leading a cross-functional affordability and member experience initiative., - Achieved 5:1 ROI for two consecutive years through optimized team performance and resource management., - Led department reorganization of 70+ staff with minimal disruption and sustained high performance.
Certification
- Registered Nurse
Timeline
Director, Utilization Management
UCare
10.2023 - Current
Director, Clinical Operations
UCare
11.2020 - 10.2023
UM Program Development Manager
HealthPartners
11.2018 - 11.2020
Supervisor, Utilization Management
HealthPartners
10.2015 - 10.2018
Utilization Management Review Specialist
HealthPartners
09.2014 - 10.2015
Senior Utilization Management Specialist
Blue Cross Blue Shield of Minnesota
09.2008 - 08.2014
Master of Business Administration (MBA) -
Concordia University
Bachelor of Science in Nursing -
South Dakota State University
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