Dawn Miller
Summary
Business professional with 28 years of seeking new opportunities in sales. With proven ability to connect with clients, assess their needs, and offer personalized solutions, you will find me to be especially valuable in a sales environment where trust and long-term relationships are critical.
Overview
19
19
years of professional experience
Work History
Director of Clinical Operations
Blue Cross Blue Shield of Texas
12.2013 - 12.2023
- Operational Oversight of 81 clinicians in various roles (utilization management, case management, social workers) to ensure organizational goals and objectives are exceeded within budget constraints
- Clin Ops Lead for implementation ensured that staffing, technology, and programs were in place to support staff
- Developed strategies to meet and remediate new Performance Guarentes
- Analysis Tableau and Blue Insights reports to highlight trends, monitor program effectiveness, and drive process improvements
- Acted as subject matter expert for service delivery processes, workflows, systems, reporting needs, training, and quality audits/projects
- Built relationships with internal and external stakeholders to identify root causes, resolutions for current process issues
- Presents monthly, quarterly, semi-annual, and annual integrated client facing reports
- Collaboration with Client Consultant, Principal Analyst, Account Executive to ensure clinical operations shine
- Designed and upsold specialized programs to increase profitability such as American Airlines, Teacher Retirement System, Federal Employment Program
Associate Director Clinical Performance Manager
Optum - United Health Group
05.2005 - 03.2013
- Analysis of quarterly claims data to provide insight on member demographics, medical spend (inpatient, outpatient, and professional trends) and provide strategy to control cost using medical management
- Analyzed weekly operational performance reporting, monthly and quarterly reports to ensure engagement performance goals were achieved
- Developed strategies to correct defects
- Prepared and presented reporting trends/client facing reports to provide value statements and strategies for improvement to consultants and clients
- Designed and upsold specialized programs to 46 clients
Education
Bachelor of Science - Nursing
Texas Tech Health Sciences Center
Skills
- Leadership
- Client Relationship Building
- Upselling Products
- Goal-Oriented Strategy Development
- Process Improvement
- Customer Satisfaction
- Customer Retention
- Communication
- Reporting
- Community Engagement
- Advocacy
- Adaptability
- Continuous Learning
- Policy Adherence
- Technology Proficiency
Timeline
Director of Clinical Operations
Blue Cross Blue Shield of Texas
12.2013 - 12.2023
Associate Director Clinical Performance Manager
Optum - United Health Group
05.2005 - 03.2013
Bachelor of Science - Nursing
Texas Tech Health Sciences Center
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