Summary
Overview
Work History
Education
Skills
Timeline
Generic

Dayna Quast

Spencer,TN

Summary

Results-driven professional with extensive experience in leadership and strategic oversight. Adept at driving organizational success through effective team collaboration and dynamic problem-solving. Recognized for adaptability and keen focus on achieving objectives.

Overview

20
20
years of professional experience

Work History

Associate Director, Account Management

Optum
11.2023 - Current
  • Led teams of 19 Account Manager, Financial Support and Invoicing personnel, supervising daily performance as well as training and improvement plans.
  • Managed cross-functional teams for multiple lines of business and multiple clients represented, successfully meeting revenue goals and deliverables.
  • Fostered a culture of continuous improvement by encouraging staff to share innovative ideas and providing resources for professional development.
  • Prioritized tasks and allocated resources appropriately to keep teams focused and productive.
  • Assisted senior leadership in managing all aspects of operations.
  • Reduced backlog of open AR and pursued revenue development strategies to keep department aligned with 90 day metrics.

Sr Director, Post Audit Operation-Refund Recovery

Change Healthcare
08.2022 - 11.2023
  • Directed Post-Audit administrative support and Refund Recovery efforts for Post Pay Audits including inbound and outbound correspondence, cash posting, account management operations, and provider resolution services to obtain recoveries from hospitals and providers.
  • Responsible for maximizing revenue while reducing expenses through a variety of system enhancement identification and outsourcing options
  • Worked with Client Management to attend all Client MBR/QBRs to address recovery results for 20+ clients.
  • Partnered with Clients including Blues Plans intake payment calculations and refund reviews internally to reduce the staffing on the client on increase the applying the revenue
  • Assisted with converting all employees to full time remote workforce
  • Redesigned organization to build out Centers of Excellence for Pre-Audit and Post-Audit focus areas
  • Oversee 80+ remote operations team and direct reports focused on increase employee satisfaction, providing regular coaching, skip level 1:1, and feedback sessions
  • Create training manuals and monitor daily inventory to define processes and procedures for maximum optimization of workflow efficiency
  • Optimized project timelines by effectively delegating tasks and prioritizing workload among team members.
  • Cultivated a culture of innovation by promoting creative thinking and encouraging employees to take calculated risks in pursuit of solutions.
  • Developed strong relationships, fostered collaboration and mutual growth opportunities to develop monthly business reviews.
  • Achieved departmental goals by developing and implementing strategic plans and initiatives.
  • Fostered work culture of collaboration and inclusion to increase morale and reduce turnover.

Director, Post Audit Operations & Refund Recovery

Change Healthcare
04.2019 - 08.2022
  • Managed Post-Audit administrative support and Refund Recovery efforts for Post Pay Audits
  • Enhanced outreach to facilities and providers to maximize obtaining recoveries for medical audits. Developed escalation process to ensure outreach was impactful.
  • Facilitated cross-functional collaboration for improved decision-making processes within the organization.
  • Oversee onsite and remote operations team and direct reports through routine team meetings, employee 1:1, awards and recognitions, performance review processes and individual focus audits when appropriate for team of 60 employees with varying roles within the recovery process
  • Create training manuals and monitor daily inventory to define processes and procedures for maximum optimization of workflow efficiency
  • Attend client MBR and QBRs
  • Developed high-performing teams by providing mentorship, guidance, and opportunities for professional growth.
  • Enhanced team collaboration through regular communication, goal setting, and performance evaluations.
  • Established a culture of continuous improvement by fostering open communication channels and empowering employees to voice their ideas.
  • Cultivated a positive work environment that fostered employee engagement, increased retention rates, and boosted overall team morale.

Operation Manager, Refund Recovery

EquiClaim, a Change Healthcare Company
01.2014 - 08.2022
  • Managed Refund Recovery efforts for Payment Integrity medical audit. Motivated employees to meet monthly and yearly revenue goals for business and clients.
  • Developed bonus program for individual revenue targets achieved.
  • Resolved staff member conflicts, actively listening to concerns and finding appropriate middle ground.
  • Maximized performance by monitoring daily activities and mentoring team members.
  • Enhanced customer satisfaction by resolving disputes promptly, maintaining open lines of communication, and ensuring high-quality service delivery.
  • Controlled costs to keep business operating within budget and increase profits.


Business Analyst

Equiclaim, a Change Healthcare Company
06.2013 - 01.2014
  • Create Case Studies for suspicious providers identified by actuary FWA team to disperse to potential clients.
  • Actively participated in team meetings to share knowledge, exchange ideas, address challenges, and collaborate on potential solutions.
  • Developed high-quality documentation to support training efforts, helping employees fully understand new systems and procedures.
  • Performed gap analysis between existing systems or processes and desired state, identifying areas for improvement or enhancement.
  • Improved business processes by analyzing current practices and recommending optimization strategies.

Client Implementation and Account Manager

Equiclaim, a Change Healthcare Company
06.2010 - 06.2013
  • Increased client satisfaction by building strong relationships and addressing their needs promptly.
  • Maintained high client retention rate by providing exceptional customer service and anticipating client needs.
  • Managed a diverse portfolio of accounts, ensuring timely communication and effective problem resolution.
  • Successfully resolved escalated issues, preventing potential loss of valuable clients while maintaining positive relationships with all parties involved.
  • Conducted regular account reviews to identify areas for improvement and ensure continued success.
  • Collaborated with sales team to identify potential upsell opportunities and expand client base.
  • Established clear communication channels between clients and internal teams, ensuring seamless project execution.
  • Collaborated with managers to provide customer feedback and recommend operational changes to meet emerging trends.

Investigative Specialist

Emdeon Business Services
04.2005 - 06.2013
  • Responsible for conducting claim reviews in a timely manner, thoroughly documenting all phone calls, conversations, and actions taken on each review.
  • Investigation, documentation, and development of cases for potential fraud and abuse on all new clients prior to mainstreaming.
  • Utilization of IBM's Fraud and Abuse Management system and other in-house reports for trends, pattern analysis and financial exposure.
  • Averaged 98% on quality audits annually
  • Conducted weekly conference calls with clients to develop client exception manuals.
  • Facilitated department training during transition of implementation to mainstreaming
  • Assisted in development and deployment of Deployment Eligibility pilot for approximately 800 insured's
  • Completed offsite client training
  • Reviewed, tracked and reported suspected fraud to insurance departments, FBI, State and Federal authorities


Education

Nursing

Gateway Technical College
Kenosha, WI

High School Diploma -

Wilmot Union High School
Wilmot, WI
06-1993

Skills

  • Strategic leadership
  • Analytical thinking
  • Relationship building
  • Coaching and mentoring
  • Decision-making
  • Team collaboration and leadership
  • Process improvement
  • Critical thinking
  • Managing operations and efficiency

Timeline

Associate Director, Account Management

Optum
11.2023 - Current

Sr Director, Post Audit Operation-Refund Recovery

Change Healthcare
08.2022 - 11.2023

Director, Post Audit Operations & Refund Recovery

Change Healthcare
04.2019 - 08.2022

Operation Manager, Refund Recovery

EquiClaim, a Change Healthcare Company
01.2014 - 08.2022

Business Analyst

Equiclaim, a Change Healthcare Company
06.2013 - 01.2014

Client Implementation and Account Manager

Equiclaim, a Change Healthcare Company
06.2010 - 06.2013

Investigative Specialist

Emdeon Business Services
04.2005 - 06.2013

Nursing

Gateway Technical College

High School Diploma -

Wilmot Union High School

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Dayna Quast