Summary
Overview
Work History
Education
Skills
Statement
References
Timeline
BusinessDevelopmentManager
Kaylin Phillips

Kaylin Phillips

Salt Lake City,UT

Summary

Talented Manager with expert team leadership, planning, and organizational skills built during successful career. Smoothly equip employees to independently handle daily functions and meet customer needs. Diligent trainer and mentor with exceptional management abilities and results-driven approach.

Overview

17
17
years of professional experience

Work History

Manager, Risk Adjustment

Molina Healthcare
04.2022 - Current
  • Developed and maintained relationships with customers and suppliers through account development.
  • Accomplished multiple tasks within established timeframes.
  • Assisted in organizing and overseeing assignments to drive operational excellence.
  • Maintained positive customer relations by addressing problems head-on and implementing successful corrective actions.
  • Recruited, interviewed and hired employees and implemented mentoring program to promote positive feedback and engagement.

Program Manager Provider Engagement, Risk Adjustment

Molina Healthcare Inc
08.2019 - 04.2022
  • Develop a Risk Adjustment work plan template to be used on a national level with multiplate health plan states
  • Create initiatives & manage existing initiatives with each health plan to help aid risk efforts
  • Attend bi-monthly meeting with each health plan to discuss risk adjustment initiatives progress and reporting
  • Facilitate between teams when developing procedures
  • Communicate and evaluate reporting.

Regional Specialist Risk Adjustment

Molina Healthcare Inc
10.2017 - 08.2019
  • Facilitated with contracted provider groups in both Utah and Idaho to provide daily needs regarding Risk Adjustment program
  • Strategized to increase Health Plan RAF
  • Prepared and analyzed provider reports to be discussed during monthly provider meetings
  • Collaborated with regional staff to create/aid in additional processes and reports.

Specialist Risk Adjustment

Molina Healthcare Inc
03.2016 - 10.2017
  • Taught and trained medical groups of program expectations
  • Coordinated with medical groups for yearly plans based off forecasted goals
  • Recorded and analyzed information to forecast future strategies
  • Reconciled Risk Adjustment charts that will not be accepted by CMS (Centers for Medicare & Medicaid Services)
  • Controlled provider groups’ member roster details
  • Trained new employees on team procedures and provider management.

Risk Adjustment Coordinator

Molina Healthcare Inc
02.2014 - 03.2016
  • Assisted in reports regarding provider groups status in Risk Adjustment program
  • Ensured monthly payments for said provider groups (Incorporated monthly allocated provider payments system)
  • Coordinated monthly mailings to members regarding program information
  • Managed & work closely with In-home Assessment vendors
  • Trained new employees on team procedures and provider management.

Health Educator

Molina Healthcare Inc
08.2007 - 02.2014
  • Conducted outbound calls to members to ensure compliance regarding HEDIS, inquire into member health
  • Provided mailings to members to promote wellness
  • Lead Internal Wellness Program by coordinating health education, health resources, etc.

Education

Bachelor of Science - Health Science, Health Promotion and Lifetime Wellness

Brigham Young University—Idaho
08.2007

Skills

  • Operations Management
  • Strategic Planning
  • Team Leadership
  • Problem-Solving
  • Staff Training and Development

Statement

From an early age I had a passion for health and when combined with my innate drive to create I constantly find myself with opportunities to help others around me – a situation I believe I thrive in. With a strong sense of determination, I believe there is always another way to accomplish your goals even among the constantly changing world of healthcare. I maintain simplicity during demanding situations which allows me to carry out my job tasks with proficiency and authority. These abilities have been sculpted over the years; as I’ve delved into the professional realm, I have anchored myself as an independent thinker while maintaining a team-oriented perspective.

References

  • Steve Hawes, HN Capitol, Owner, (801) 706-4321, steve@hn-capital.com
  • Jana Brady, Clear View, Provider Partners Health Plan, (415) 608-1288, janabbb@yahoo.com
  • Mark Bigelow, EXL Health, VP, Risk Adjustment & Quality Product Development, (425) 923-9429

Timeline

Manager, Risk Adjustment

Molina Healthcare
04.2022 - Current

Program Manager Provider Engagement, Risk Adjustment

Molina Healthcare Inc
08.2019 - 04.2022

Regional Specialist Risk Adjustment

Molina Healthcare Inc
10.2017 - 08.2019

Specialist Risk Adjustment

Molina Healthcare Inc
03.2016 - 10.2017

Risk Adjustment Coordinator

Molina Healthcare Inc
02.2014 - 03.2016

Health Educator

Molina Healthcare Inc
08.2007 - 02.2014

Bachelor of Science - Health Science, Health Promotion and Lifetime Wellness

Brigham Young University—Idaho

Similar Profiles

CREATE PROFILE
Kaylin Phillips