Summary
Education
Skills
Work History
Overview
Generic
Kelli Stark

Kelli Stark

Scotia,US

Summary

Healthcare professional with deep understanding of healthcare ecosystem and proven ability to generate meaningful results. Known for fostering team collaboration and adapting to changing project demands. Possesses strong skills in client relations and strategic planning, along with reliable and flexible approach to problem-solving. Experienced with conducting thorough utilization reviews to ensure effective resource use and patient care. Utilizes clinical judgment to assess and recommend appropriate treatment plans. Track record of ensuring compliance with healthcare regulations and improving patient outcomes.

Education

Practical Nurse - Practical Nursing

Linton Vocational Center
Schenectady, NY
01.1987

Skills

  • Clinical judgment
  • Care coordination
  • Quality improvement
  • Geriatric care
  • Healthcare technology
  • Microsoft office
  • Teamwork and collaboration
  • Patient advocacy
  • Interpersonal communication
  • Professionalism

Work History

Healthcare Consultant

Pratt Case Management
06.2025 - Current
  • Advocated for patients'' rights and well-being during interdisciplinary meetings, ensuring their voice was heard in decision-making processes.
  • Provided emotional support and encouragement to patients and their families during challenging times, fostering trust and building lasting relationships.
  • Improved patient satisfaction by addressing concerns, answering questions, and providing education on treatment options.
  • Participated in continuing education opportunities to stay informed about the latest developments in the field of home health care consulting.
  • Served as a liaison between insurance companies, patients, and healthcare providers to facilitate proper coverage for necessary services.

Director of Client Experience

StageCoach Improv
10.2023 - 06.2025
  • Collaborated with cross-functional teams to ensure seamless integration of client feedback into product development processes.
  • Increased customer retention rate through proactive outreach efforts, including regular check-ins and follow-up communications.
  • Oversaw the resolution of complex client issues, earning a reputation for going above and beyond to ensure satisfaction.
  • Onboarded new clients through established sales and implementation cycle.

Nurse Care Manager/Utilization Review Nurse

HealthFirst
02.2016 - 06.2022
  • Assisted Project Manager with several projects including but not limited to creation of Quick Reference Guides, IIR MCG criteria training: Authorization requirement coding project. Created internal Medical Policies including Home Health Aide Policy 31 version 1 and Enteral Feeding Policy currently used by Utilization Review Department.
  • Managed a caseload of members with a variety of health issues.
  • Appeals/Denials Resolution Review
  • Documents all interventions and telephone encounters with providers, members and vendors following appropriate HealthFirst Medical policy and procedure.
  • Utilizes and evaluates available clinical data, including completed assessments, nursing progress notes, physical therapy notes, and other data as applicable to make an appropriate recommendation for quality services.
  • Consistently suggests ideas for process improvement; Created Home Care Referral form used to streamline requests from providers.
  • 2020 Performance rating of Exceptional Impact.
  • Improved patient care quality by conducting thorough utilization reviews and making recommendations for optimal treatment plans.
  • Fostered a culture of continuous learning by actively participating in departmental meetings, trainings, and continuing education opportunities related to utilization review.
  • Increased patient satisfaction by advocating for necessary patient care and services.

Nurse Care Manager/Utilization Review Nurse

Anthem
08.2011 - 02.2016
  • Provided Supervisory coverage for both short and long term absences of Team Lead for Predetermination and Initial Inpatient Review teams.
  • Preceptor for New Employees
  • Instructed New Hire Education and Training Course 2014 and 2015
  • Conducted pre-certification, inpatient (if not associated with CM or DM triage) retrospective, out of network and appropriateness of treatment setting reviews within scope of licensure by utilizing appropriate medical policies and clinical guidelines in compliance with department guidelines and consistent with the member's eligibility, benefits and contract.
  • Applied clinical knowledge to work with facilities and providers for care coordination.
  • May access and consult with peer clinical reviewers, Medical Directors and/or delegated clinical reviewers to help ensure medically appropriate, quality, cost effective care throughout the medical management process.
  • Facilitates accreditation by knowing, understanding, and accurately applying accrediting and regulatory requirements and standards.
  • (Telecommute Position)

Lead Instructor Technical Training - Nursing Assistant Program

LPN Career Glenmont Job Corps Academy
04.2008 - 07.2012
  • Acts in place of Department Manager whenever necessary - Covering all duties as manager including wherein.
  • Schedules NYS certification
  • Certified Nursing Program Team Lead
  • Provides instruction of Nursing Assistant course following approved training curriculum in accordance with NYS and center procedures. Revises training curriculum and materials as required. Provides individual student case management. Works as part of a team with other departments in developing employability of students, including career preparation, career development and career transition.
  • Maintains efficient and timely documentation in accordance with company and DOL guidelines, ensures that all USDOL, OMS and CTTRC goals are achieved.
  • Provides personal and employability counseling to students. Maintains class discipline, student accountability and appearance of training area.
  • Participates in the provision of social/employability skills instruction.
  • Establishes and maintains placement and workplace learning linkages with employers in the community.
  • Participates in Vocational Center Employer Steering Committee
  • Monitors student progress and posts pertinent information to Student Profile and PCDP.
  • Stresses professional norms and promotes professional behavior.

Overview

35
35
years of professional experience

Similar Profiles

CREATE PROFILE