Kiesha Williams
South San Francisco,USA
Summary
Strategic leader in healthcare administration with strong expertise in project management and operational oversight. Aligns departmental goals with organizational objectives through data analytics, driving performance improvements. Manages resources, ensures compliance, and negotiates with vendors to optimize efficiency and enhance service delivery.
Overview
18
18
years of professional experience
Work History
Director, Member Services Department
Health Plan of San Mateo
South San Francisco, CA
10.2022 - Current
- Lead strategic planning, direct daily operations, and resource management for the Member Services Department, overseeing call centers and eligibility functions for Medi-Cal, HealthWorx, and ACE programs.
- Establish and execute annual and long-term departmental goals, aligning customer support metrics with organizational objectives and member satisfaction benchmarks.
- Develop, monitor, and control departmental budget, optimizing resource allocation to support organizational growth and operational efficiency.
- Lead, coach, mentor and collaborate with cross-functional teams, driving high performance, staff development, and a culture of continuous improvement.
- Utilize data analytics to assess call center KPIs, Medi-Cal enrollment trends, member satisfaction trends, and implementing targeted action plans to enhance service delivery and outcomes.
- Ensure full compliance with evolving industry regulations by proactively updating departmental policies, procedures, and workflows.
- Manage regulatory audits and represent the department in interactions with external agencies, providers, and community partners, strengthening organizational reputation and relationships.
- Negotiated and managed vendor contracts while leading process improvement initiatives and overseeing budgeting to enhance operational effectiveness.
- Work in partnership with IT Operations and business stakeholders to implement automation and AI initiatives that improve call center efficiency, increase agent productivity and responsiveness, and enhance member self-service experiences.
Manager, Member Services Department
Health Plan of San Mateo
South San Francisco, CA
05.2019 - 10.2021
- Managed a team of 25 staff members, including Supervisors and Member Services Representatives, to ensure effective operations.
- Managed quality, production levels, strategic initiatives, and employee development while preparing and overseeing operational goals and objectives.
- Achieved staff results by communicating job expectations, planning and monitoring job performance, coaching and counseling staff, and implementing corrective actions when necessary.
- Managed the hiring, selection, and onboarding process for new employees while providing ongoing staff development.
- Collaborated with Director to develop, monitor, and control departmental budget and resource allocation.
- Oversaw overall Call Center operations to provide customer support for Medicaid and other programs for San Mateo County.
- Interpreted eligibility information from state, federal, and local agencies, and communicated this information understandably to others. Interacted with staff and other HPSM departments regarding member eligibility problems and issues.
- Participated in department and management meetings; represented the department and organization at internal and external events.
- Developed and updated department policies and procedures, workflows, and resource materials.
- Monitored management reports and other materials to assure that the departments are compliant with regulatory requirements and responsive to trends.
- Executed responsibilities to maintain workflow and enhance departmental efficiency.
Adjunct Professor
Community College of Baltimore
Baltimore, MD
05.2017 - 08.2021
- Facilitated twelve-hour online health information technology courses for Community College of Baltimore County.
- Developed engaging course materials addressing foundations of health IT, quality management, and EHR processes.
- Conducted interactive discussions to enrich student learning experiences.
- Evaluated assignments and delivered constructive feedback to promote skill development.
HEDIS Project Manager
Santa Clara Family Health Plan
San Jose, CA
11.2018 - 05.2019
- Effectively managed the Healthcare Effectiveness Data and Information Set (HEDIS), quality improvement initiative by establishing and maintaining project timelines with a focus on ensuring that all system program changes are implemented by the end of the year.
- Collaborated with internal and external stakeholders to ensure accuracy of HEDIS data, identifying issues and trends to enhance efficiency and quality of healthcare plan.
- Monitored and evaluated project resource needs, ensuring continuity of projects and timely communication with stakeholders.
- Generated reports and reviewed medical records against claims to analyze physician productivity and understand patient outcomes, supporting informed decision-making.
Director of Operations
Primary Medicine
Pikesville, MD
10.2016 - 06.2018
- Spearheaded the implementation of the Medicare CCM program, resulting in approximately $20k per month of additional revenue for the practice.
- Developed and managed annual operating budget of $150k for business and staffing expenses, ensuring financial viability through effective accounts payable and service consolidation.
- Negotiated vendor contracts for office supplies, utilities, and marketing, achieving $7k monthly savings in overhead costs.
- Enhanced the productivity and efficiency of the practice by implementing new workflow processes and developing Standard Operating Procedures and training manuals for each position, including clinical staff.
- Managed human resources functions, including recruitment, hiring, training, payroll, benefits, and staff management, providing mentorship and constructive feedback to enhance team performance.
- Effectively supported the successful business operations of a private physician group with a staff of 22, including physicians by managing all facets of budget management, HR functions, financial reporting & IT management.
IT Applications Manager
Sinai Hospital
Baltimore, MD
08.2015 - 10.2016
- Spearheaded the execution of new system implementations, releases, and upgrades and ensured all seamless transition for all users by providing technical direction and guidance in systems analysis and technical tools.
- Led diverse, cross-functional teams (security, system administration, help desk) in efficiently performing system implementations, releases, and upgrades to the GE Centricity application upgrade.
- Oversaw system upgrades and customer support for a team of 5 while implementing solutions to improve user productivity.
- Successfully supported all Ambulatory departments in the proper, efficient, and compliant use of the GE Centricity Patient/Physician Billing and registration system.
- Collaborated with department heads, physicians, and stakeholders to create workflow processes and training sessions for effective system utilization.
- Developed user manuals and training materials to enhance understanding and effective use of the system.
- Controlled all facets of the HR process for the department, including onboarding, recruiting, interviewing, and hiring.
Application System Analyst
University of Maryland Medical System
Baltimore, MD
12.2011 - 07.2015
- Effectively led planning, workflow, design and build activities for EPIC Ambulatory EHR Implementation and optimization efforts to over 300 clinics within the UMMS system.
- Spearheaded complex Specialty EMR Ambulatory implementations and enhancement requests for (Orthopedics, Otolaryngology, Cardiology, Internal Medicine, Pulmonary Transplant, Hepatology, Nephrology, Cardiac Surgery).
- Facilitated MyChart Implementations: Big-Bang University of Maryland Shore Systems, Baltimore Washington Medical Center (OBGYN, Orthopedics, Surgical Specialty, Senior Care, ID, General Surgery, Neurosurgery), University of Maryland School of Medicine (Family Medicine, Cardiology, Transplant, ID, Cardiac Surgery).
- Identified system optimization opportunities, collaborating with vendors to design and implement targeted solutions that enhanced user experience.
- Managed workflow and business process changes, ensuring successful integration and optimization of new or modified clinical information systems across departments.
- Maintained up-to-date project documents for all initiatives that include technical details, user expectations, project goals, work effort, accountability, and deliverables.
- Provided application support and training to end-users, facilitating smoother transitions to new systems and enhancing user proficiency.
Clinical Operations Specialist
University of Maryland Faculty Physicians, Inc.
Baltimore, MD
12.2010 - 12.2011
- Analyzed clinical and operational workflows, providing recommendations for successful transition to EMR application.
- Identified workflow resources and developed escalation processes to enhance operational efficiency.
- Provided ongoing support and training for the EMR, GE Registration, Billing and Scheduling system.
- Contributed to rollout schedule and internal business decisions for EMR implementation in Faculty Practice Ambulatory offices.
- Implemented staffing plans that effectively addressed responsible departmental needs and productivity measures.
Practice Manager
University of Maryland Faculty Physicians
Baltimore, MD
07.2008 - 12.2010
Education
Master of Business Administration - Project Management
Strayer University
Alexandria01-2019
Bachelor of Business Administration - Human Resource Management
Strayer University
Alexandria01-2009
Associates in Arts - Business Administration
Strayer University
Alexandria, VA01-2007
Skills
- Healthcare operations
- Insurance expertise
- Call center operations
- Customer service technology
- Operational management
- Project management
- Process improvement
- Compliance oversight
- Strategic planning
- Resource allocation
- Budget management
- Staff development and training
- Team performance management
- Leadership initiatives
Software Competency
- Call Center Systems: Five9 & AVAYA Phone Systems | CRM System | Eligibility Systems
- EMR Systems: EPIC Ambulatory | MyChart | Quest EHR | Medhok
- PBM System: RxNova
- Practice Management Systems: Cerner | GE Centricity | CollaborateMD
- Billing Revenue Systems: GE Centricity/Quest Billing | HEALTHsuite
- Human Resource Systems: ADP/Paychex/ Timekeeping Systems/Payroll & Benefits/Ceridian Dayforce
- Microsoft Office Suite: MS Word | Excel | PPT | Adobe | Viso | MS TEAMS | OneNote | Smartsheet
- Project Management Systems: SharePoint | Confluence
- Agentic Applications: CoPilot | ChatGtp | Claude
Timeline
Director, Member Services Department
Health Plan of San Mateo
10.2022 - Current
Manager, Member Services Department
Health Plan of San Mateo
05.2019 - 10.2021
HEDIS Project Manager
Santa Clara Family Health Plan
11.2018 - 05.2019
Adjunct Professor
Community College of Baltimore
05.2017 - 08.2021
Director of Operations
Primary Medicine
10.2016 - 06.2018
IT Applications Manager
Sinai Hospital
08.2015 - 10.2016
Application System Analyst
University of Maryland Medical System
12.2011 - 07.2015
Clinical Operations Specialist
University of Maryland Faculty Physicians, Inc.
12.2010 - 12.2011
Practice Manager
University of Maryland Faculty Physicians
07.2008 - 12.2010
Master of Business Administration - Project Management
Strayer University
Bachelor of Business Administration - Human Resource Management
Strayer University
Associates in Arts - Business Administration
Strayer University