Summary
Overview
Work History
Education
Skills
Accomplishments
Timeline
Volunteer

KIMBERLY STETSON

Bothell,WA

Summary

Dedicated service-oriented professional with over 35 years of experience in healthcare, focusing on advancing diversity, equity, and inclusion. Demonstrates a proven ability to engage diverse populations through attentive listening and effective solution implementation. As a Program Coordinator, excels in strategic planning, operational support, and fostering collaboration to improve processes and enhance customer service. Renowned for attention to detail and the ability to align program goals with organizational objectives to drive positive outcomes.

Overview

18
18
years of professional experience

Work History

Program Coordinator, Care Management

Community Health Plan of Washington
Seattle, WA
12.2023 - Current
  • Delivered administrative and project coordination support to various Care Management teams.
  • Created and now coordinates the referral hub program.
  • Onboards all new care management employees.
  • Part of the employee-led Grassroots Learning program.
  • Founding member of the Community Pride Employee Resource Group, and also part of the leadership team.
  • Prepared detailed reports for stakeholders, highlighting program achievements and challenges.
  • Assisted in the creation and revision of program policies and procedures to ensure compliance.
  • Maintained comprehensive databases of participants, activities, and outcomes for reporting purposes.

Member Engagement Specialist, Care Management

Community Health Plan of Washington
Seattle, WA
02.2019 - 12.2023
  • Facilitates communication and coordination between various stakeholders effectively.
  • Ensured timely management of requests and information concerning audits and annual reports.
  • Ensured compliance with company policies during onboarding process.
  • Collaborated with diverse individuals to achieve objectives and resolve issues in care management services.
  • Prioritized and organized tasks to efficiently accomplish service goals.
  • Facilitated HCA required care services tailored to the particular needs of Native Americans, immigrants, youth and older adults.

Intake Coordinator, Utilization Management

Community Health Plan of Washington
Seattle, Washington
01.2018 - 02.2019
  • Maintained precise records for member and provider requests.
  • Recognized as a top coordinator in the UM team.
  • Led initiative aimed at boosting efficiency via employee suggestions.
  • Enhanced workflow by developing effective intake protocols.
  • Kept precise records of client intakes in electronic database.
  • Evaluated staff performance for compliance with quality benchmarks and procedural accuracy.
  • Set standards alongside management to enhance departmental operations.
  • Ensured provision of top-notch care through collaboration with diverse professionals.

Utilization Review Specialist

Seattle Children's Medical Center
Seattle , WA
03.2007 - 03.2017
  • Coordinated with providers to gather essential clinical data, strengthening authorization decisions.
  • Enhanced criteria by incorporating evolving standards for improved utilization review.
  • Evaluated documentation to confirm conformity with required standards.
  • Determined additional staffing, equipment, and service needs by examining historical information and seasonal fluctuations.
  • Facilitated open communication channels between governance boards, department heads, and healthcare personnel.
  • Coordinated with insurance carriers to secure authorization for patient services.
  • Executed retrospective evaluations of medical procedures and treatments.
  • Coordinated strategies to improve workforce administration and training in healthcare environments.
  • Performed concurrent, retrospective, and discharge planning reviews.

Education

Master of Arts - Public Health with a Health Care Administration concentration

University of Arizona Global Campus
Glendale
01-2024

Bachelor of Arts - Health Care Administration

University of Arizona Global Campus
Glendale, AZ
03-2024

Skills

  • Diversity, Equity, and Inclusion principles
  • Verbal communication
  • Written communication
  • Organizational skills
  • Time management
  • Corporate communications
  • Problem solving
  • Customer service, sensitive to the needs of diverse populations
  • Attention to detail, collects, and tracks information for reports and audits
  • Coordination of weekly and monthly reports
  • Process improvement
  • Data analysis
  • Database management
  • Cross-functional coordination
  • Performance quality assurance
  • Teamwork and collaboration
  • Staff evaluation
  • Referral coordination
  • Promotions development
  • Active listening
  • Project coordination
  • Multitasking Abilities
  • Critical thinking
  • Administration
  • Management
  • Telecommunications
  • Creating presentations
  • Research

Accomplishments

  • Thumbs Up nominations
  • Pat On The Back award

Timeline

Program Coordinator, Care Management

Community Health Plan of Washington
12.2023 - Current

Member Engagement Specialist, Care Management

Community Health Plan of Washington
02.2019 - 12.2023

Intake Coordinator, Utilization Management

Community Health Plan of Washington
01.2018 - 02.2019

Utilization Review Specialist

Seattle Children's Medical Center
03.2007 - 03.2017

Master of Arts - Public Health with a Health Care Administration concentration

University of Arizona Global Campus

Bachelor of Arts - Health Care Administration

University of Arizona Global Campus

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KIMBERLY STETSON