Results-oriented executive professional with history of delivering impactful organizational changes and strategic initiatives. Proven ability to lead and inspire teams, ensuring alignment with company goals and fostering culture of excellence. Renowned for adaptability and strong focus on achieving measurable results through effective collaboration and leadership.
2021-2022: Tasked with establishment of new portfolio management team designed to provide end-to-end support to Behavioral Health Clinical Operations (approx 2600 staff) supporting upwards of 100 initiatives annually
Created and instituted all new processes to include: standardized intake protocol, governance review committee, sizing/scoring scale to rank work requests, leadership prioritization forum, adoption of demand/capacity and project system and team documentation expectations
2023-Current: Significant expansion of role as part of organizational re-structuring, including oversight of all Enterprise Clinical Services (ECS) implementations impacting medical/behavioral Utilization Management function
Accountable to Senior Vice President of Utilization Management, inclusive of 8 senior leaders and their operational teams, delivering on operational financial targets, building and maintaining full portfolio and providing guidance on operational strategy
Associate Director of Care Advocacy- Behavioral Health
Optum, UnitedHealth Group
04.2015 - 02.2021
Led large operational teams of up to 300+ personnel, supervising daily performance as well as training and improvement plans
Primary oversight of managerial team, ensuring continuous improvement on long and short-term organizational objectives
Oversight of individual and team performance metrics, driving employee productivity while measuring operational and member-centric outcomes
Assisted senior leadership in managing all aspects of operations, inclusive of addressing negative trends, pursuing growth and optimization opportunities
Responsible for key business productivity metrics (KPI's) and associated financial spend for operating, benefit expenses
Manager of Care Advocacy- Behavioral Health
Optum, UnitedHealth Group
03.2012 - 04.2015
Provide direct supervision to clinically licensed staff: monthly one-to-one meetings, monthly call auditing, monitoring of call/KPI metrics, all team meetings, evaluation of performance and corrective measures, as needed
Maximized performance by monitoring daily activities and mentoring team members to ensure all regulatory, compliance and customer requirements met
Provide clinical oversight on complex behavioral health issues
Senior Care Advocate- Behavioral Health
Optum, UnitedHealth Group
07.2011 - 03.2012
Assist Clinical Program Manager in day-to-day management of clinical team (75+ employees)
Serve as a subject matter expert to front-line staff regarding appropriate protocols and procedures, as well as identifying and coordinating ongoing training in accordance with company policies and continuing education requirements
Provide clinical guidance through staffing of complex cases, ensuring appropriate application of clinical guidelines
Resolve account and customer escalations, promoting customer satisfaction
Care Advocate- Behavioral Health
Optum, UnitedHealth Group
03.2009 - 07.2011
Responsible for handling mental health crisis calls and providing real-time guidance and resolution
Serviced third-party payors in obtaining authorization for behavioral health services, documenting necessary related clinical information
Documented all clinical activities and progress in electronic medical record in accordance with policy and procedures.
Therapist
Inner Wisdom Counseling Center
10.2007 - 03.2009
Company Overview: Inner Wisdom Counseling Center is a partial hospital program providing therapeutic services to adults with behavioral health needs
Provided individual and group therapy sessions to patients suffering from mental health and substance related issues.
Case Manager Supervisor
The Bair Foundation
05.2002 - 10.2007
Company Overview: The Bair Foundation is a therapeutic foster care agency that works with Child Protective Services to provide children with special needs a nurturing foster home
<ul><li>Lead a high performing team of Case Managers, Injury Management Advisor and Technical Specialist. Acting as a Third Party Administrator and responsible for the management of the portfolio of Youi CTP Claims.</li><li>My role was to oversee and supervise the day to day operation of the claims team and to ensure that both our Statutory Benefits and Common Law claims portfolio are being managed at a high level and in line with the legislation.</li><li>I am responsible for design and implementation of framework for effective claims strategies to uplift Customer Experience including Business and Regulator deliverables.</li><li>Established and developed strong working relationships with our client Youi to ensure that regular business performance updates are provided, improve reporting and claims governance including risk oversight are being identified.</li><li>Develop new initiatives and ideas to assist with the continuous improvement of claims processes and procedure including the rolling out of such plan to the business.</li></ul> at Employers Mutual Limited<ul><li>Lead a high performing team of Case Managers, Injury Management Advisor and Technical Specialist. Acting as a Third Party Administrator and responsible for the management of the portfolio of Youi CTP Claims.</li><li>My role was to oversee and supervise the day to day operation of the claims team and to ensure that both our Statutory Benefits and Common Law claims portfolio are being managed at a high level and in line with the legislation.</li><li>I am responsible for design and implementation of framework for effective claims strategies to uplift Customer Experience including Business and Regulator deliverables.</li><li>Established and developed strong working relationships with our client Youi to ensure that regular business performance updates are provided, improve reporting and claims governance including risk oversight are being identified.</li><li>Develop new initiatives and ideas to assist with the continuous improvement of claims processes and procedure including the rolling out of such plan to the business.</li></ul> at Employers Mutual Limited