Hi, I’m
Ruth Elisabet Hyland
Sachse,TX
Summary
Hardworking and dependable candidate able to manage multiple priorities simultaneously with accuracy and a positive attitude. Ready to help team achieve company goals.
Overview
25
years of professional experience
Work History
E-commerce
Entrepreneur/Business Owner
03.2021 - Current
Job overview
- Prepared bank deposits and handled business sales, returns and transaction reports.
- Consulted with customers to assess needs and propose optimal solutions.
- Put together realistic budgets based upon costs and fees for successfully operating business.
- Developed and implemented marketing strategies to generate new customers and increase sales and profit margins.
- Conducted target market research using social media to discover customer needs and analyze competitor trends.
- Worked with marketing teams to create print and online advertisements to bring in new customers.
- Assessed damaged materials and notified manufacturers/suppliers of needed repairs.
- Performed statistical analyses to gather data for operational and forecast team needs.
- Interacted well with customers to build connections and nurture relationships.
- Managed purchasing, sales, marketing and customer account operations efficiently.
- Negotiated price and service with vendors to decrease expenses and increase profit.
- Handled problematic customers and clients to maintain excellent customer service.
- Monitored daily cash discrepancies, inventory shrinkage and drive-off.
- Supervised creation of exciting merchandise displays to catch attention of store customers.
- Built Social Media brand by implementing effective marketing and customer engagement plans
Hyland Home
Stay at Home Mom
02.2017 - Current
Job overview
- Mediated between family members (my kids) to facilitate conflict resolution and build healthy family relationships.
- Offered community resources as entertainment to clients to meet family needs.
- Developed and implemented social work plans to achieve desired goals and properly align social work activities.
- Responded to crises and emergency situations to provide immediate assistance to children or husband in need.
- Developed education and social programs to provide clients with knowledge and skills for healthy, productive lives.
- Skilled at working independently and collaboratively in team environment
- Self-motivated, with strong sense of personal responsibility
- Proven ability to learn quickly and adapt to new situations
- Worked well in team setting, providing support and guidance
Blue Cross Blue Shield of Texas
Clinical Account Consultant
09.2013 - 05.2017
Job overview
- Presented Clinical Programs overview to internal employees of Blue Cross Blue Shield of Texas
- Presented utilization, engagement and estimated cost avoidance data in client facing review meetings
- Communicate with Clinical Operations team regarding changes to client benefit design and incentives then update Group profiles which clinicians use to guide members during medical management program engagement
- Collaborate with Client Consultant team to drill into high cost claimants and determine which diagnoses are driving costs and then provide recommendations HCSC resources (BCC, etc.) that may help decrease costs
- Provide suggestions and recommendations on best resources for clients based on membership’s work environment and associated risk factors
- Consult client on potential incentives to assist in increasing engagement into BCC programs and provide examples of successes
- Research group specific member cases in medical management system to provide success stories during client facing meetings showing how members have been motivated to change health status
- Maintained clean and organized files by keeping account's records up-to-date.
- Maintain positive, collaborative relationships and open communication with Account Executives and Account Managers to gather updates on benefit changes, client dynamics, and to assist with report requests.
Disease Management, Blue Cross Blue Shield Texas
Supervisor
06.2011 - 09.2013
Job overview
- Presented Blue Care Connection Condition Management program to prospective clients and active custom group accounts based on understanding of client’s needs and benefit design
- Managed all phases of project (development, implementation, follow-up) to develop job aid for Condition Management Low Back Pain program
- Managed BCBSTX telecommuter program offsite staff.
- Served as Communications co-chair for Business Resource Group, WISE: Women Improving Strength of Enterprise
- Chaired Internal meetings for Medical management supervisors under direction of Vice President of Clinical Programs.
- Collaborated with client’s external vendor to help provide staff understanding of vendor’s roles and services offered to improve staff’s ability to provide members information on available benefits
- Collaborated with colleagues to identify best practices for Condition management outreach process
- Participated in Management Effectiveness Series, Leadership module established for Health Care Service Corporation employees.
- Performed chart and telephonic quality audits monthly to insure members receive excellent customer service.
- Performed chart and telephonic quality audits monthly to insure members receive excellent customer service
- Communicated consistently with direct reports upcoming business processes, changes and future strategies.
- Provided direct reports with upcoming educational opportunities to assist them in obtaining Continuing Education hours for required licensure.
- Implemented Peer recognition and Team building objectives in 2012 for Commercial Condition management team.
- Applied strong leadership talents and problem-solving skills to maintain team efficiency and organize workflows.
- Handled customer complaints, resolved issues, and adjusted policies to meet changing needs.
Free City International, Refugee
English Teacher Volunteer
01.2013 - 05.2013
Job overview
- Assessed student progress and provided feedback to improve performance and establish academic success.
- Developed innovative lesson plans to engage students in English language learning.
- Prepared and implemented lesson plans covering required course topics.
Utilization Management, Blue Cross Blue Shield
Supervisor
12.2007 - 06.2011
Job overview
- Presented Utilization Management program to active custom group account based on understanding of client’s needs and benefit design
- Collaborated with case management vendor, Active Health to identify member needs and provide solutions
- Collaborated with Call Center supervisors to determine optimal process flow and develop best practices
- Collaborated with Manager to problem solve workload barriers
- Served as Team Lead for 2011 Blue Pulse initiatives project for Utilization, Lifestyle management, and Condition management departments
- Implemented mentorship program for new employees hired into Utilization management department
- Conducted chart audits to identify training needs for Quality Improvement department
- Insured medical reviews were completed within URAC accreditation standards
- Trained staff to have comprehensive understanding of impact of URAC standards on their work
- Collaborated with Training department to ensure quality chart reviews.
- Applied strong leadership talents and problem-solving skills to maintain team efficiency and organize workflows.
- Handled customer complaints, resolved issues, and adjusted policies to meet changing needs.
Blue Cross Blue Shield Of Texas
Medical Reviewer II
06.2006 - 12.2007
Job overview
- Mentored new employees for Utilization Management department ensuring that understood departmental policies as well as regulatory standards like URAC
- Collaborated with Medical directors to determine medical necessity of medical and surgical requests
- Evaluated member medical history to determine medical necessity for medical and surgical services
- Approved and denied medical services based on case review and medical necessity
- Provided referrals to Behavioral Health and Case Management for members with complicated medical history
- Consulted with Blue Pulse Committee on methods to improve employee engagement and satisfaction.
- Utilized electronic medical record systems to store, retrieve and process patient data.
- Input data into computer programs and filing systems.
Richardson Independent School District
School Nurse
08.2003 - 08.2006
Job overview
- Provided health care in a bilingual environment for Spanish-speaking primary-age children
- Served as a community-liaison to locate medical, dental, and financial assistance
- Educated teachers and students to promote preventative measures and to avoid health problems
- Developed after school Yoga Class for teachers and faculty personnel.
- Assessed student health and identified potential health concerns to provide appropriate care.
- Administered medication to students as prescribed by physicians to provide necessary treatment and manage health conditions.
- Served as liaison between families, school personnel, and other healthcare providers on behalf of students.
- Educated students on various health topics to promote overall health and wellbeing.
International Mission Board
Mentor/leader
07.2001 - 07.2003
Job overview
- Participated on team to meet physical and spiritual needs of low-income families in Valencia
- Developed faith based leadership classes for high school and university students.
Dallas Public Schools
School Nurse
10.2000 - 08.2001
Job overview
- Provided resources for battered women and abused children
- Collaborated with Dallas Police Department to assist children with possible abuse
- Provided health care to primary-age children
- Insured preventative measures on school campus for every child
- Developed teaching resources for teachers and faculty personnel to increase wellness.
- Assessed student health and identified potential health concerns to provide appropriate care.
- Administered medication to students as prescribed by physicians to provide necessary treatment and manage health conditions.
- Served as liaison between families, school personnel, and other healthcare providers on behalf of students.
- Educated students on various health topics to promote overall health and wellbeing.
Children’s Medical of Dallas
Registered Nurse
02.2000 - 10.2000
Job overview
- Educated and prepared each patient and family for surgical procedures
- Collaborated with specialty teams to insure familiarity of hospital environment
- Focused on patient’s comfort level to minimize pain and discomfort during recovery.
Parkland Health and Hospital System
Registered Nurse, Labor and Delivery
07.1998 - 02.2000
Job overview
- Maintained positive and calm setting for patients in labor
- Focused on education for pain control and breathing techniques.
Education
University of Mary Hardin BaylorBelton, TX
Bachelor of Science from Nursing
05.1998
Skills
- Strong Analytical and Problem-Solving Skills
- Product Organization
- Customer Consulting
- Brand Representation
- Speaking
- Customer Service
- Business Relations
- Coordination
- Product Promotion
- Data Evaluation
Accomplishments
- Years Supervisory ExperienceYears Clinical Nursing ExperienceYears Medical Management Operational Experience
- Knowledge of Blue Care Connection (BCC) Programs
- Experience Managing Client Facing Clinical Staff
- Lead Experience on Cross-Departmental Project Components
Affiliations
Licensed Registered Nurse, State of Texas
Certified Case Manager Toastmasters Member?????
LEADERSHIP____________________________________________________________________________
Trustee and Treasurer, Ventures & Values, a Non profit business consulting firm
Committee member, WISE Richardson Chapter: Women Influencing Strategic Enterprise, a Business Resource Group
Languages
Spanish
Limited Working
Timeline
Entrepreneur/Business Owner
E-commerce
03.2021 - Current
Stay at Home Mom
Hyland Home
02.2017 - Current
Clinical Account Consultant
Blue Cross Blue Shield of Texas
09.2013 - 05.2017
English Teacher Volunteer
Free City International, Refugee
01.2013 - 05.2013
Supervisor
Disease Management, Blue Cross Blue Shield Texas
06.2011 - 09.2013
Supervisor
Utilization Management, Blue Cross Blue Shield
12.2007 - 06.2011
Medical Reviewer II
Blue Cross Blue Shield Of Texas
06.2006 - 12.2007
School Nurse
Richardson Independent School District
08.2003 - 08.2006
Mentor/leader
International Mission Board
07.2001 - 07.2003
School Nurse
Dallas Public Schools
10.2000 - 08.2001
Registered Nurse
Children’s Medical of Dallas
02.2000 - 10.2000
Registered Nurse, Labor and Delivery
Parkland Health and Hospital System
07.1998 - 02.2000
University of Mary Hardin Baylor
Bachelor of Science from Nursing
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