Stephanie Hughes
Sequatchie,TN
Summary
Accomplished Systems Supervisor at BlueCross BlueShield of Tennessee, adept in leadership and capacity planning. Excelled in enhancing system efficiency through automation, leading cross-functional teams to develop technology solutions, and managing budgets effectively. Demonstrated strong problem-solving abilities and excellent communication, ensuring high-quality project outcomes and improved operational efficiency.
Overview
11
11
years of professional experience
1
1
Certification
Work History
Systems Supervisor
BlueCross BlueShield of Tennessee
04.2024 - Current
- Improved system efficiency by streamlining processes and implementing automation tools.
- Implemented a monthly performance matrix for monitoring team key performance indicators .
- Perform monthly and annual performance reviews for staff and provide coaching.
- Work as a liaison with both internal and external vendors and coordinating request for proposals for new vendors.
- Collaborate with cross-functional teams to develop comprehensive technology solutions for business needs.
- Attended meetings to deliver status reports to key stakeholders.
- Ensure NCQA and EQRO documentation is prepared for each evaluation.
- Wrote strategic business plans outlining need for departmental information technology resources.
- Implemented robust disaster recovery plans, minimizing potential losses from unforeseen events.
- Lead a team of business analysts to optimize network performance and enhance security measures.
- Manage budgets and resource allocation effectively for all projects without sacrificing quality results.
- Monitor system performance metrics regularly, identifying areas for optimization or upgrades when necessary.
Supervisor Health Promotion
BlueCross BlueShield of Tennessee
01.2022 - 04.2023
- Oversaw daily operations of the department of 18 Health Navigators, ensuring smooth workflow and timely completion of tasks.
- Provided reporting for forecast analysis and ad-hoc reporting in support of decision-making.
- Applied strong leadership talents and problem-solving skills to maintain team efficiency and organize workflows.
- Improved customer satisfaction with timely response to inquiries, addressing concerns, and finding effective solutions.
- Increased team productivity by implementing efficient workflows and setting clear expectations for staff members.
- Enhanced communication within the team by holding regular meetings and encouraging open dialogue among all members.
- Resolved conflicts among team members promptly, maintaining a harmonious working environment conducive to productivity.
- Identified operational inefficiencies and implemented corrective measures to increase effectiveness.
- Achieved significant improvements in operational efficiency, introducing and enforcing quality control measures.
- Evaluated staff performance and provided coaching to address inefficiencies.
- Educated staff on organizational mission and goals to help employees achieve success.
- Provided educational updates to the staff by writing detailed processes and updating the staff knowledge center repository.
Clinical Quality Research Analyst
BlueCross BlueShield of Tennessee
08.2017 - 01.2022
- Prepared detailed reports summarizing research findings and recommendations for further action.
- Conducted in-depth qualitative and quantitative research to identify trends and generate insights.
- Collaborated with cross-functional teams to generate relevant insights from diverse datasets.
- Streamlined internal workflows by automating data collection, analysis, and reporting tasks.
- Interpreted data and made recommendations from findings.
- Conducted quality audits for physicians, utilization management staff.
- Created audit tools based on departmental duties.
- Worked with IT to create a database to house audits and provide reporting.
- Led multiple workgroups to foster communication across areas of function in BlueCare.
- Tracked key metrics and developed spreadsheets and data models.
- Developed questionnaires and facilitated focus group discussions.
Utilization Management LPN
Blue Cross Blue Shield of Tennessee
01.2014 - 09.2017
- Utilized time management skills to prioritize tasks effectively, allowing for efficient completion of daily responsibilities.
- Maintained accurate documentation of all relevant clinical data, ensuring compliance with regulatory standards.
- Determined medical necessity for DME items using MCG (Miliman Care Guidelines)
Education
Master of Science - Health Administration Management
University of Phoenix
Tempe, AZ04-2022
Bachelor of Science - Health Administration
University of Phoenix
Tempe, AZ04-2019
Practical Nursing Certificate - Practical Nursing
Chattanooga State Community College
Chattanooga, TN07-2008
Skills
- Capacity planning
- Microsoft Office Suite
- Performance analysis
- Teamwork and collaboration
- Problem-solving
- Time management
- Attention to detail
- Excellent communication
- Multitasking Abilities
Leadership
- Problem-solving abilities
- Budget Management
- HIPAA
- Team building
- Task prioritization
- Decision-making
- Relationship building
- Adaptability and flexibility
- Interpersonal skills
Accomplishments
- BlueCare Awards Of Excellence nominee for innovation
- BlueCare Employee of the Year 2022
Certification
- Lean Six Sigma Green Belt Certification
- Milliman Care Guidelines (MCG)
- Six Sigma Yellow Belt Certification
Timeline
Systems Supervisor
BlueCross BlueShield of Tennessee
04.2024 - Current
Supervisor Health Promotion
BlueCross BlueShield of Tennessee
01.2022 - 04.2023
Clinical Quality Research Analyst
BlueCross BlueShield of Tennessee
08.2017 - 01.2022
Utilization Management LPN
Blue Cross Blue Shield of Tennessee
01.2014 - 09.2017
Master of Science - Health Administration Management
University of Phoenix
Bachelor of Science - Health Administration
University of Phoenix
Practical Nursing Certificate - Practical Nursing
Chattanooga State Community College
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