Work Preference
Summary
Overview
Work History
Education
Skills
Certification
Timeline
Generic
Open To Work

Tammy Jennings

Houston,TX

Work Preference

Job Search Status

Open to work
Desired start date: 2 weeks notice

Desired Job Title

Clinical Program ConsultantNetwork Program ManagerBusiness Process Analyst – Clinical ServicesSenior Recovery/Resolutions Analyst

Work Type

Full TimeConsulting

Location Preference

RemoteHybrid
Location: Houston, TX, US
Open to relocation: Yes

Salary Range

$98000/yr - $200000/yr

Important To Me

Career advancement401k matchHealthcare benefitsStock Options / Equity / Profit SharingPaid time offCompany CulturePaid sick leaveWork-life balanceWork from home optionFlexible work hoursPersonal development programs

Summary

Experienced with healthcare operations, organizational management, and regulatory compliance. Utilizes strategic planning to optimize facility functions and improve patient services. Track record of effective team leadership and operational efficiency.

Overview

16
16
years of professional experience
1
1
Certification

Work History

Clinical Program Consultant

Optum
12.2022 - Current
  • Lead the creation and execution of Cost Benefit Impact Assessments (CBIA) for new initiatives affecting Optum Enterprise Clinical Services (ECS) and UnitedHealthcare Clinical Services (USC), to ensure accurate staffing and cost needs to gauge ROI and operational impacts.
  • Work closely with clinical operations, finance, workforce management, and business operations to gather data, and refine staffing and cost assumptions, ensuring accurate assessments that influence strategic decisions.
  • Develop and present business impact analyses to senior leadership, offering recommendations on staffing, resource allocation, and process improvements based on data-driven insights.
  • Partner with finance and workforce management teams to refine the CBIA process and improve data accuracy.
  • Provide clear, actionable communication to leadership through written, visual, and oral presentations, ensuring transparency and informed decision-making at all organizational levels.
  • Support cost development and approval processes, ensuring that initiatives are appropriately sized.

Network Program Manager

UnitedHealthcare
08.2018 - 12.2022
  • Provide leadership and direction for training initiatives on solutions and strategies.
  • Collaborate in the development of ancillary, network, and affordability strategies.
  • Facilitated stakeholder engagement sessions with providers and internal teams, gathering requirements, setting priorities, and managing expectations across diverse groups.
  • Supported the overall cost development and approval process, ensuring timely approval initiatives for successful implementation.
  • Define project scope, goals, and objectives.
  • Utilized project management principles to adapt project plans, and timelines, delivering programs on time and within budget.
  • Facilitate communication among team members and stakeholders.
  • Identify and mitigate risks that could impact project success.
  • Provided data-driven insights and regular project performance updates, leveraging data analytics tools to track progress, mitigate risks, and inform strategic decisions.
  • Formalize project closure, evaluate successes, and track lessons learned.

Business Process Analyst – Clinical Services

UnitedHealthcare
04.2013 - 08.2018
  • Close partnership and collaboration with assigned Market Chief Medical Officers (MCMOs) to ensure their program coordination, data analysis, and ongoing support needs are met.
  • Provide analytical and project management support to MCMOs for Medicare and Commercial lines of business.
  • Support the strategic and tactical needs of all UHC MCMOs, United Clinical Services, and Optum functional area leadership.
  • Contact/Relationship Manager for specific MCMOs - act as a hub for Interdisciplinary Team (IDT) of physicians, APNs, nurses, clinical and executive leadership, finance, and risk/underwriting.
  • Led weekly Clinical Rounds to identify areas of opportunity for process improvements, gaps in care, etc. to improve the member experience.
  • Created comprehensive business impact analysis to support Enterprise Clinical Services Operations, facilitating informed decision-making.
  • Reporting/Data Analytics - produce a variety of reports for various markets, including daily census, target monitoring, trend data, risk, finance, and ad hoc reports.
  • Evaluated available data to identify and develop new process enhancements, summarizing conclusions and presenting recommendations to leadership.
  • Produced Monthly and Quarterly Business Reviews to evaluate performance, revenue growth, and member satisfaction.
  • Proficient with multiple internal reporting tools/systems to dive into data and identify actionable opportunities for affordability initiatives, including the use of Tableau, PowerBi, and Excel Pivots.

Senior Recovery/Resolutions Analyst

UnitedHealthcare
10.2009 - 04.2013
  • Focus on the subset of claims with the highest potential for impact.
  • Review claims on a prepayment basis, with an end-to-end scope which may include authorization, billing, coding requirements, clinical and medical guidelines, data entry, duplicates, provider contracts, timely filing, and suspect fraud, waste, or abuse.
  • Collaborate with others to identify and solve moderate to complex problems and create strategies that encourage efficiency and quality.
  • Assist in stopping overpayment and underpayment of claims, by identifying and preventing errors that could impact the payment amount of a claim.
  • Conduct/utilize investigations/overpayment identifications to determine accuracy of claims payment prospectively and retrospectively.
  • Analyze contractual requirements to determine if funds are owed to payers.
  • Update applicable claims systems to ensure that claims payment reflects accurate payment levels.
  • Demonstrate understanding of contractual compliance regulations in provider- specific contracts, state-specific COC’s and customer-specific contracts.

Education

Bachelor’s Degree - Healthcare Management with a Concentration in Healthcare Administration

University of Phoenix
Phoenix, AZ

Skills

  • Program & Project Management
  • Data Analysis and Reporting
  • Tableau, Power BI, Excel
  • Data-Driven Decision Making
  • Cost Business Impact Analysis and Staffing Summaries
  • Cross-Functional Collaboration and Leadership
  • Claims Platform Experience
  • Clinical workflow optimization
  • Healthcare analytics
  • Quality improvement
  • Best practices implementation
  • Healthcare management
  • Workflow planning

Certification

  • Level 1 Medicare and Retirement Certified | UnitedHealthcare, 2018
  • Certified in Medical Coding and Billing | UnitedHealthcare

Timeline

Clinical Program Consultant

Optum
12.2022 - Current

Network Program Manager

UnitedHealthcare
08.2018 - 12.2022

Business Process Analyst – Clinical Services

UnitedHealthcare
04.2013 - 08.2018

Senior Recovery/Resolutions Analyst

UnitedHealthcare
10.2009 - 04.2013

Bachelor’s Degree - Healthcare Management with a Concentration in Healthcare Administration

University of Phoenix

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