Tara Patrick
Director
Cedar Hill,Tx.
Summary
To oversee the infrastructure that coordinates necessary clinical, behavioral, and social care resources for members. To demonstrate the ability to function effectively under all types of circumstances while maintaining a clear perspective of goals to be accomplished. To have the ability to streamline and implement new structures and roles that create speed, efficiency, and support rapidly shifting business demands
Overview
6
6
years of post-secondary education
14
14
years of professional experience
Work History
DIRECTOR
ONESHARE HEALTH, LLC
Dallas, TX
11.2020 - Current
- Provided department oversight of 48+ staff, both indirect and direct reports.
- Set strategic goals for operational efficiency and increased productivity including establishment of operating standards regarding Hold Time, Service Level, Auxiliary Utilization, Agent Unavailability percentage, and Average Handle Time in accordance with industry standards.
- Analyze current operational processes and performance, recommending solutions for improvements.
- Key contributor in restructure and expansion of Operations department, including development and implementation of Member Resolution team.
- Collaborate with executive-level management in development of performance goals and long-term operational plans.
- Develop, implement, and monitor day-to-day operational systems and processes that provide visibility into goals, progress, and obstacles for our key initiatives.
- Collaborate and maintain relationships with all department heads within organizations to help make decisions regarding operational activities and goals.
- Oversee all activities related to call center and workforce management, including systems and processes, ensuring compliance with established benchmarks and standards at met consistently.
- Manage performance reports and dashboards and work queues to meet and exceed established turnaround times.
- Direct supervision of Managers and indirect supervision of both calling centers and Member Resolution teams including but not limited to supervisors, team leads and representatives.
- Defined, implemented and revised operational policies and guidelines.
- Evaluated performance, adjusted strategies and maintained agile, sustainable operations.
- Worked collaboratively with functional leaders to implement new procedures and corrective actions to improve quality.
- Directed management meetings to enhance collaboration and maintain culture based on trust and group problem-solving.
MANAGER
AETNA, A CVS HEALTH COMPANY
Dallas, TX
07.2018 - Current
- Provided oversight to 45+ call center staff and direct reports, approving timecards, conducting monthly 1-on-1 staff meetings, and assuring job goals are met within compliance.
- Met required operating standards regarding Hold Time, Service Level, and abandonment rate percentage in accordance with HHSC guidelines.
- Accountable for achievement of highest Net Promotor Score (NPS) for Medicaid call center staff for 2 consecutive months.
- Updated policies, procedures, and job aids as well as collaborated on configuration of IVR systems in order to optimize member experience.
- Serve as liaison between Senior Health Plan leadership and POD management regarding call center requirements and needs.
- Actively assisted in with implementation of internal processes to increase both member and employee satisfaction survey results.
- Act in role of liaison between multiple departments such as Provider Relations, Network Development, Claims, Utilization Management, and Informatics partners to ensure gaps identified are addressed and remedied.
- Addressed telephonic member and provider inquiries related to benefits and services.
- Submitted monthly scorecard reports to all required parties.
- Generated internal ad-hoc reports and analysis as needed for Medicaid Operation and Shared Services management.
SUPERVISOR STAR+PLUS
SUPERIOR HEALTH PLAN
Dallas, TX
05.2015 - 07.2018
- Responsible for division of 20+ direct reports, including in-office and remote staff, conduct monthly 1-on-1 meetings, maintain staffing, and assure job goals and compliance are met.
- Responsible for daily supervisory operations including recruiting and hiring of staff, office administration, time & attendance and compliance with regulatory requirements.
- Met and/or exceeded job goals and HHS state required compliance metrics quarterly for Service Level, Hold Time, and Abandonment Rate percentage.
- Service level Requirement 80% - End of year average exceeded goal by reaching 86%.
- Operational adherence goal of 90% (adhering to daily work schedule) was met/exceed by team(s) by end of year average of 91.5%.
- Completed monthly call quality audits using Avaya CMS Supervisor and Uptivity recording system to ensure that staff met or exceeded goal of 90%.
- Goal was exceeded with yearly team(s) average of 93.4%.
- Key contributor in the creation of internal Policy & Procedures and training curriculum for onboarding & refresher training to ensure contractual requirements.
- Act as interim Trainer to increase product knowledge for telephonic service coordinators that directly correlated to the positive increase in monthly quality audits scores & HIPAA compliance.
- Post Statewide training (traveled to all 5 regional offices in Texas):.
- Maintained retention rate of front-line telephonic staff at 94% for 4 consecutive quarters in 2017.
- Utilized a variety of learning & development tools such as webinars, in-person classroom training, PowerPoints, training alerts and virtual correspondence via the development of our Training SharePoint site.
- Continued in role of liaison between multiple departments such as Service Coordination clinical staff, Assessments, Authorizations, Provider Relations, Appeals and Grievances, Fair Hearings, and Training partners to ensure gaps identified are addressed and remedied.
- Generated internal ad-hoc reports and analysis as needed for Shared Services Operation management.
- Positively impacted HBR savings by consistently decreasing monthly error rate of upgrade waiver assessment referrals submitted and reduction of financial charges mandated by HHS for out of TAT assessment requirement.
- Assisted with oversight of telephonic staff in 4 regions in Texas: Lubbock, San Antonio, Corpus Christi, and McAllen.
- Assisted with implementation and training of Star Kids plan requirements as outlined in state contract which included execution of new HCPC/CPT codes and pre-authorization structure.
LEAD SERVICE COORDINATOR STAR+PLUS
SUPERIOR HEALTH PLAN
Dallas, TX
09.2013 - 05.2015
- Perform supervisory and administrative duties related to delivery of Long-Term Support Services.
- Compile, track and review multiple reports involving Individual Service Plans (ISP) and Medical Necessity Approval/Denials to ensure that timely submission is made in order to remain in compliance with state regulations.
- Continued partnership with HHSC Provider Support Unit (PSU) in weekly meetings to ensure Star Plus Waiver Individual Service Plans (ISP) were submitted timely and correctly in order to meet contractual compliance and mitigate financial sanctions.
- Met CMS required operating standards regarding Hold Time, Service Level, and abandonment rate percentage.
- Assisted with resolution of member/provider complaints or fair hearings and resolved claim issues through root cause analysis.
- Conducted staff meetings, monitored monthly performance scorecards, and assured job goals were met.
- Act in role of liaison between multiple departments such as Service Coordination clinical staff, Assessments, Authorizations, Provider Relations, Appeals and Grievances, Fair Hearings, and Training partners to ensure gaps identified are addressed and remedied.
- Aid with coaching of team related to delivery of Long-Term Support Services.
- Monitor inbound call queue to ensure adherence to established guidelines.
- Send queue status reports, as requested, to staff and upper management with team’s progress.
- Assist, assign, and track annual waiver reassessments and waiver upgrades, to designated service coordinator and follow up to ensure completion.
- Address and resolve, as needed, any escalated calls made by members and/or providers.
SERVICE COORDINATOR STAR+PLUS
SUPERIOR HEALTH PLAN
Dallas, TX
10.2011 - 09.2013
- Identified special needs members through completion of health screens and other resources.
- Worked with community outreach/member advocates to coordinate member’s care so that all unmet needs are addressed.
- Educated members on various community resources available for long term support services with goal of aiding in member's compliance and ultimately yielding positive health outcomes.
- Interviewed, determined eligibility and develop/modify care plans, while encouraging positive working relationships with members, providers, families, and primary care physicians based on members needs.
- Partnered with HHSC Provider Support Unit (PSU) in weekly meetings to ensure Star Plus Waiver Individual Service Plans (ISP) were submitted timely and correctly in order to meet contractual compliance and mitigate financial sanctions.
- Participated in member requested State Fair Hearings in order to provide explanation and documentation of adverse determination actions taken by health plan surrounding Long-Term Support Services such as Personal Attendant Services (PAS).
- Trained/mentored new Service Coordinators both in office as well as other service delivery areas thru out state.
PROGRAM COORDINATOR STAR+PLUS
SUPERIOR HEALTH PLAN
Dallas, TX
02.2011 - 10.2011
- Initiated/entered authorization requests for various Long-Term Support Services.
- Attended ongoing trainings and in services as directed.
- Performed tasks necessary to promote member compliance such as verifying start of care for long term care services, confirmation of delivery of requested durable medical equipment, etc.
- Screened members for eligibility of Long-Term Support Services and benefits.
- Answered phone queue and processed incoming faxes within established standards.
- Trained/mentored new Program Coordinators on current processes and protocols.
INTAKE COORDINATOR
UNITED HEALTHCARE
Dallas, TX
04.2008 - 01.2011
- Assisting providers/ facilities with entering prior authorization request for medical services (ex: home health care, durable medical equipment, office visits, etc.).
- Processing detailed prior authorization request of services that have been received via Right Fax, interoffice email system Intake Resolution Team (IRT), and/ or Voice Cert system.
- Providing group leadership and assistance to supervisor with questions and escalated call thru Vital Line
Education
Bachelor of Science - Biology
JACKSON STATE UNIVERSITY
Jackson, MS. 08.1996 - 08.2002
Skills
Process improvements
Timeline
DIRECTOR
ONESHARE HEALTH, LLC
11.2020 - Current
MANAGER
AETNA, A CVS HEALTH COMPANY
07.2018 - Current
SUPERVISOR STAR+PLUS
SUPERIOR HEALTH PLAN
05.2015 - 07.2018
LEAD SERVICE COORDINATOR STAR+PLUS
SUPERIOR HEALTH PLAN
09.2013 - 05.2015
SERVICE COORDINATOR STAR+PLUS
SUPERIOR HEALTH PLAN
10.2011 - 09.2013
PROGRAM COORDINATOR STAR+PLUS
SUPERIOR HEALTH PLAN
02.2011 - 10.2011
INTAKE COORDINATOR
UNITED HEALTHCARE
04.2008 - 01.2011
Bachelor of Science - Biology
JACKSON STATE UNIVERSITY
08.1996 - 08.2002
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