Toni Hampton
Moreno Valley,CA
Summary
Experienced in managing small projects or components of larger projects under the oversight of senior project managers. Effectively leads project team members by leveraging guidance from senior leadership and securing necessary internal or external resources. Proactively supports project risk management by analyzing and resolving trigger events. Maintains regular communication with project team members and works closely with key stakeholders to provide support. Demonstrated success as a project management professional, delivering high-impact projects in diverse environments. Skilled in driving project timelines and ensuring quality outcomes through strategic planning and execution. Highly collaborative, adaptable, and dedicated to achieving team success and client satisfaction.
Overview
18
18
years of professional experience
Work History
Project Manager II - Utilization Management
Kaiser Permanente
08.2016 - Current
- Pursues effective relationships with others by sharing resources, information, and knowledge with coworkers and members
- Listens to, addresses, and seeks performance feedback
- Pursues self-development; acknowledges strengths and weaknesses based on career goals and takes appropriate development action to leverage / improve them
- Adapts to and learns from change, challenges, and feedback; demonstrates flexibility in approaches to work
- Assesses and responds to the needs of others to support a business outcome
- Completes work assignments by applying up-to-date knowledge in subject area to meet deadlines; follows procedures and policies, and applies data and resources to support projects or initiatives with limited guidance and/or sponsorship
- Collaborates with others to solve business problems; escalates issues or risks as appropriate; communicates progress and information
- Supports the completion of priorities, deadlines, and expectations
- Identifies and speaks up for ways to address improvement opportunities
- Manages small projects or components of larger projects with oversight from more senior project managers
- Develop and executes project plans independently or under the direction of others
- Assists with project financials by monitoring financial aspects for assigned project initiatives
- Monitors project performance (e.g., on time, on budget, within scope, and with quality) against plan under the guidance of more senior project managers
- Assists with project activities related to organizational change management (e.g., development and execution of user adoption, implementation, and training plans) as defined by the project
- Allocates resources, establishes schedules, and makes task assignments
- Leads the work of project team members with guidance from more senior project managers
- Requests internal or external resources to support completion of project activities and changes in schedule, scope, and budget
- Promotes project vision and objectives with project team
- Supports the management and proactive mitigation of project issues and risks by assisting in the analysis and resolution of trigger events
- Supports policy and procedure adherence of project plans by following KP, departmental, and/or business line policies and procedures
- Provides ongoing support to project personnel by regularly communicating with project team members to ensure schedule data and changes are accurately interpreted and accounted for
- Works closely with key stakeholders
- Provides real-time updates to project managers regarding scheduling conflicts and budget disparities
Utilization Management Coordinator
Monarch Healthcare
05.2016 - 08.2016
- Prioritized to consistently meet turnaround times and deadlines
- Verified eligibility and medical benefits
- Achieved high staff morale and retention through team building, effective communication and prompt problem solving
- Entered referral requests for Commercial, Medi-Cal and Medicare members into on-line system and approved request per clinical criteria for pass-through services
- Acted as initial contact and resource related to outreach, screening, and education of providers for authorization processing
- Acted as resource for clinical services department staff, inter-departmental staff, and health plan and provider offices
- Assisted with retro review claims process as needed
Utilization Analyst- Utilization Management
Kaiser Permanente
03.2008 - 08.2016
- Facilitated transfers and admissions of Kaiser patients from non-Kaiser facilities back to Kaiser Permanente
- Evaluated and distilled analyses conducted by other departments and/or outside consultants
- Provided analytical support to physicians, medical staff, and management from both Kaiser and Non-Kaiser emergency departments
- Investigated and reported issues relating to patient care or conditions that might hinder patient well-being
- Analyzed referrals and claims information for accuracy per established guidelines and provides education/feedback and reports as applicable
- Prepared detailed analysis of outside medical activity and submits reports/finding as requested
- Escalated to and consulted with senior staff when solution is unclear
- Reported problems with procedures and made suggestions for improvements
- Consistently complied with applicable laws and regulations and ensured that Kaiser Permanente adhered to Medicare and Medi-Cal regulations
Case Correspondence Clerk- California Outside Utilization Mgmt
Kaiser Permanente
08.2006 - 03.2008
- Contacted Non-Kaiser Facilities to obtain admission information on Kaiser members
- Entered patient information into OTRS and assign to appropriate case manager
- Utilized IM81, OPAS, and E-Referral to research patient information
- Answered calls from Doctors and/or Case managers and retrieve patient information
- Observed strict confidentiality and safeguarded all patient related information
- Created, maintained, and entered information into databases
- Trained and assisted staff
Education
High School -
Bellflower High School
06-1998
Skills
- Quality Assurance Process
- Service Focus
- Applied Data Analysis
- Relationship & Team Builder
- Complex Problem Solver
- Project Management
- Leadership
- Budget planning
- Project prioritization
- Risk management
Quote
Happiness is when what you think, what you say, and what you do are in harmony.
Mohandas Gandhi
Timeline
Project Manager II - Utilization Management
Kaiser Permanente
08.2016 - Current
Utilization Management Coordinator
Monarch Healthcare
05.2016 - 08.2016
Utilization Analyst- Utilization Management
Kaiser Permanente
03.2008 - 08.2016
Case Correspondence Clerk- California Outside Utilization Mgmt
Kaiser Permanente
08.2006 - 03.2008
High School -
Bellflower High School
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