Tia Kastanes
Rocklin,CA
Summary
Accomplished and results-driven Director of Clinical Operations with over 15 years of experience in healthcare management. Proven track record of successfully leading cross-functional teams to optimize clinical processes and enhance operational efficiency. Adept at developing and implementing strategic initiatives to ensure compliance with regulatory standards and improve overall patient care delivery. Demonstrated expertise in clinical management, resource allocation, and performance optimization. Strong interpersonal and communication skills, fostering collaborative relationships with internal and external stakeholders. Committed to driving continuous improvement in clinical operations to achieve organizational objectives and elevate the quality of healthcare services.
Overview
16
16
years of professional experience
1
1
Certification
Work History
Director of Clinical Operations
TeleMed2U
09.2021 - Current
- Developed systems and procedures for effective project management and clinical operations.
- Researched and resolved disputes, billing discrepancies and claims efficiently to maintain customer satisfaction, boosting satisfaction ratings.
- Fostered strong, positive relationships with key providers by coordinating, facilitating and leading partnership meetings and identifying on-site enrollment opportunities.
- Increased provider satisfaction scores by collecting and credentialing demographic updates, investigating claims and inquiries and overseeing network integrity.
- Brought in 376 new providers to enhance coverage and meet program goals.
- Initiated physician and hospital orientations to support ongoing education of health care provider community.
- Contributed to and enhanced audit processes to maximize quality management standards.
- Identified network gaps and collaborated with recruiters to fill deficiencies.
- Assisted with physician recruitment by identifying specific providers within designated territories, negotiating rates for new physicians and distributing provider agreements.
- Supervise and provide guidance to department heads, including but not limited to, finance, facilities, human resources, and administrative services.
Manager of Clinical Operations/Provider Relations
TeleMed2U
05.2021 - 09.2021
- Proven experience in building and sustaining high-performing teams.
- Ability to identify and lead operational initiatives that align with organizational goals.
- Strong communication skills for providing ongoing education, training, and communication to all providers.
- Proven experience in building and maintaining strong relationships with major IPA/Medical Groups, PPO physicians, and hospitals.
- Ability to actively participate in escalated complex claims issues by facilitating meetings with providers and coordinating internal research for resolution.
- Understanding and adherence to regulatory and legislative matters affecting provider relations.
- Proficiency in data management related to provider demographics.
- Active participation in cross-functional work teams, projects, and meetings.
- Commitment to getting results the right way and fostering continuous learning within the team.
- Strong networking skills for effective management of servicing major IPA/Medical Groups, PPO physicians, and hospitals.
Emergency Compliance and Operations Manager
Kaiser Permanente
05.2016 - 05.2021
- Stay abreast of federal, state, and local regulations related to emergency management and ensure the organization's compliance.
- Develop, update, and maintain comprehensive emergency response plans in collaboration with relevant stakeholders.
- Conduct risk assessments to identify potential emergency scenarios and develop mitigation strategies.
- Serve as the central point of contact during emergency situations, coordinating communication and activities among various departments and external agencies.
- Implement and oversee incident command systems to manage resources efficiently during emergencies.
- Organize and oversee emergency response drills to evaluate the effectiveness of plans and identify areas for improvement.
- Conduct after-action reviews of emergency responses to identify lessons learned and areas for improvement.
- Implement corrective actions and updates to emergency plans based on lessons learned and changing regulations.
- Coordinate and conduct regular emergency preparedness training sessions for staff across all levels.
- Ensure that emergency plans align with industry best practices and regulatory requirements.
Clinical Business Consultant
Independent Contractor
07.2014 - 05.2016
- Collaborate with clinical teams to analyze and understand existing workflows and processes.
- Identify opportunities for optimization, efficiency improvements, and cost reduction in clinical operations.
- Utilize data analytics to assess clinical performance metrics and identify areas for improvement.
- Generate insightful reports and dashboards to support informed decision-making by clinical and business leadership.
- Work closely with clinical leaders and executives to align clinical goals with overall organizational strategy.
- Contribute to the development of strategic initiatives that enhance patient care quality and operational efficiency.
- Develop and implement performance improvement initiatives based on evidence-based practices and industry benchmarks.
- Monitor and evaluate the impact of implemented improvements on clinical outcomes.
- Identify opportunities for cost containment without compromising patient care quality.
- Collaborate with regulatory affairs teams to ensure clinical practices align with industry standards and legal requirements.
Paralegal
Hall Law Office
10.2013 - 07.2014
- Conduct comprehensive reviews of medical records, ensuring accuracy, completeness, and relevance to legal cases.
- Summarize and organize medical information for use in legal proceedings.
- Communicate with healthcare providers, medical facilities, and experts to obtain necessary medical records and information.
- Facilitate the exchange of information between legal teams and medical professionals.
- Conduct legal research related to medical issues, regulations, and standards.
- Summarize and present findings to attorneys to support case strategy.
- Draft and prepare legal documents, including medical chronologies, affidavits, and discovery responses.
- Collaborate with attorneys to ensure accurate and legally sound document preparation.
- Assist in the preparation for hearings, ensuring all medical evidence is properly presented.
- Draft settlement agreements and liaise with medical professionals for supporting documentation.
Business Manager
Galleria Surgery Center
12.2008 - 10.2013
- Oversee and coordinate the day-to-day clinical operations of the oral and maxillofacial surgery department.
- Ensure efficient patient flow, timely scheduling, and optimal utilization of surgical suites.
- Recruit, train, and supervise clinical and administrative staff within the oral and maxillofacial surgery department.
- Provide ongoing training and professional development opportunities for clinical personnel.
- Develop and manage the departmental budget, ensuring cost-effective operations.
- Monitor and control expenditures related to supplies, equipment, and staffing.
- Collaborate with surgeons and other healthcare professionals to maintain and improve the quality of patient care.
- Implement and monitor protocols for patient safety and satisfaction.
- Foster positive relationships with patients, referring physicians, and other healthcare providers.
- Address patient concerns and ensure effective communication between the surgical team and other healthcare professionals.
EMT-Paramedic
American Medical Response, AMR
08.2007 - 02.2011
- Respond promptly to emergency calls, assessing the scene and ensuring personal and bystander safety.
- Administer initial medical care and assess the condition of patients, including vital signs and medical history.
- Conduct thorough patient assessments to determine the nature and severity of the medical condition or injury.
- Triage patients based on the urgency of their medical needs and prioritize care accordingly.
- Administer basic life support (BLS) interventions, including CPR, airway management, and automated external defibrillator (AED) use.
- Provide advanced life support (ALS) interventions if trained as a Paramedic, such as medication administration and intravenous (IV) therapy.
- Maintain accurate and complete documentation of patient assessments, interventions, and other relevant information.
- Ensure the readiness and proper functioning of emergency vehicles and medical equipment.
- Stay current with advancements in pre-hospital care, emergency medical protocols, and relevant certifications.
- Pursue ongoing training and professional development opportunities to enhance skills and knowledge.
Education
Associate of Science - Biology
University Of California - Davis
Davis, CABachelor of Science - Psychology
University Of Phoenix
Phoenix, AZ2015
Master of Science -
UC Davis
Davis, CASkills
- Leadership and Team Management
- Strategic Thinking
- Protocol Development
- Provider Recruitment
- Regulatory Compliance
- Quality Assurance
- Staff Training
- Performance Metrics
- Process Improvement
- Strategic Planning
- Quality Improvement
- Cross-functional Collaboration
Certification
- ACLS - Advanced Cardiac Life Support
- AHA - American Heart Association Instructor
- BLS - Basic Life Support
- PALS - Pediatric Advanced Life Support
- Six Sigma Certification
- Kaizen Certification
- Lean Healthcare Certification
Timeline
Director of Clinical Operations
TeleMed2U
09.2021 - Current
Manager of Clinical Operations/Provider Relations
TeleMed2U
05.2021 - 09.2021
Emergency Compliance and Operations Manager
Kaiser Permanente
05.2016 - 05.2021
Clinical Business Consultant
Independent Contractor
07.2014 - 05.2016
Paralegal
Hall Law Office
10.2013 - 07.2014
Business Manager
Galleria Surgery Center
12.2008 - 10.2013
EMT-Paramedic
American Medical Response, AMR
08.2007 - 02.2011
Associate of Science - Biology
University Of California - Davis
Bachelor of Science - Psychology
University Of Phoenix
Master of Science -
UC Davis
Similar Profiles
Kero AgaibyKero Agaiby
Associate Governmental Program Analyst at CA Department of Fish and WildlifeAssociate Governmental Program Analyst at CA Department of Fish and Wildlife
Emmersyn PlantzEmmersyn Plantz
Queen Aggravain at Once Upon A Mattress Youth EditionQueen Aggravain at Once Upon A Mattress Youth Edition
Jason HetlandJason Hetland
Solutions Implementation Consultant at One IncSolutions Implementation Consultant at One Inc
Tyler GalindoTyler Galindo
Family Caregiver at Family MembersFamily Caregiver at Family Members
Cami MaxwellCami Maxwell
Director of Clinical Operations at Personalized Health PartnersDirector of Clinical Operations at Personalized Health Partners