Summary
Overview
Work History
Education
Skills
Websites
Certification
Education
Awards
Timeline
Generic

Tiffany Hendricks

Frisco,TX

Summary

Dedicated, innovative and performance-driven professional with progressive experience managing clinical and nonclinical activities, improving clinical and non-clinical quality, conceptualizing patient care initiatives and programs, and streamlining compliance processes across medical, customer service and health sciences. Proven success in outstanding quality improvement, operational strategy, quality initiatives according to procedures/regulations, and resolving complex clinical and non-clinical performance gaps. Ability to independently set and manage multiple competing priorities, internal/external program execution through appropriate tracking and operating mechanisms. Outstanding communicator; able to establish and maintain strong rapport and relationships with wide range of stakeholders. Energetic leader with integrity that strives to achieve desired organizational outcomes and value.

Overview

18
18
years of professional experience
1
1
Certification

Work History

Senior Director, Care Management Oversight/ Operations Integrity

Cityblock Health, Inc.
01.2022 - Current
  • Operational responsibility for Care Management Oversight, Process Improvement and Clinical Audit teams to ensure quality delivery to Commercial, Medicaid, Medicare, Dual Eligible populations across 6 markets
  • Strategic leader and subject Matter expert to internal partners regarding regulatory compliance, model of care requirements and quality of care
  • Optimized operational processes using analytics tools to address client-specific metrics.
  • Design, build and implement end to end processes for Delegation Oversight team to drive successful CMS, NCQA, State Department, and client audits of execution of delegation arrangements, contracts, and agreements for startup organization
  • Promote cross functional collaboration within organization to drive successful outcomes and corrective action plan management
  • Spearheaded cross functional initiatives across organization and delegated markets tore Management Delegation program and Cityblock Model of Care markets
  • Established data-driven decision-making processes and implemented best practices in analytics to optimize performance across organization.
  • Championed continuous improvement initiatives to drive operational excellence within organization.
  • Partnership and relationship management with clients, large health plans to ensure strategy alignment, completion of tactical initiatives, data sharing for existing and new client contracts
  • Development of comprehensive playbook to influence key levers to drive total cost of care savings with improved outcomes
  • Design and develop data visualization / reporting dashboards for KPI's, regulatory compliance, qualitative measures.

Lead Operations Director - Premier Model

United HealthCare
01.2020 - 01.2022
  • Operational oversight of clinical and non-clinical programs for Premier model across 3 national accounts
  • Drive outcomes to ensure all accounts are achieving and delivering according to customer expectations, NPS, standards of holistic care, and performance goals
  • Ensuring all team members are aligned on customer goals/ commitments and UHC business and financial goals
  • Support overall daily operations ensuring compliance and meeting key performance benchmarks
  • Monitor productivity standards and staffing needs
  • New implementation support / RFP process support
  • Supports processes that ensure consumer centric concierge approach
  • Continuous identification of efficiencies and process improvements to result in simplifying member experience and enhancing the Premier product
  • Presenting overall outcomes of operations for client facing meetings
  • Collaboration with Clinical Affordability team for Medical Cost Action planning activities and adoption to improve member outcomes and/or contain costs
  • Oversight of integration between Utilization Management, Clinical, and non-Clinical teams.
  • Facilitated cross-functional collaboration for improved decision-making processes within organization.
  • Oversaw operations and provided corrective feedback to achieve daily and long-term goals.
  • Proactively identified potential risks and implemented mitigation strategies to minimize negative impacts on projects or business operations.

Director of Clinical Quality/ Care Management

United HealthCare - (Optum)
01.2010 - 01.2020
  • Administered and monitored >5,000 team members across the care management/population health programs and utilization management with a $2M yearly budget in adherence to quality care and audit standards within a matrixed organization
  • Oversight of enterprise clinical audit management team of 11 staff members to ensure quality care delivery and achievement of improved outcomes
  • Delivered executive-level leadership and education to 150+ clinical staff members on client audit processes and compliance best practices
  • Conduct root-cause analysis and generate recommendations on clinical performance to drive value delivery through medical management
  • Created and executed Proscore Quality Monitoring system amalgamating customer/organizational tools to identify risks, improve clinical management, value delivery and drive continuous process improvements
  • Streamlined and standardized External Clinical Audit program requirements in compliance with regulatory principles to accomplish set objectives to align with NCQA, URAC standards, and customer expectations/requirements
  • Created clinical and non-clinical program recommendations for National Accounts resulting in favorable audit outcomes, client retention, contract renewals, and increased program performance
  • Strategically restructured quality audit process to data-driven methodology to ensure business met service level goals and performance guarantees
  • Developed end to end process for audit management and internal quality monitoring program
  • Key subject matter expert/consultant for care management product development
  • Developed key reporting metrics and tools related to account performance
  • Cultivated positive work environment that fostered employee engagement, increased retention rates, and boosted overall team morale.
  • Developed high-performing teams by providing mentorship, guidance, and opportunities for professional growth.
  • Enhanced team collaboration through regular communication, goal setting, and performance evaluations.
  • Reduced operational risks while organizing data to forecast performance trends.

Director of Inpatient Division

Craig Ranch Hospital
01.2009 - 01.2010
  • Managed process of new start up facility
  • Oversaw group of >50 clinical and non-clinical staff members
  • Coordinated government compliant and accredited medical and health services
  • Conceptualized and implemented key performance initiatives by delivering quarterly new hire training to staff to accelerate operational excellence and working capabilities of employees
  • Direct oversight of Inpatient unit and Emergency department of Ambulatory Surgical hospital
  • Minimized discharge wait time and increased compliance from 37% to 75%, process/operational efficiency and quality delivery of services by utilizing time management skills
  • Achieved patient satisfaction of > 96% division-wide through the provision of exceptional services
  • Critically evaluated staff performance/processes which resulted in decreased hazards and promoted regulatory compliance
  • Facilitated improved relationships with physicians and staff
  • Successfully led division through accreditation through DNV.
  • Negotiated favorable contracts with vendors for reduced costs and improved service quality.
  • Increased company revenue by streamlining processes and implementing cost-saving measures.
  • Drafted and distributed reports to assist board members with critical business decisions.
  • Implemented innovative programs to increase employee loyalty and reduce turnover.

Interim Chief Nursing Officer (CNO) / Director of Clinical Services

Select Specialty Hospital of North Dallas
01.2006 - 01.2009
  • Oversight of overall operations of an 86-bed long term acute care facility, mobilizing > 100 cross-functional health care team members with diligence and prioritization
  • Administered and oversaw clinical team comprised of nursing, rehab, and respiratory departments
  • Responsibility for nursing standards and practice in accordance with laws, regulatory and accreditation requirements, research and professional standards
  • Managed budget for clinical services division
  • Managed patient care delivery, nursing, other clinical disciplines throughout facility
  • Contributed to long term strategic planning
  • Led performance improvement activities
  • Ensured adaptation and implementation of clinical compliance with National Patient Safety Goals
  • Enabled attainment of organizational objectives by motivating >100 staff in delivering excellent patient care
  • Successfully led hospital through accreditation from JCAHO.
  • Maintained proper staff levels within budget parameters to deliver high levels of care to every patient.
  • Maximized staff and patient protections by enforcing optimal disease prevention protocols.
  • Coordinated patient care services and managed clinical cost control.
  • Developed and implemented new nursing protocols to improve patient outcomes while minimizing medical errors.
  • Served as liaison between nursing staff, physicians, administration, and other stakeholders for effective communication and collaboration.
  • Established and maintained effective communication with staff, physicians and community organizations to promote high quality patient care.

Education

Master of Science - Health Administration

Loyola University New Orleans
New Orleans, LA
06.2012

Master of Science - Nursing

Baylor University
Waco, TX
12.2003

Skills

  • Healthcare Service Delivery & Excellence
  • Performance/ Process Improvement
  • Regulatory & Healthcare Compliance
  • Innovative Solutioning
  • Product Development
  • Clinical Programs Execution
  • Clinical/ Non-Clinical Auditing
  • Advisory & Consultancy
  • Team Leadership & Development
  • Collaborative Leadership
  • Culture Transformation
  • Policy Development

Certification

  • Registered Nurse License, Texas RN License No. 702491, 2025-09-01
  • ISO 9001 Lead Auditor Quality Certification/ Training, Bureau Veritas Group

Education

Master of Science in Nursing /Health Care Systems, Management /Health Care Administration, Loyola University of New Orleans, New Orleans, LA, 2012, Bachelor of Science in Nursing, Baylor University, Waco, TX, 2003

Awards

Sigma Theta Tau International Honor Society of Nursing

Timeline

Senior Director, Care Management Oversight/ Operations Integrity

Cityblock Health, Inc.
01.2022 - Current

Lead Operations Director - Premier Model

United HealthCare
01.2020 - 01.2022

Director of Clinical Quality/ Care Management

United HealthCare - (Optum)
01.2010 - 01.2020

Director of Inpatient Division

Craig Ranch Hospital
01.2009 - 01.2010

Interim Chief Nursing Officer (CNO) / Director of Clinical Services

Select Specialty Hospital of North Dallas
01.2006 - 01.2009

Master of Science - Health Administration

Loyola University New Orleans

Master of Science - Nursing

Baylor University

Similar Profiles

CREATE PROFILE
Tiffany Hendricks