Tiffany Parker
Atlanta
Summary
Accomplished healthcare leader and mental health clinician with over 19 years of combined experience in enhancing operational efficiencies, patient care, and financial health in diverse care delivery settings. Proven success in implementing improved quality of care practices, process optimization, and delivering value to improve healthcare outcomes. Demonstrates strong commitment to customer and patient/member satisfaction, leading strategic initiatives resulting in improved clinical care outcomes and reduced total cost of care. Adept at fostering staff development through influential leadership, resulting in high performing teams. Skilled in helping healthcare organizations achieve business goals by demonstrating strategic flexibility, critical thinking skills, and effective communication.
Overview
13
13
years of professional experience
1
1
Certification
Work History
Vice President, Clinical Strategy and Value Based Care Performance
UnitedHealthcare/UnitedHealth Group
08.2024 - Current
- Leads overall clinical, affordability and value-based care strategies, clinical model design, and clinical performance outcomes for individual marketplace health plans.
- Facilitates deployment of strategies to ensure effective and scalable clinical models and new programs.
- Leads clinical program evaluation and identify opportunities for quality and program improvements.
- Develops and executes comprehensive strategies to improve Star ratings and Exchange Quality Rating System ratings.
- Responsible for expansion and execution of value-based partnerships and individual market expansions.
- Establishes key performance indicators for value-based care arrangements and clinical operational readiness.
- Develops and execute affordability strategies to achieve medical cost savings targets.
- Spearheaded affordability governance with cross-functional partners to execute medical cost saving initiatives.
- Manages departmental P&L budget and intersegment service agreements (ISAs).
- Key business partner on network development, risk adjustment activities, provider incentive programs, and program integrity initiatives.
Vice President, Clinical Strategy and Value Based Care Performance
UnitedHealthcare/UnitedHealth Group
08.2024 - Current
- Leads overall clinical, affordability and value-based care strategies, clinical model design, and clinical performance outcomes for individual marketplace health plans.
- Facilitates deployment of strategies to ensure effective and scalable clinical models and new programs.
- Leads clinical program evaluation and identify opportunities for quality and program improvements.
- Develops and executes comprehensive strategies to improve Star ratings and Exchange Quality Rating System ratings.
- Responsible for expansion and execution of value-based partnerships and individual market expansions.
- Establishes key performance indicators for value-based care arrangements and clinical operational readiness.
- Develops and execute affordability strategies to achieve medical cost savings targets.
- Spearheaded affordability governance with cross-functional partners to execute medical cost saving initiatives.
- Manages departmental P&L budget and intersegment service agreements (ISAs).
- Key business partner on network development, risk adjustment activities, provider incentive programs, and program integrity initiatives.
AVP, Chief of Staff, Business Strategy and Transformation Lead
Optum/UnitedHealth Group
08.2022 - 08.2024
- Coordinated execution of business priorities and large-scale initiatives with executive leadership teams.
- Monitored trends and competitive landscape for Medicare Advantage plans and developed strategies to close any gaps in the market.
- Managed P&L; monitoring expenses and resource allocation in tandem with finance and business partners.
- Drove fast paced, strategic initiatives to promote overall business collaboration and achievement of business goals/measured business objectives.
- Led the planning, development, and execution of quarterly and monthly business reviews, governance meetings, town halls, and other key business meetings.
- Proactively identified gaps and process improvement opportunities and worked across functions to develop and execute remediation plans.
- Influenced and acted as both a sounding board to the CEO and a thought leader to solve unique and complex problems with broad impact on the business.
AVP, Chief of Staff, Business Strategy and Transformation Lead
Optum/UnitedHealth Group
08.2022 - 08.2024
- Coordinated execution of business priorities and large-scale initiatives with executive leadership teams.
- Monitored trends and competitive landscape for Medicare Advantage plans and developed strategies to close any gaps in the market.
- Managed P&L; monitoring expenses and resource allocation in tandem with finance and business partners.
- Drove fast paced, strategic initiatives to promote overall business collaboration and achievement of business goals/measured business objectives.
- Led the planning, development, and execution of quarterly and monthly business reviews, governance meetings, town halls, and other key business meetings.
- Proactively identified gaps and process improvement opportunities and worked across functions to develop and execute remediation plans.
- Influenced and acted as both a sounding board to the CEO and a thought leader to solve unique and complex problems with broad impact on the business.
Director, Account Services/Program Director
Optum/UnitedHealth Group
05.2021 - 08.2022
- Program Director for population health care delivery programs (nurse case/disease management) supporting employer sponsored commercial health plans.
- Partnered with consulting firm on delivery and execution of all clinical program requirements.
- Measured and monitored key performance indicators for all population health clinical programs.
- Identified healthcare trends and implemented strategies to improve trends and affordability savings.
- Evaluated client level medical cost and utilization trends and collaborated with partners/consultants to implement interventions to mitigate trends.
- Clinical subject matter expert to product and operations staff for innovative program design and development, and quality improvement initiatives.
Director, Account Services/Program Director
Optum/UnitedHealth Group
05.2021 - 08.2022
- Program Director for population health care delivery programs (nurse case/disease management) supporting employer sponsored commercial health plans.
- Partnered with consulting firm on delivery and execution of all clinical program requirements.
- Measured and monitored key performance indicators for all population health clinical programs.
- Identified healthcare trends and implemented strategies to improve trends and affordability savings.
- Evaluated client level medical cost and utilization trends and collaborated with partners/consultants to implement interventions to mitigate trends.
- Clinical subject matter expert to product and operations staff for innovative program design and development, and quality improvement initiatives.
Director, Clinical Operations
Optum/UnitedHealth Group
03.2019 - 05.2021
- Provided leadership to and was accountable for the performance of managers and senior level professional staff in executing delegated care management programs to commercial, Medicaid, and Medicare members.
- Responsible for all operational components for behavioral health case management and utilization review.
- Devised policies, procedures, and guidelines for clinical operations to drive improved quality and operational efficiencies and translated contractual requirements into stable and scalable operational solutions.
- Implemented functional, market level, and/or site strategy, plans, production and/or organizational priorities.
- Identified and resolved technical, operational, and organizational problems to influence clinical outcomes across the continuum of care.
- Influenced and led high performing teams to deliver high-quality, valuable, and impactful services to members and providers.
Director, Clinical Operations
Optum/UnitedHealth Group
03.2019 - 05.2021
- Provided leadership to and was accountable for the performance of managers and senior level professional staff in executing delegated care management programs to commercial, Medicaid, and Medicare members.
- Responsible for all operational components for behavioral health case management and utilization review.
- Devised policies, procedures, and guidelines for clinical operations to drive improved quality and operational efficiencies and translated contractual requirements into stable and scalable operational solutions.
- Implemented functional, market level, and/or site strategy, plans, production and/or organizational priorities.
- Identified and resolved technical, operational, and organizational problems to influence clinical outcomes across the continuum of care.
- Influenced and led high performing teams to deliver high-quality, valuable, and impactful services to members and providers.
Director, Affordability and Solutions
Optum/UnitedHealth Group
10.2014 - 03.2019
- Measured and monitored key performance indicators for all population health clinical programs.
- Identified healthcare trends and implemented strategies to improve trends, total cost of care, and affordability savings.
- Evaluated client level medical cost and utilization trends and collaborated with internal and external partners to implement interventions to mitigate trends.
Director, Affordability and Solutions
Optum/UnitedHealth Group
10.2014 - 03.2019
- Measured and monitored key performance indicators for all population health clinical programs.
- Identified healthcare trends and implemented strategies to improve trends, total cost of care, and affordability savings.
- Evaluated client level medical cost and utilization trends and collaborated with internal and external partners to implement interventions to mitigate trends.
Manager, Clinical Implementations
Centene Corporation
09.2013 - 10.2014
- Implemented clinical programs for new and prospective markets for government sponsored health plans.
- Oversaw technical writing response for request for proposals (RFPs) and developed go to market strategies and methodologies for service delivery.
Manager, Clinical Implementations
Centene Corporation
09.2013 - 10.2014
- Implemented clinical programs for new and prospective markets for government sponsored health plans.
- Oversaw technical writing response for request for proposals (RFPs) and developed go to market strategies and methodologies for service delivery.
Clinical Supervisor
Centene Corporation
09.2012 - 12.2013
- Led clinical operations and quality oversight for high-risk case management and utilization management teams.
Clinical Supervisor
Centene Corporation
09.2012 - 12.2013
- Led clinical operations and quality oversight for high-risk case management and utilization management teams.
Education
Master of Business Administration - Healthcare Management
Columbia Southern University
Orange Beach, AL01.2019
Master of Arts - Professional Counseling
Argosy University
Atlanta, GA10.2008
Bachelor of Science - Psychology
University of Tennessee at Chattanooga
Chattanooga, TN05.2005
Skills
- Business Planning and Development
- Strategic Planning and Execution
- P&L Management
- Business and Financial Acumen
- Product/Clinical Model Development
- Customer Centric/Stakeholder Engagement
- Organizational/Operational Effectiveness
- Team/Leader Development
Certification
- Licensed Professional Counselor (LPC), GA License # LPC006730; Georgia Composite Board of Professional Counselors, March 2009
- Certified Case Manager (CCM), Certificate # 4214311; The Commission for Case Manager Certification, April 2015
- Certified Professional Clinical Supervisor (CPCS), Certificate # 922; Licensed Professional Counselor Association of Georgia, April 2018
Timeline
Vice President, Clinical Strategy and Value Based Care Performance
UnitedHealthcare/UnitedHealth Group
08.2024 - Current
Vice President, Clinical Strategy and Value Based Care Performance
UnitedHealthcare/UnitedHealth Group
08.2024 - Current
AVP, Chief of Staff, Business Strategy and Transformation Lead
Optum/UnitedHealth Group
08.2022 - 08.2024
AVP, Chief of Staff, Business Strategy and Transformation Lead
Optum/UnitedHealth Group
08.2022 - 08.2024
Director, Account Services/Program Director
Optum/UnitedHealth Group
05.2021 - 08.2022
Director, Account Services/Program Director
Optum/UnitedHealth Group
05.2021 - 08.2022
Director, Clinical Operations
Optum/UnitedHealth Group
03.2019 - 05.2021
Director, Clinical Operations
Optum/UnitedHealth Group
03.2019 - 05.2021
Director, Affordability and Solutions
Optum/UnitedHealth Group
10.2014 - 03.2019
Director, Affordability and Solutions
Optum/UnitedHealth Group
10.2014 - 03.2019
Manager, Clinical Implementations
Centene Corporation
09.2013 - 10.2014
Manager, Clinical Implementations
Centene Corporation
09.2013 - 10.2014
Clinical Supervisor
Centene Corporation
09.2012 - 12.2013
Clinical Supervisor
Centene Corporation
09.2012 - 12.2013
Master of Arts - Professional Counseling
Argosy University
Bachelor of Science - Psychology
University of Tennessee at Chattanooga
Master of Business Administration - Healthcare Management
Columbia Southern University
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