Summary
Overview
Work History
Education
Skills
Certification
HIGHLIGHTED IMPACT FOR CENTENE'S LTSS ROLE
Timeline
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Tiffany Reid

Fort Lauderdale,FL

Summary

Professional with significant expertise in team leadership and operational management. Proven track record in driving team collaboration and delivering impactful results. Skilled in conflict resolution, process optimization, and strategic planning, with flexible approach to evolving business needs. Known for reliability, strong communication, and fostering productive work environment.

Overview

10
10
years of professional experience
1
1
Certification

Work History

Supervisor, Program Management (Remote)

United BioSource Corporation
09.2022 - Current
  • Lead a team of Case Managers and Reimbursement Specialists in managing all phases of case workflows, including benefit verification and call management.
  • Developed SOPs that improved efficiency and compliance, resulting in a 15% reduction in errors.
  • Oversaw daily operations of the department, ensuring smooth workflow and timely completion of tasks.
  • Conduct new hire training and mentoring to build program proficiency.
  • Act as point-of-contact for prior authorizations and appeals; liaise with stakeholders.
  • Conduct case quality reviews and escalate safety events or product complaints.
  • Applied strong leadership talents and problem-solving skills to maintain team efficiency and organize workflows.

Team Leader (RDBU)

Allcare Plus Pharmacy
10.2019 - 09.2022
  • Led a team of 8, managed key client relationships, and supported healthcare projects.
  • Delivered sustainable payer data for physicians; ensured legal and regulatory compliance.
  • Acted as SPOC for Copay Assistance Program across three brands.
  • Set performance expectations for the team, monitoring progress towards goals and providing constructive feedback as needed.
  • Streamlined workflows for increased efficiency, reducing turnaround times for critical tasks.

Reimbursement Specialist

Express Scripts
08.2015 - 09.2019
  • Identified trends in reimbursement denials, recommending process improvements to minimize future occurrences.
  • Enhanced the overall financial performance of the organization by diligently monitoring outstanding claims and following up on overdue payments.
  • Built proactive, client-specific edits into system to prevent future denials.
  • Billed and collected for claims submitted on clients' behalf with sales totaling $15K.
  • Verified accuracy of accounts payable payments, resulting in 35% reduction in payment errors and check reissues.

Education

Master of Science (MS) - Human Resources Management

Florida International University
Miami, FL
06.2019

Bachelor of Science (BS) - Psychology

University of Central Florida
Orlando, FL
12.2016

Skills

  • Expertise in LTSS and HCBS service coordination
  • Regulatory compliance for Medicaid and Medicare
  • Behavioral Health Integration
  • Prior Authorization & Appeals
  • Staff Leadership & Training
  • Multidisciplinary Team Collaboration
  • Workflow Optimization
  • Member Advocacy & Education
  • Patient-Centered Communication
  • Community Resource Navigation

Certification

SHRM Certified Professional (SHRM-CP)

HIGHLIGHTED IMPACT FOR CENTENE'S LTSS ROLE

  • Focus Area: Demonstrated Experience
  • Service Plan Development: Created SOPs and monitored execution of case plans for compliance and timeliness
  • Multidisciplinary Collaboration: Worked with reimbursement teams, providers, and payers for coordinated care
  • Community & Program Navigation: Supported member access to financial support, pharmacy, and waiver services
  • Quality & Compliance: Conducted audits and escalated adverse events per standards
  • Training & Leadership: Trained new hires and led high-performing case management teams

Timeline

Supervisor, Program Management (Remote)

United BioSource Corporation
09.2022 - Current

Team Leader (RDBU)

Allcare Plus Pharmacy
10.2019 - 09.2022

Reimbursement Specialist

Express Scripts
08.2015 - 09.2019

Master of Science (MS) - Human Resources Management

Florida International University

Bachelor of Science (BS) - Psychology

University of Central Florida

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