R. Tina Blades
Katy,TX
Summary
Experienced Administrative Manager with over 20 years of experience in business operations, specializing in customer service oversight, client intake processes, provider network relations, and credentialing. Proven track record of successfully managing teams and developing strategic plans that enhance operational efficiency and elevate customer satisfaction. Expertise in creating and implementing effective business protocols and data-gathering tools, combined with strong organizational, communication, and problem-solving skills. Recognized for fostering collaboration within teams while consistently delivering results in fast-paced environments.
Overview
32
32
years of professional experience
Work History
Administrative Manager
UTHealth - Employee Assistance and Wellbeing Programs
10.2012 - Current
- Manages the day to day business processes and Supervision of direct reports, including new hire selection, hiring and termination, on-going training on processes, time reports, vacations, sick leave requests and yearly performance evaluations.
- Manages high profile providers and build key relationships within the behavioral health community to promote and maintain the goodwill of UTEAP.
- Negotiates and maintain Provider Contracts for EAP Network.
- Provides training & development of external provider education programs to ensure reimbursement rate structures are clear and UTEAP processes are followed.
- Maintains accountability for provider utilization, to include overseeing data analysis to understand root cause of any outlier utilization.
- Identify, assess and resolve provider issues regarding adjustments/processing of invoices and claim issues.
- Recruit and generate leads, prescreen and follow up with mental health providers for participation in the Network.
- Oversight of provider files and credentialing information for the EAP, to include initial applications, reappointments, trends in complaint issues and overall client satisfaction.
- Developed current Provider Guidelines, FAQ’s, application for participation and other forms that are published on website to move processes toward electronic submissions.
- Responds to questions on departmental, unit, service line or system policies and procedures. Ensures knowledge is disseminated to those affected.
- Identifies and solves problems independently whether they are fiscal or administrative.
Director of Physician Services
ELITE ER (Company closed/out of business)
05.2012 - 09.2012
- Developed and implemented the organization of the Credentialing Processing Center policies and procedures for Central Processing and Ambulatory Care Centers.
- Liaisoned with hospital medical staffing as the point person for completing and ensuring compliance and delivery of required information to clients in a timely manner.
- Provided introductory and ongoing training/education to credentialing staff to ensure that policies and procedures are followed.
- Assisted Manager with establishing and maintaining an effective communication pathway with various areas of the department, resolved issues and improve processes to ease the flow of information between departments.
Credentialing Specialist Reviewer
HCA HEALTHCARE SHARED SERVICES
12.2010 - 05.2012
- Responsible for development and implementation of the Credentialing Processing Center policies and procedures for Central Processing and Ambulatory Care Centers.
- Liaisoned with hospital medical staffing as the point person for completing and ensuring compliance and delivery of required information to clients in a timely manner.
- Provided introductory and ongoing training/education to credentialing staff to ensure that policies and procedures are followed.
- Assisted Manager with establishing and maintaining an effective communication pathway with various areas of the department, resolved issues and improve processes to ease the flow of information between departments.
Standardized Patient (SP) Trainer
EDUCATION COMMISSION FOR FOREIGN MEDICAL GRADUATES (ECFMG)
04.2004 - 09.2010
- Responsible for recruitment and interviewing candidates for selection as Standardized Patients.
- Trained new candidates in all aspects of case portrayal, checklist item recognition and documentation standards.
- Identified adult learning styles and adapted existing training techniques to maximize the adult learners’ progress and success.
- Observed SP’s for Quality Assurance purposes and intervened or retrained as needed to maintain the standardization of case portrayal and exam protocols.
- Facilitated and presented various learning techniques and best practices to colleagues to further enhance peer coaching and instructional skills.
- Coordinated SP operations logistics to include: form generation, case assignments to SP’s, projection of SP training and staffing needs, emergency manual checklist distribution during technical interruptions, oversight of center SP-case calibration and quality assurance.
Credentialing Supervisor/Regional Credentialing
BLUE CROSS BLUE SHIELD OF TEXAS
12.1993 - 12.2003
- Supervised a staff of ten responsible for the integrity of information of providers; set training goals and objectives; developed in-house training "refresher" course to insure that analysts were informed of latest procedural changes and expectations.
- Developed individual goals and tracking process that increased individual performance and decreased errors in completion of tasks.
- Created and maintained company policies and procedures to insure compliance with TDI and NCQA standards.
Education
Bachelors Degree -
Peirce College
Philadelphia, PA12.2012
Skills
- Human resources professional certification (PHR)
- Executive Leadership Institute – University of Texas @ Houston 2018
- CPCS - Certified Provider Credentialing Specialist 1993 – 2003
Timeline
Administrative Manager
UTHealth - Employee Assistance and Wellbeing Programs
10.2012 - Current
Director of Physician Services
ELITE ER (Company closed/out of business)
05.2012 - 09.2012
Credentialing Specialist Reviewer
HCA HEALTHCARE SHARED SERVICES
12.2010 - 05.2012
Standardized Patient (SP) Trainer
EDUCATION COMMISSION FOR FOREIGN MEDICAL GRADUATES (ECFMG)
04.2004 - 09.2010
Credentialing Supervisor/Regional Credentialing
BLUE CROSS BLUE SHIELD OF TEXAS
12.1993 - 12.2003
Bachelors Degree -
Peirce College