Tina Williams
Hampton,Virginia
Summary
Motivated and experienced community connector and business professional with a proven track record in the Health and Wellness industry. With 22 years of experience, seeking to leverage knowledge and expertise by collaborating with other business professionals. Goal is to create access, provide education, and empower the client base. Together, can make a meaningful impact in the lives of individuals seeking health and wellness solutions.
Accomplished Broker adept at growing business through deep knowledge of Healthcare and strong relationship-building abilities. Leveraging over 28 years of experience to generate profits and dividends.
Overview
27
27
years of professional experience
Work History
Broker Relationship Manager
CenterWell Senior Primary Care
07.2023 - Current
- Establish and cultivate relationships with broker partners, acting as a primary point of contact
- Understand the needs and goals of broker partners and tailor interactions accordingly
- Regularly communicate with broker partners to build trust and foster strong partnerships
- Identify and pursue new business opportunities with broker partners
- Develop and execute strategies to increase business volume and market share
- Assist broker partners in identifying and securing new clients
- Focus on retaining existing broker partners and driving repeat business
- Address any concerns or issues raised by broker partners promptly and effectively
- Ensure that broker partners receive excellent service and support
- Develop and implement strategies to achieve business objectives
- Collaborate with internal teams to ensure alignment and effective execution
- Monitor and analyze performance data to identify areas for improvement
- May be involved in presentations to broker audiences
- Act as a product advocate and escalate issues to senior management
- Build and execute pipelines using external and internal data sources
Community Outreach Specialist Sr.
United Healthcare
08.2017 - 06.2023
- Creates opportunities for relationship building with Community Based Organizations (CBO) as well as key Providers and Specialists (PCP, Dental, etc.) that have density in the MA eligibility population in the Tidewater Region of Virginia and surrounding areas
- Provides knowledge, resources and help to those in our community who are in need and offer a more meaningful health care experience
- Hold compliant formal and informal events in a niche market to open the door for brand awareness
- Creates and tracks CMS approved initiatives through SMRT, FLP, Salesforce and UnitedHealthcare Producer Help Desk data systems
- Coordinate member and community education events and facilitate the opportunities for qualified, local sales agents to engage
- Train and develop Sales Agents to offer products and facilitate meetings that meet the Center for Medicare and Medicaid Services (CMS) guidelines
- Develop 20 community outreach events monthly
- Manage monthly budget, sponsorship request, and funding reconciliation through Concur and SharePoint /Growth Portal System
Community Outreach Specialist
Humana Inc.
11.2016 - 08.2017
- Participated in community education and engagement activities throughout Virginia
- Developed network of community partners and maintained relationships with existing partners/stakeholders
- Delivered presentations to network providers, members, and community as needed
- Developed weekly/monthly scheduling of community outreach initiatives
- Created and developed strategic marketing plan for Virginia Commonwealth Coordinated Care
- Managed monthly budgets, financial requests, and sponsorship requests
- Ordered, monitored, and replenished marketing materials as needed
- Provided thorough data analysis for all claims related to Home Health Care and other related services prior to processing
Medical Management Specialist I
Anthem Inc.
06.2016 - 11.2016
- Responsible for providing non-clinical support to the Medical Management and/ or Operations areas
- Primary duties may include but are not limited to: Gathers clinical information regarding case and determines appropriate area to refer or assign cases (Utilization Management, Case Management, QI, Med Review)
- Provides information regarding network providers or general program information when requested
- May assist with complex cases
- May act as liaison between Medical Management and/or Operations and internal departments
- Maintains and updates tracking data bases
- Prepares reports and documents all actions
- Tracked HEDIS performance data to identify opportunities for improvement, monitor the success of quality improvement initiatives
- Partnered with network providers to host HEDIS improvement strategy initiatives and member incentivized programs
Community Relations Representative
Anthem Inc.
05.2014 - 06.2016
- Developed and maintained new contacts and/or partnerships in the community
- Leads and manages strategies within a specific territory or business initiative
- Responsible for maintaining and growing Anthem’s Medicaid membership through educating and servicing the population
- Includes meeting the community’s need for ongoing educational and social service outreach to existing and potential members
- Community contacts include providers, health clinics, senior centers, long term care facilities community aid organizations, health departments and faith/non-profit human services organizations
- Provide home visits, telephonic assistance, outreach and/or guidance to members and potential members regarding benefit and enrollment questions, and/or aiding on any social service needs
- Assists with home visits necessary to ensure resolution to members around continuity of care issues
- Interface with other department to ensure member’s medical and/or behavioral health needs are addressed
- Work with various populations; Pregnant Women and Children, Aged, Blind and Disabled (ABD), and Medicare Duals
Outreach Care Specialist
WellPoint Inc.
07.2013 - 05.2014
- Responsible for ensuring that appropriate member treatment plans are followed on complex cases and for proactively identifying ways to improve the health of our members and meet quality goals
- Primary duties may include but are not limited to: Coordinate’s follow-up care plan needs for members by scheduling appointments or enrolling members in programs
- Assesses member compliance with medical treatment plans via telephone or through on-site visits
- Identifies barriers to plan compliance and coordinates resolutions
- Identifies opportunities that impact quality goals and recommends process improvements
Pediatric Case Specialist
Peninsula Institute for Community Health
01.2013 - 06.2013
- Assisted with provision of case management services; ensures effective cooperation of related systems of service intervention
- Develops and maintains professional relationships with other health care providers and human service agencies by coordinating provision of services
- Develops and maintains case management and service plan records
- Developed instruments useful in the assessment of service and service delivery
- Maintained records per patient visit, utilization, and referrals
- Ensured patient access to community health and other service agencies
- Makes routine home visits and follow-ups as necessary
- Develops and submits reports to funding agencies detailing statistical, patient demographics, and quantified utilization of programs and services
Outreach Coordinator
Peninsula Institute for Community Health
06.1998 - 01.2013
- Developed procedures and initiatives for patient recruitment and retention for nine Community Health Centers
- Coordinated access to care at area hospitals, urgent care facilities, schools, businesses, civic organizations, specialty physician’s offices, and other healthcare facilities, for patients and consumers in the entire Southeastern region of Virginia and North Carolina
- Provided community access and awareness through established forums including health fairs, civic organizations, faith-based organizations, provider networking, and grassroots
- Identified through outreach efforts clients that may be eligible for FAMIS and assisted with the application and enrollment of patients into the program
- Wrote an average of 24 comprehensive reports and presentations each year
- Conducted needs' assessments and referred clients to financial, medical, social and community assistance and services
- Generated exposure of the organization and its services through various advertising methods, such as design of marketing tools; billboards, printed literature, and press releases
Education
High School Diploma - General
Kecoughtan High School
Hampton, VAComputer Information Systems - undefined
Electronic Computer Programming Institute
Hampton, VAPublic Administration - undefined
Thomas Nelson Community College
Hampton, VASkills
- Medicare Marketing Specialist
- Proficient in Provider Relations Management
- Extensive Experience in Grassroots Health Initiatives
- Managed Care Enrollment Expert
- Quality Assurance Specialist
- Proficient in Medical Coding Standards
- Healthcare Quality Improvement Specialist
- Performance Improvement Coach
- Virginia Health Insurance Licensure
- UnitedHealthcare Medicare Practitioner
- Visual Design Expertise
- Trained Personal Care Provider
Timeline
Broker Relationship Manager
CenterWell Senior Primary Care
07.2023 - Current
Community Outreach Specialist Sr.
United Healthcare
08.2017 - 06.2023
Community Outreach Specialist
Humana Inc.
11.2016 - 08.2017
Medical Management Specialist I
Anthem Inc.
06.2016 - 11.2016
Community Relations Representative
Anthem Inc.
05.2014 - 06.2016
Outreach Care Specialist
WellPoint Inc.
07.2013 - 05.2014
Pediatric Case Specialist
Peninsula Institute for Community Health
01.2013 - 06.2013
Outreach Coordinator
Peninsula Institute for Community Health
06.1998 - 01.2013
Computer Information Systems - undefined
Electronic Computer Programming Institute
Public Administration - undefined
Thomas Nelson Community College
High School Diploma - General
Kecoughtan High School
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