Tracey Phillips
PHILADELPHIA,PA
Summary
Dynamic and personable healthcare professional with diverse industry experience. Thrives both independently and in collaborative team settings, demonstrating adaptability and a strong commitment to excellence. Recognized as a fast learner who embraces challenges and consistently delivers high-quality results. Motivated self-starter with a proven track record of proficiency, reliability, and dedication to enhancing patient care and operational efficiency.
Overview
1
1
Certification
29
29
years of professional experience
Work History
Senior Clinical Trainer
Health Partners Plans
Philadelphia, PA
06.2020 - 06.2026
- Delivered comprehensive training programs for clinical teams, enhancing operational efficiency. Executed job-specific training for clinical staff, resulting in improved service delivery. Managed successful upgrades and implementations of clinical systems, optimizing workflow and user experience.
Training Specialist
Health Partners Plans
Philadelphia, PA
01.2014 - 01.2020
- Enhanced care navigation unit performance by delivering targeted job-specific training and support. Achieved comprehensive understanding of Medicare pharmacy protocols through effective training delivery. Created impactful training materials in collaboration with pharmacy department for the upcoming benefit year. Improved grievances and appeals process training by partnering with complaints, grievances & appeals unit to revise materials. Implemented training solutions that effectively addressed staff needs and enhanced learning outcomes. Executed successful training programs for new hires in CCMS, developing structured training agendas. Provided clear and concise updates on weekly learning and development reports for all staff attending job-specific training.
Supervisor, Quality Review
Health Partners Plans
Philadelphia, PA
01.2010 - 01.2014
- Achieved successful candidate selection for quality review specialist position through targeted interviews. Enhanced performance appraisal process by assessing employee work quality against departmental standards. Optimized administration of docman application for efficient quality review appeal management. Delivered timely decisions on quality review appeals, enhancing operational effectiveness. Streamlined timecard approvals and leave requests, improving staff management. Increased productivity measurement accuracy for telecommuters and onsite employees. Effectively delegated projects and tasks to team members to maximize efficiency. Strengthened collaboration with internal operations to resolve quality standards and statistical issues. Advanced automation of manual processes in partnership with information services. Defined and documented business requirements for enrollment department line of business separation. Innovated workflow processes for quality review of Medicare line of business, enhancing operational efficiency. Ensured compliance through ongoing monitoring of monthly transactions via quality performance accuracy system. Led monthly enrollment meetings to analyze and discuss key performance indicators. Contributed to corporate goals by assisting internal audit in claims accuracy assessments.
Senior Quality, Review and Training Specialist
Health Partners Plans
Philadelphia, PA
01.2007 - 01.2010
- Provided training support for Health Care Management, Provider Affairs, Provider Services, and Member Relations. Assisted in implementation of product changes to meet training needs. Learned regulatory and contractual standards to determine impact on business processes. Conducted trainings that impact operational business units based on regulatory changes. Identified training needs, develop appropriate materials and successfully implement effective training solutions. Collaborated with the Quality Review staff to identify areas of improvement. Designed and implemented curriculum for new hire training.
Quality, Review and Training Specialist
Health Partners Plans
Philadelphia, PA
02.2001 - 05.2007
- Achieved successful training outcomes by equipping new hires with knowledge of core systems. Developed comprehensive assessments that accurately measure understanding of core systems. Produced detailed report cards that effectively demonstrate trainee proficiency.
- Created and delivered targeted training initiatives aimed at improving employee competencies and knowledge retention.
- Crafted comprehensive instructional materials that address and support a wide range of learning preferences and requirements.
Senior Utilization Management Representative
Health Partners Plans
Philadelphia, PA
10.1997 - 06.2001
- Oversaw hospital admissions, medical procedures, medical equipment, and transportation services for health partners' members. Managed communication between health partners and Health First to address authorization and claim discrepancies. Delegated tasks and streamlined workflow for representatives in the utilization management department. Orchestrated cross-coverage strategies for utilization management representatives. Led training initiatives for all new staff members. Facilitated onboarding processes for new hires at Tenet Health Systems. Compiled first-level appeals for inpatient stays for review by the medical director. Contacted hospitals to obtain crucial maternity and newborn information.
Education
Diploma - Nursing
Roxborough Memorial School of Nursing
Philadelphia, PA12-2022
MA - Organizational Development
Saint Joseph's University
Philadelphia, PA05-2014
Master of Science - Public Health
Drexel University
Philadelphia, PA01-2012
Bachelor of Science - Business Administration
Peirce College
Philadelphia, PA01-2009
Skills
- CareProminence, Market Prominence, eCIS (Department of Public welfare system), Microsoft Excel, Microsoft Word, Microsoft PowerPoint, HealthRules Payor (HRP), MACESS, OnBase, Softheon, and Salesforce
- Training delivery
- Healthcare staff relations
- Developing curriculum
- Teamwork and collaboration
- Problem-solving abilities
- Small group instruction
- Student evaluation
- Developing lesson plans
- Reliability
- Adaptability and flexibility
- Self motivation
Accomplishments
- Instrumental in developing and introducing curriculum for rollout of application CareProminence for Healthcare Management, Medical Management, & Quality Management teams.
- Received and maintain 98% positive rating from students.
- Revamped curriculum for Community Engagement staff.
- Collaborated with team of 50 in the development of MHK CareProminence.
Certification
Six Sigma Green Belt - Healthcare
Timeline
Senior Clinical Trainer
Health Partners Plans
06.2020 - 06.2026
Training Specialist
Health Partners Plans
01.2014 - 01.2020
Supervisor, Quality Review
Health Partners Plans
01.2010 - 01.2014
Senior Quality, Review and Training Specialist
Health Partners Plans
01.2007 - 01.2010
Quality, Review and Training Specialist
Health Partners Plans
02.2001 - 05.2007
Senior Utilization Management Representative
Health Partners Plans
10.1997 - 06.2001
Diploma - Nursing
Roxborough Memorial School of Nursing
MA - Organizational Development
Saint Joseph's University
Master of Science - Public Health
Drexel University
Bachelor of Science - Business Administration
Peirce College