Manager/Director of Health Services Operations

SUMMARY

Leader with over ** years experience in the healthcare industry.

Exceptional decision maker using analytic skills to drive results.

Strategic and creative thinker who has successfully managed people and

projects across multiple functional areas. Collaborative partner, often

recruited to turn around underperforming teams, who wins cooperation with

all levels of an organization.

. Clinical Operations Management

. Program Development

. Organizational Effectiveness

. Learning Development

EXPERIENCE

. Psychiatric Assessment

. Clinical Supervision

. Change Leadership

. Performance Catalyst

CIGNA, Eden Prairie, MN 2002 - 2012

Manager, Workforce Development (2010 - 2012)

Managed a virtual multidisciplinary team comprised of Registered Nurses,

Licensed Behavioral Clinicians and non-clinical Coaches who supported

medical, behavioral, specialty and call center teams to determine employee

learning needs

. Developed and implemented strategy and project oversight for multiple

projects to support business objectives for 1,200 employees

nationwide.

. Increased audit performance by 40% through data analysis and

collaboration with operations and quality leaders.

. Developed and implemented benchmark targets and scorecard reporting

metrics to ensure senior leaders received key coaching results as well

as identify additional needs related to reaching business goals.

. Selected to drive completion for a project that was behind schedule by

compiling a team of leaders from the corporate training department,

outsourced training vendor, IT systems, and operations resulting in

the project being completed three weeks ahead of schedule.

. Developed and implemented a caregiver burnout prevention pilot program

by collaboratiing with clinical operations and an external vendor

resulting in successful launch.

Director, Health Operations Business Unit & Coach Development Center (2007

- 2010)

Directed a multi-functional team of eight direct reports and 35 indirect

reports responsible for providing Health & Wellness Coach training as well

as providing support nationwide for the resolution of denials, appeals and

complaints

. Managed a budget of over $2M and provided monthly P&L input to

Operations Vice President and Finance.

. Directed the development of standard operating procedures that led to

an increase in performance guarantee compliance from 50% to 100%.

. Engineered a customer letter generation solution project that reduced

compliance risk and saved the company $750,000.

. Evaluated waste within the organization related to using vendors for

Physician Peer Review resulting in savings to the organization of over

$200,000 annually.

. Directed partnerships with state compliance officials and

accreditation agencies.

. Sponsored and led a four year community engagement initiative

resulting in monetary donations of over $45,000 and a 20% increase in

employee volunteer hours.

. Launched a curriculum development grant partnership between Cigna and

Normandale Community College that ultimately resulted in 26 hours of

cross-training course content.

. Developed and implemented an integrated on-boarding and new hire

training process for 200+ new hires resulting in improved employee to

company assimilation.

Director, Personal Advocate Call Center (2006 - 2007)

Directed member and provider call center operations across four sites

nationally with three direct reports and 125 indirect reports managing a

budget of over $5M.

. Directed the achievement of customer performance guarantees including:

Average Speed of Answer, Abandonment Rates, Service Levels and First

Call Resolution.

. Directed a staffing project in partnership with internal and external

recruiting managers to provide bi-lingual staffing in select locations

to support customer/account expectations.

. Retained top talent by building a business case with Human Resources

Directors and Compensation to provide equitable pay across the

department.

. Sponsored two Kaizen and Lean Six Sigma projects resulting in a

significant reduction in time spent on calls.

Supervisor, Clinical Operations (2003 - 2006)

Led administrative and clinical service direction for a multi-faceted

behavioral health care team with 16 direct reports. Responsible for

utilization management of ASO, PPO, and EPFI business, to over three

million members nationally from over 25 Fortune 100/500 customers/accounts.

. Customer relationship management with key contacts and a 99% account

retention.

. Increased team productivity by 25%.

. Reached goal of 100% compliance with all performance guarantees.

. Increased URAC/NCQA procedural compliance scores by 15% nationally.

OTHER RELEVANT EXPERIENCE

Care Manager, Clinical Operations, CIGNA Behavioral Health

Psychiatric Crisis Supervisor, Mercy Hospital

Psychiatric Crisis Worker (on-call), United, Abbott, & Children's Hospitals

Child and Family Therapist, Storefront Group

Day Treatment Therapist, St. Joseph's Home for Children

EDUCATION, LICENSES AND CERTIFICATIONS

MBA (in progress), Capella University, Expected graduation 2013

Master of Social Work, University of St. Thomas

Bachelor of Science in Social Work & Psychology, Augustana College

Six Sigma Yellow Belt Certification

Performance Catalyst Behavior Coaching Certification

Change Leadership Training Certification

Licensed Independent Clinical Social Worker (License #: MN 13192)

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