Customer Service Management
Resume:
Dianna Yu
Email: abox7u@r.postjobfree.com
Address: ** **** ***** **
City: lemont
State: IL
Zip: 60439
Country: USA
Phone: 630-***-****
Skill Level: Director
Salary Range: 100
Primary Skills/Experience:
See Resume
Educational Background:
See Resume
Job History / Details:
Dianna Y. Yu, RN
87 W Logan Street
Lemont, Illinois 60439
Phone MOBILE 630-***-****
abox7u@r.postjobfree.com
Summary
Clinical Healthcare Professional adept at designing and implementing operational strategies to proactively identify trends and opportunities to improve hospital readmission in Sub-Acute and Long Term Care settings. Able to identify trends and opportunities to improve program quality, efficiency and effectiveness. A nurse with a passion to ensure the most profitable contract is in place when the best care is being delivered to the consumers. Efficient, versatile manager. Results driven. Fluent in speaking, reading and writing Mandarin.
Lexington Health Care
Vice President, Outcomes and Contract Management 2011-Present
Vice President, Care Management
A key leader in the design and development of analytic outcome reports across 10 buildings at monthly and/or quarterly basis. Identifies trends and opportunities. Collaborates with business partners in Sales, Marketing, Finance, Billing and Clinical Operations.
Responsible for contract management and administration in accordance with company policies, legal requirements, and customer specifications. Reviewed and administered contracts and modifications; prepared contract review records and obtained necessary management approvals. Led negotiations of contracts and changes with customers. Assisted in preparation of presentations for program and customer reviews. Prepared and maintained contract documentation and provided information to property and procurement departments.
Utilized Costpoint and Business Objects or Excel to generate monthly reports on accounts receivable and similar key contract metrics and to track progress for management review.
Overseen the case managers who catalysts by guiding patients and providing cohesion to other professionals in the health care delivery team, enabling their clients to achieve goals more effectively and efficiently.
UnitedHealth Group 2006-2011
Director, Customer Solutions, OptumHealth, Operations
A key leader in the design, development of analytic processes and procedures and execution of a newly established Disease Solutions Clinical Performance Management Team, assisting in the development of strategy and operational solutions for OptumHealth customers of case management and disease management products and services. Assisted in the development of monitors and controls to achieve program goals of member engagement and cost reduction. Identified trends and collaborated with business partners in Sales, Customer Service, Finance, Account Management, Affordability and Network to establish strategic cooperation and actionable solutions resulting in compliance to OptumHealth goals and metrics, readmission reduction and retention.
* Established proactive performance metrics with Medical and Finance Leaders in the Southeast region to improve the trend and outcomes for 2M members across 13 states.
* Assumed responsibility for the Northeast region to established proactive performance metrics with Medical and Finance to improve the trend and outcomes for 2M members across 11 states.
* Managed 30 large and mid sized employer groups and their employee population. Proactively managed performance metrics and guarantees, served as expert clinical operations resource for OptumHealth clinical programs, identified program opportunities for those member populations, participated in on site visits and scheduled customer meetings.
* Implemented -phone scrub process- to improve the volume to accurate phone numbers available to the operations nurses improving the ability to reach members by 74% across the north and south east regions.
* Resolved member and customer related issues through proactive intervention, timely resolution and punctual insight into opportunities as they presented themselves exceeding the expectations of the customer.
Clinical Programs Manager, United Resource Networks 2000- 2006
Developed and implemented clinical programs to improve operations, customer service and allow continued business growth across United Resource Networks for Kidney Resource Services, Transplant (both solid organ and bone marrow), Congenital Heart Disease and Cancer Services.
Established metrics and implemented and oversaw monitors to ensure consistency and to provide ongoing communication with the clinical leadership across URN.
* Kidney expert representative to cross functional Product Development Team for program development.
* Led implementation and subsequently monitored standards, assessments, procedures, and policy guidelines for a program that services eight million people.
* Led a team of 15 nurses. Responsible for providing quality nursing care through staff development, quality assurance measures and management functions.
* Developed training materials, timelines and project objectives for program implementation. Created scheduled updates and communicated summarized results for leadership review.
* Liaison for URAC accreditation
* Liaison representing URN for cross organizational communication with OptumHealth products and service teams.
* Reviewed and communicated customer specific account instructions to ensure team wide understanding and compliance with state and federal mandates.
* Through hands on experience coordinating care for transplant recipients reviewed and improved operations processes from evaluations through the transplant event to discharge planning and follow-up care.
* Developed training and delivered programs and materials across URN Operations. Provided education and support to providers, members and family members to ensure consistent understanding of the process and responsibility of each party and the URN nurse to improve the outcome of Transplant or Cancer treatment and recovery. Created peer preceptor program for all new employees. Coordinated all -in-service- training programs for clinical staff in office. Performed measurement analysis with regard to effectiveness of training courses through assessment and user feedback tools.
Case Manager, UnitedHealthcare 1997- 2000
* Responsible for utilization review, disease management and complex case
management as a level two care coordinator.
* Provided resources to the member, proactively identified and enrolled member
with chronic and/or complex medical conditions into the appropriate program
Edwards Hospital, Naperville, IL 1995-1997
Charge Nurse
* Responsible to carry out the primary care physician`s treatment plan
* Responsible for assignment details for nurses on duty
* Provided patient care
St. Joseph Medical Center, Joliet, IL 1993-1995
Charge Nurse
* Responsible to carry out the primary care physician`s treatment plan
* Responsible for assignment details for nurses on duty
* Provided patient care
Education /Certification
Cardinal Tien College of Health Care and Management, Taiwan, ROC. BSN 1978
Moraine Valley, Palos Hills, IL Associate Degree Nursing (Registered Nurse) 1992
Certified Clinical Instructor in a Basic Nursing Assistant Training Program (BNATP) 1994
Green Belt Certification, UnitedHealth Care 2006
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