Tanya Williams
Florissant
Summary
Results-oriented Senior Case Manager with extensive experience in managing large caseloads and developing tailored case management plans. Proven expertise in facilitating communication between providers and clients while ensuring compliance with legal standards. Strong leadership and organizational skills enhance service delivery and client advocacy. Committed to fostering positive relationships and coordinating individualized services.
Overview
18
18
years of professional experience
Work History
Sr Case Manager
UBC / Mallinckrodt
12.2024 - Current
- Provided training and mentorship to junior staff on case management best practices and procedures.
- Served as case coordinator, assuming responsibility for complex, high-volume assignments and guiding endeavors to successful completion.
- Perform quality checks on cases and report trends to leadership.
- Troubleshoot complex cases, spanning multiple disease-states, while interfacing with key stakeholders to ensure optimal start to therapy.
Case Manager
UBC / Mallinckrodt
05.2021 - 12.2024
- Facilitated ongoing case management services to support successful outcomes and meet stabilization goals
- Coordinated support services and optimized communication between healthcare workers and patients
- Collaborated with various healthcare providers to facilitate delivery of services
- Informed patients and families of treatment options and at-home care strategies to reduce unnecessary burden on hospital resources
Customer Service Representative
UBC / Allergan
07.2020 - 04.2021
- Resolved customer issues by evaluating account information and proposing solutions.
- Activated customer accounts, ensuring quality assurance satisfaction levels were maintained.
- De-escalated customer concerns while maintaining a calm and friendly demeanor.
- Handled 40-85 calls daily regarding prescription and delivery inquiries.
- Assisted customers in understanding account details, improving overall service experience.
Sr Reimbursement Specialist
UBC / AbbVie
04.2020 - 07.2020
- Created a comprehensive manual for new hire training programs.
- Ensured application completeness and accuracy through thorough analysis.
- Processed over 100 patient applications for various program medications.
- Utilized medical terminology to accurately process prescription requests.
- Conducted outbound calls to obtain necessary information from doctors and patients.
Sr Reimbursement Specialist
UBC / Amgen
07.2016 - 12.2019
- Enhanced patient services by adapting quickly to new methods and procedures.
- Demonstrated top performance by building strong relationships and merging ideas.
- Utilized Medicare knowledge to support Nephrology patients effectively.
- Allocated decision-making skills to achieve optimal outcomes on calls.
- Advocated for patients and doctors by securing benefits from payers.
- Ensured accurate documentation for all contacts entered into the system.
Reimbursement Specialist
Express Scripts
12.2015 - 04.2016
- Ensured accurate benefit investigations for healthcare providers and patient needs.
- Verified insurance benefits, enhancing patient and physician office communication.
- Secured prior authorization efficiently, meeting payer requirements and patient needs.
- Maintained comprehensive database records for effective file management and completion.
- Facilitated effective communication through inbound and outbound calls with stakeholders.
Sales Coordinator
Anthem Blue Cross Blue Shield
12.2007 - 01.2013
- Ensured data accuracy by developing comprehensive sales reports.
- Generated distribution and sales reports for six Captive Agents.
- Conducted application audits and entered data into the underwriting system.
- Resolved billing and claims inquiries while managing material supply inventory.
- Facilitated onboarding for new hires, including equipment requisitions and training.
- Supported interviews for Captive Agent Assistants and maintained the Director's schedule.
Education
Certification - HR & Payroll Management
International Open Academy
RemoteSkills
- Case Management: Utilization Review, Care Coordination, Stabilization Goals, Patient Advocacy
- Reimbursement & Insurance: Benefit Investigations, Prior Authorizations, Medicare Policies, PBM Plans
- Technical: Salesforce, Microsoft Office Suite, Data Management, Multi-line Telephone Systems
- Soft Skills: Decision Making, Problem Resolution, Team Building, De-escalation, Interpersonal Communication
Timeline
Sr Case Manager
UBC / Mallinckrodt
12.2024 - Current
Case Manager
UBC / Mallinckrodt
05.2021 - 12.2024
Customer Service Representative
UBC / Allergan
07.2020 - 04.2021
Sr Reimbursement Specialist
UBC / AbbVie
04.2020 - 07.2020
Sr Reimbursement Specialist
UBC / Amgen
07.2016 - 12.2019
Reimbursement Specialist
Express Scripts
12.2015 - 04.2016
Sales Coordinator
Anthem Blue Cross Blue Shield
12.2007 - 01.2013
Certification - HR & Payroll Management
International Open Academy