Clea Davis Email & Phone Number

Pflugerville, TX, US

United States

United States

Austin, Texas Area

• Coordinated all letter approval processes to ensure state regulatory compliance and continuity with member and provider-facing materials.
• Performed statistical analysis of service utilization and complaint trends to pinpoint areas of improvement within functional areas.
• Created streamlined administrative provider termination process within department for the agency structure using Lean Six Sigma methodologies.
• Created and managed member transition plan for Utilization… Show more
• Created and managed member transition plan for Utilization Management using PMBOK methodologies to provide members with materials and communication during service changes.
• Collaborated with internal functional areas and external customers to provide complaint resolutions to members and providers.

Austin

• Audited Vistar database to ensure accurate provider information for provider directory and state reports.
• Communicated with providers via mail and phone to correct discrepancies to provider’s demographic information or provider setup.
• Reviewed and prepared files for approval by the Medical Director and/or Credentialing Committee.
• Generated staff production reports for review and provided debriefs with management.
• Provided provider and facility credentialing statuses at… Show more
• Provided provider and facility credentialing statuses at weekly network management meetings.

Austin, TX

• Monitored licensing boards and prepared sanction reports with updates for monthly Credentialing Committee meetings.
• Maintained provider data management and credentialing functions in Vistar, including data entry and loading statuses into current databases.
• Monitored annual continuous credentialing improvement projects.
• Prepared documents and files for audit before Credentialing Committee and annual state audits.
• Executed and finalized provider contracts with corresponding… Show more
• Executed and finalized provider contracts with corresponding contractual reimbursement rate sheets. Show less

B.S. Healthcare Administration, Health Information Management

Associate Healthcare Administration

Gained more knowledge in Health care law and how to communicate with my co-worker and subordinates in a respectful way.

Education record