Molly Tighe Email & Phone Number

Greater Minneapolis-St. Paul Area

• Analyze provider data, systems and processes to identify opportunities for improvement, data clean-up efforts and data integrity initiatives• Produce internal site validation reporting• Develop, document and facilitate clinic closing process• Administrator of Provider Portal for Provider Demographic changes• Communicate Provider updates to appropriate departments for system updates

Minneapolis, Mn

Served as administrator of Target Clinic’s electronic medical record and billing system – user access, table maintenance, ad-hoc-report building and clearing claims in hold status. Managed application and renewal process for facility licenses for 79 clinics in 6 states. •Achieved 50% reduction in response time to field team questions by creating notification process and monthly metrics for HQ team and leaders.•Led project team and collaborated with key stakeholders, creating detailed checklist of more than 100 tasks required for opening new clinic locations. •Tracked and coordinated weekly payments for operational clinic expenses, ensuring vendors were paid appropriately and timely.

Minneapolis, Mn

Developed credentialing process for practitioners to guarantee payer forms were approved quickly and ensure maximum reimbursement.•Recreated clinic report and presented metrics at weekly meetings, allowing team to make decisions and take action where appropriate. •Developed a database for practitioners’ information and application tracking, creating efficiencyin the credentialing process.•Ensured 400 practitioners kept all applicable licenses current by developing mail-merged email reminder messages.•Researched new-graduate licensing processes and created process-flow document, illustrating complexities and assisting recruiters in determining appropriate practitioner start dates

Minneapolis, Mn

Established recredentialing process for contracted practitioners and managed vendor relationship. •Compiled data for quality management quarterly report, supporting final report creation and dissemination.•Served as program coordinator for United Way campaign for employees, raising over $15,000 for programs.

Greater Minneapolis-St. Paul Area

Hired and supervised team of 6 recredentialing coordinators. Identified, investigated, and reported on professional concerns in practitioner credentialing files.•Developed and implemented procedures, ensuring network of 50K practitioners remained in compliance with NCQA Standards.•Identified, created, and facilitated departmental education for new hires and retraining sessions, guaranteeing performance expectations were met. •Performed quality assurance on 100 practitioner files per week, confirming NCQA Credentialing Standards were met.•Prepared practitioner credentialing files for 35 different audits each year, securing delegation contract renewals and NCQA Accreditation.

Bachelor Of Science (B.S.), Health/Health Care Administration/Management

Activities and Societies: Delta Sigma Pi - Business Fraternity

Mini Mba In Healthcare Certificate

Supervision & Management Certificate Program