Mori Mclennan Email & Phone Number

Antioch, Ca, Us

Fairfield, California, United States

Manage and oversee the day-to-day performance of a 16-20 employee team ofScheduling Coordinators, Staffing Coordinators, Client Service Representatives, TrainingCoordinator, and Managers, in a contact center environment. Ensuring optimal schedulesand customer service is provided to our clients in all of our 15 regions across the country. Create and monitor cross-functional department interactions and workflows to ensurethat performance standards and client satisfaction targets are met. Responsible for staff recruiting, performance management, training, and development. Develops, oversees and ensures documentation of the scheduling, client services, and training systems, workflows, including process, policy, and operating structure. Responsible for the volume of work produced ensuring scheduling, client services, and training meets operational goals regarding resources, clients and budget targets. Works intimately with the Senior Director Product Operations to create and improve current scheduling and client services systems.

Oakland, Ca

As the Director of Administrative Services, I’m responsible for the overall management of multiple departments, including, Office Administration, Vendor Services, and Facility Services. I’m also responsible for organizing New Hire Orientation, creating organizational and program budgets in collaboration with the Director of Finance, and providing a wide range of support to the Executive Team. In addition, I promote a culture of high performance and continuous improvement, that values learning and a commitment to quality and exemplifies our company’s mission and core principles. I foster and maintain a process for selecting, developing, motivating, and evaluating staff. I mentor and develop staff using a supportive and collaborative approach, assign accountabilities, set goals, establish priorities, conduct semiannual and annual performance evaluations, administer salary adjustments, and provide coaching and counseling when appropriate. I’ve developed and currently maintain departmental process maps, customer diagrams for all office and administrative personnel, and client lifecycle workflows. I manage and increase the effectiveness and efficiency of Administrative Services through improvements to each function, as well as coordination and communication between administrative and clinical functions. I’ve collaborated with the Human Resources department on the implementation of evaluations for Administrative personnel. In partnership with the Director of Finance, I created and maintain budgets for all 6 offices, for office supplies, program supplies etc. I maintain HIPAA compliant records and practices. I ensure facilities meet government regulations and environmental, health and security standards. I’m responsible for the relocation and expansion of new offices. I manage the upkeep of equipment and supplies for all offices to meet health and safety standards.

Oakland, Ca

In this role, I was responsible for managing operational projects including but not limited to creating policies and procedures for customer service, account management, software implementation, data systems, information technology, and policies and procedures for all office administrative tasks. I managed projects as defined to include creating process and procedure, oversight of implementation and ability to meet established deadlines. I improved the operational systems, processes and policies in support of our mission, specifically, help support and develop information flow and management systems, business process and organizational planning. I contributed to the development and execution of projects to enhance profitability, productivity and efficiency throughout our company’s operations. I interacted regularly with Leadership and individual departments to ensure that the company’s operational priorities are aligned with total company direction. I worked with other teams to ensure high quality service to both internal and external customers. I provided analytical support to Leadership and individual departments including development of internal management reporting capabilities. I submitted relevant monthly operating data to the CEO. I continually investigated and introduced process improvement measures and presented suggestions to the CEO for consideration. I promoted a culture of high performance and continuous improvement that valued learning and a commitment to quality, and provided a work environment that promoted positive energy, creativity and teamwork. I mentored and developed staff using a supportive and collaborative approach: assigned accountabilities, set objectives, established priorities, conducted annual performance appraisals, administered salary adjustments, and monitored and evaluated results

Pleasant Hill

As an Associate Director of Client Relations I directly and indirectly managed a team of over 15 employees, covering multiple business areas including Client Access, Customer Service, Office Management, and Scheduling. I was accountable for managing and maintaining all processes and functional areas related to client relations, including but not limited to, client access, capacity management, treatment scheduling, provider relations, and customer service. I developed and maintained the business intelligence reporting frameworks and tools necessary to ensure clients have access to efficient, timely, and high-quality services. I worked cross functionally with other departments to determine and meet all contractual and regulatory requirements related to client services; (CARF and DMHC), I also drove continual process improvement to better align the organization with quality and operational objectives.

Pleasant Hill Ca

In this role, I proactively communicated ESBA’s belief in the provision of high quality services through effective oversight of operational aspects of services. Developed and managed positive working relationships with all departments in ESBA through regular communication as well as interfaced with the Commission on Accreditation of Rehabilitation Facilities (CARF), Kaiser Staff members and Behavioral Health Provider Network (BHPN) staff. I coordinated internal resources and third parties/vendors for the flawless execution of projects as assigned.I assisted in the definition of project scope and objectives, involving all relevant stakeholders and ensuring technical feasibility. Developed a detailed project plan to monitor and track progress within our internal systems JIRA/Confluence. Reported and escalated to Executive team as needed. Performed risk management to minimize project risks. I provided feedback regarding the effectiveness and efficiency of operations, the reliability of financial and management reporting, and compliance with laws and regulations. I worked closely with ESBA internal departments and network providers to assist in conducting internal audits of ESBA departments, conducting audits of network providers, and compiling report findings. I assisted in the coordination of support plans to members of the Behavioral Health Provider Network (BHPN) while maintaining high quality services within behavioral health and therapy. I also assisted in identifying new procedures, methods and/or tools to improve the efficiency and accuracy of the quality process and department. Prepared quality documentation and reports by collecting, analyzing and summarizing information and trends.Supported the development of corrective action and performance improvement plans for Behavioral Health Provider Network (BHPN).

Pleasanton, Ca

In this role as a Clinical Outcome Specialist, I received and investigated all clinical complaints from physician users, patients or distributors. I was responsible for gathering clinical information pertinent to each complaint and the documentation of this information into our internal system know as SAP. I ensured timely complaint investigation, escalation and closure and customer cal backs. I completed clinical complaint reports using FileMaker Pro within a 30 day timeframe. I Interfaced with complainants, Customer Service, Quality, Sales/Practice Service Specialist, and the Clinical Training departments as needed. I assisted in general compliance activities such as, audits and reporting to the FDA. I am the secondary contact for all clinical inquiries from physicians, clinics, patients, distributors or internal customers.

Pleasanton, Ca

In this role, I was responsible for providing management oversight, supervision, counsel Quality Assurance and mentoring to Sr. Case Managers, Case Managers, and Case Coordinators for Medicare and Commercial grievance and/or appeals to ensure accuracy, timeliness, quality of work, and compliance with all applicable regulatory agency guidelines and directives, and with policies and procedures. I coordinated the office daily activities, acting as the key resource for MCRC staff related to operational and content questions. I took on the role as Interim Assistant Director and worked in conjunction with the MCRC Director and key stakeholders in support of grievance and appeal case management, including committee reports, auditing and other reports. I was responsible for reviewing and approving check requests to assist in the effectuation process up to per-designated amount. I reviewed all written correspondence to both members and internal clients for quality, grammar errors and correct medical information.I managed upwards of 80 Case Managers, Coordinators and Sr. Case Managers, who work directly with Utilized Management (UM), Skilled Nursing Facilities (SNF), Local Member Services (LMS), Health Plan Regulatory Services (HPRS), Durable Medical Equipment and other clinical and administrative leadership to investigate and facilitate resolution of complex and high profile member requests and appeals. I was responsible for ensuring complaints, grievances and appeals were processed by our staff in accordance with regulations, compliance standards, policies and procedures. Regulators include, but are not limited to: Department of Managed Healthcare (DMHC), Department of Health Services (DHS), Department of Labor, Department of Consumer Affairs, and the National Committee for Quality Assurance (NCQA), Medi-Cal and Centers for Medicare / Medicaid Services.

Pleasanton, Ca

I was responsible for ensuring complaints, grievances and appeals are processed in accordance with regulations, compliance standards, policies and procedures. Regulators include, but are not limited to: Department of Managed Healthcare (DMHC), Department of Health Services (DHS), Department of Labor, Department of Consumer Affairs, and the National Committee for Quality Assurance (NCQA), Medi-Cal and Centers for Medicare / Medicaid Services.I managed a database for member cases. I was responsible for timely case resolution and compliance with federal and state regulations, laws and accreditation standards.I communicated with a diverse set of internal and external clientele to achieve excellent results in the area of case handling, compliance, documentation and enhancement of the member experience. Partnered with and outreach to internal staff, other Member Services departments, managers and physicians to resolve issues as quickly as possible.I mentored my peers in preparation for positions of increased responsibility, as well as, participated in presentations at departmental meetings, trainings and audits when requested by Management. I also assisted in the implementation of new procedures used throughout the department as well as led the training presentation and individual follow up. I was also designated as an interim Team Lead when additional management was needed. I served as a member of a Management Project Team which is working on streamlining the Member Case Resolution Centers’ and Local Member Services Departments’ existing process. I have coordinated and led sub-group meetings to delineate, discuss and develop ideas and suggestions that has been discussed in the statewide group meetings.

Walnut Creek, Ca

I served as the facilitator of all New Employee Orientation for the Diablo Service Area (DSA), ensuring the smooth functioning of presentations from various department within Kaiser Permanente. I coordinated administrative workflow of the department, including, managing calendars for Senior Leadership staff, travel, expense reports, office and material organization. I maintained pertinent information on the Department Shared drive including personnel files and training documents of Physicians and Nurses. Directed printing and production of promotional materials and the set up as well as take down of all Diablo Service Area training classes. I performed special assignments for manager which required researching and collecting information needed to complete projects or reports; locating, analyzing and summarizing data to identify variances and provide recommendations; and producing reports requiring specialized content knowledge which may be the basis of significant decisions. Trained Sr. Leadership and Clinical staff on Joint Commission (JCAHO Standards) and performed mock JCAHO surveys.

Walnut Creek, Ca

I served as Health Plan Representative in coordinating the organization's responsibility for the complaintprocess. I promoted member satisfaction and retention and create opportunities to advocate for the member by (1) utilizing current customer service strategies and (2) communicating with excellent written and verbal skills to influence key decision-makers. I provided guidance to fellow Health Plan Representatives in resolving complex, escalated issues with discretion. I participated in work groups/committees and other special projects requiring Member Services expertise and input; as well as represented for the Member Services Director.I attended off-site Health Plan presentations at local Assisted Living Facilities representing the Kaiser Permanente Medicare Sales Team to present and discuss with residents the benefits of the Senior Advantage Medicare Program. I investigated and responded to quality of service complaints, with emphasis on professional documentation, thorough research and file maintenance. I prepared customized written responses to internal and external clients. I served as liaison that assists in communication between Social Security, Medicare, Social and Human Services, Contra Costa Health Plan and members to resolve problems that may occur resulting in termination of accounts and/or delays in enrollment.

Oakland, Ca

Education record

Associate’S Degree, Merchandise Marketing