Tiffany Miles

Tiffany Miles Email and Phone Number

Manager, Clinical Negotiations @ Multiplan
Chicago, IL, US
Tiffany Miles's Location
Greater Chicago Area, United States, United States
Tiffany Miles's Contact Details

Tiffany Miles personal email

n/a
About Tiffany Miles

As a Clinical Operations Manager with 10+ years of experience in various health care settings, I have developed and demonstrated core competencies in resolution and process improvement, business analysis and strategic planning, vendor and contract management, audits and documentation, and customer relationship management (CRM). I have a proven track record of leading and mentoring high-performing teams, delivering exemplary operations and customer service, and implementing improvement initiatives that enhance efficiency, quality, and profitability.In my most recent role at AIM Specialty Health, I oversaw a team of 12 direct reports, monitored and assessed the volume, source, and type of claims, and coordinated Medicaid rosters against state eligibility data. I also helped the business understand drivers, trends, and product stress points, and built solid, trust-based relationships with clients and stakeholders. Previously, at MultiPlan, I managed complex internal and external operational matters, negotiated contracts with vendors, and ensured compliance with audits and documentation. I am a tenacious problem solver who delivers viable solutions to complex problems, and a catalyst for revenue growth and profitability. I am passionate about applying my skills and expertise in process improvement and CRM to help organizations achieve their goals and optimize their outcomes.

Tiffany Miles's Current Company Details
Multiplan

Multiplan

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Manager, Clinical Negotiations
Chicago, IL, US
Tiffany Miles Work Experience Details
  • Multiplan
    Manager, Clinical Negotiations
    Multiplan
    Chicago, Il, Us
  • Aim Specialty Health
    Manager Ii, Clinical Operations
    Aim Specialty Health Jul 2021 - Dec 2022
    Chicago, Il, Us
  • Multiplan
    Manager, Clinical Negotiations
    Multiplan Jun 2016 - Jul 2021
    Direction and oversight of a team of 12 direct reports, monitoring employee performance to ensure adherence to metrics and managing all aspects of hiring, terminations, annual reviews, and training and performance feedback. Ensure completion of special projects as assigned and lead one on one meetings and team meetings. Monitor and assess overall volume, source, and type of claims including client specific directives, and implementation of corresponding improvement initiatives.Key Roles and Responsibilities:►Focus on resolution and process improvement, fulfilling all obligations while maximizing cost effectiveness, helping business in understanding drivers, trends and product stress points and helping partners attract and retain business.►Leverage data, management information and technology to identify and optimize opportunities to support business strategies and improve results.►Provide instruction, strategy, and direction to negotiators on individual fee cases.
  • Blue Cross Blue Shield Illinois/Hcsc
    Government Programs
    Blue Cross Blue Shield Illinois/Hcsc 2013 - 2016
    Managed stakeholder expectations for BCBSIL Medicaid products. Provided operational assistance and program leadership to further enhance systems.Key Roles and Responsibilities:►Identified, researched, and resolved complex internal and external operational matters.►Coordinated Medicaid rosters against State of Illinois eligibility enrollment data.
  • Sedgwick Claims Management Services, Inc
    Manager Operations
    Sedgwick Claims Management Services, Inc 2012 - 2013
    Us
    Worked collaboratively to enhance processes and implement initiatives leading to increased profitability. Assessed upcoming projects to forecast projected resource requirements. Implemented conflict-resolution tactics by cooperating with clients and staff to achieve team objectives. Maintained client relationships and contracts.Key Roles and Responsibilities:►Designed performance metrics to provide traceability through organization and advance tactical and strategic business goals.►Analyzed performance data to assess, optimize and elevate operations, targeting current and expected demands.►Created policies and procedures to ensure compliance with best practices, claims management standards, state regulations.
  • Citizens Management Inc
    Manager, Disability Claims Unit
    Citizens Management Inc 2005 - 2012
    Steered program oversight and management of claims adjusters for the State of Michigan’s short-and-long-term disability claims programs. Oversite of all aspects of vendor and client vetting, selection, and management. Tracked overall program performance monitoring and reviews.Key Roles and Responsibilities:►Developed and implemented effective training, performance development and succession planning, including creating and implementing a training manual that was previously non-existent.►Formulated strategies for process improvement programs.►Led leadership meetings and communicated program performance status.►Prepared training schedules for new processes and procedures while mentoring team.
  • Ford Motor Company/Bartech
    Disability/Quality Review Analyst
    Ford Motor Company/Bartech 2002 - 2005
    Played key role as member of a Six Sigma process, charged with redesigning the Ford Motor Company Disability Program. Continually upheld and complied with industry standards.Key Roles and Responsibilities:►Recognized for a roll-out implementation of the Disability Program throughout Ford Motor locations in North America.►Provided oversight and direction of efforts of TPA staff with regards to claims management.
  • Ford Motor Company/Bartech
    Workers Compensation Administrator
    Ford Motor Company/Bartech 1997 - 2002
    Onsite administration of multi-state Workers' Compensation claims for various Ford Motor Company facilities which included litigated, indemnity, managed medical and medical only claims.Key Roles and Responsibilities:►Provided oversight of medical services and medical claims management.►Lead case management meetings to identify modified work assignments; discussion of applicable case law and the impact of various employment laws, regulations and collective bargaining agreement on individual claims.►Forecasted annual workers' compensation liability for individual facilities.►Monitored budget throughout the year and assisted with implementation of cost reduction programs.►Negotiated settlement of claims and coordinated management of litigated claims with in-house and outside counsel.

Tiffany Miles Skills

Workers Compensation Team Building Training Claims Management Insurance Leadership Claim Performance Management Disability Insurance Disabilities Process Improvement Customer Service Leadership Development Policy Short Term Disability Long Term Disability Employee Benefits Human Resources Budgets Project Management Customer Relationship Management Account Management Budget Management Budgeting Vendor Management U.s. Family And Medical Leave Act Cisco Qlikview Sharepoint Adp Payroll Peoplesoft Salesforce.com Management Contract Negotiation Public Speaking Disability Claims Management Vendor Contracts Employment Contracts Avaya Ip Telephony Ada Compliance

Tiffany Miles Education Details

  • University Of Illinois At Chicago
    University Of Illinois At Chicago
    Criminal Justice
  • The Culinary School Of Kendall College
    The Culinary School Of Kendall College
    Culinary Arts/Chef Training

Frequently Asked Questions about Tiffany Miles

What company does Tiffany Miles work for?

Tiffany Miles works for Multiplan

What is Tiffany Miles's role at the current company?

Tiffany Miles's current role is Manager, Clinical Negotiations.

What is Tiffany Miles's email address?

Tiffany Miles's email address is tm****@****ver.com

What schools did Tiffany Miles attend?

Tiffany Miles attended University Of Illinois At Chicago, The Culinary School Of Kendall College.

What skills is Tiffany Miles known for?

Tiffany Miles has skills like Workers Compensation, Team Building, Training, Claims Management, Insurance, Leadership, Claim, Performance Management, Disability Insurance, Disabilities, Process Improvement, Customer Service.

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