Erin Kam, RN

Experience

• 

  UHA Health Insurance

  Nov 2015 - now

  Responsible for the oversight and development of 29 associates belonging to the clinical, administrative, and provider relations teams; functions include utilization and care management, credentialing, and network adequacy management.Lead analysis of resource management and stewardship of premium dollars to include evaluation of appropriate staffing and department budget, improving efficiency of processes, and effective utilization management.Work collaboratively with the Chief Medical Officer and Medical Directors to develop strategies to reduce under-use, overuse, and misuse of healthcare services while also assuring UHA members receive high-quality care. Show less Recruitment, mentorship, and development of 9 utilization and care management nurses and 13 administrative staff involved in clinical reviews, care coordination, provider communication, and customer service.Responsible for team performance and accomplishing department and company goals that improve efficiency and enhance customer experience.Managed compliance with URAC accreditation standards, consistently exceeding goals of turnaround times, call abandonment rates, and necessary training. Show less Developed a population-specific project focused on members with Parkinson’s Disease to provide diagnosis education, encourage use of appropriate benefits, and connect to community resources. Encouraged open communication with other healthcare providers, including participating physicians and hospital case managers, to foster trust, understanding, and provide continued follow up. Assisted in policy development and revision based on emerging medical publications and research. Created and executed a training program for new and existing clinical staff within the company. Show less

  • Director of Clinical Operations

    Sept 2023 - now

  • Clinical Care Manager

    Oct 2020 - Sept 2023

  • RN Care Specialist II

    Jan 2020 - Sept 2020

  • RN Care Specialist I

    Nov 2015 - Dec 2019