BINCY BROWNER
Snellville
Summary
Strategic healthcare operations executive with 12+ years of experience leading business operations, organizational transformation, regulatory performance, and cross-functional execution within complex healthcare environments. Proven track record of translating enterprise strategy into operational plans, building high-performing teams, driving process optimization, and improving patient and provider experiences across multi-state organizations. Recognized for aligning stakeholders, navigating complex tradeoffs, implementing scalable operating models, and delivering measurable business outcomes.
Overview
18
18
years of professional experience
Work History
Associate Director, Clinical Operations, Utilization Management
HUMANA
Atlanta, Georgia
04.2021 - Current
- Provide strategic leadership for multi-state operational functions supporting Medicare lines of business
- Partner with executive leaders, compliance teams, technology stakeholders, and operational partners to align priorities and drive enterprise initiatives
- Lead managers and cross-functional teams responsible for operational performance, quality outcomes, compliance, and member experience
- Develop reporting frameworks, performance metrics, and governance processes to support organizational decision-making
- Drive workflow optimization and operational transformation initiatives that improve efficiency, scalability, and stakeholder satisfaction
- Manage resources, priorities, and execution across multiple workstreams while ensuring achievement of key performance objectives
- Recognized with multiple Star Awards for operational leadership and business impact
Manager, Utilization Management (Pre-Authorization, Retro, Compliance & Delegation)
HUMANA
Atlanta, Georiga
01.2019 - 04.2021
- Led a geographically dispersed team of 15 professionals responsible for critical utilization management functions across multiple states
- Directed cross-functional initiatives with compliance, provider, and operational stakeholders to maintain 95%+ audit performance
- Established the Southeast Region Retro Team, creating scalable workflows and operational processes supporting organizational growth
- Led implementation and adoption efforts for provider dispute workflows and enterprise technology solutions
- Developed talent strategies, succession plans, and performance management processes that improved engagement and team effectiveness
- Served as a key operational leader during periods of organizational change and process redesign
Manager, Post-Acute Utilization Management
HUMANA
Atlanta, Georgia
08.2013 - 01.2019
- Directed multi-state teams supporting post-acute operations across SNF, IRF, and LTAC settings
- Managed operational performance, regulatory compliance, quality outcomes, and stakeholder relationships
- Partnered with internal and external stakeholders to redesign workflows and improve care coordination processes
- Played a key leadership role in naviHealth implementation, operational integration, and change management efforts
- Developed provider engagement strategies that strengthened collaboration and improved operational effectiveness
RN, Utilization Management
HUMANA
Atlanta, Georgia
08.2012 - 08.2013
- Managed medical necessity reviews, appeals, and care transition activities
- Collaborated with providers and interdisciplinary teams to support quality outcomes and efficient care delivery
Case Manager, Skilled Nursing
PRUITTHEALTH
Norcross, GA
03.2011 - 08.2012
- Coordinated payer relations, utilization review activities, and operational workflows supporting post-acute patient populations
- Managed stakeholder communication between providers, patients, and payers to facilitate timely authorization and care transitions
Registered Nurse
EMORY DECATUR HOSPITAL
Decatur, GA
08.2008 - 02.2011
- Delivered direct patient care across medical-surgical, oncology, and renal units
- Coordinated patient education, discharge planning, and interdisciplinary care initiatives
Education
Master of Business Administration (MBA) -
Western Governors University
03-2026
Bachelor of Science in Nursing (BSN) -
Mercer University College of Nursing
05-2008
Skills
Business Operations & Strategy Operational Excellence Cross-Functional Leadership Organizational Transformation Strategic Planning & Execution Performance Management & KPI Development Process Optimization Healthcare Operations Change Management Team Development Stakeholder Alignment Program Management Resource Planning Data-Driven Decision Making Regulatory & Risk Management Coaching and mentoring Strategic leadership Analytical thinking
Timeline
Associate Director, Clinical Operations, Utilization Management
HUMANA
04.2021 - Current
Manager, Utilization Management (Pre-Authorization, Retro, Compliance & Delegation)
HUMANA
01.2019 - 04.2021
Manager, Post-Acute Utilization Management
HUMANA
08.2013 - 01.2019
RN, Utilization Management
HUMANA
08.2012 - 08.2013
Case Manager, Skilled Nursing
PRUITTHEALTH
03.2011 - 08.2012
Registered Nurse
EMORY DECATUR HOSPITAL
08.2008 - 02.2011
Master of Business Administration (MBA) -
Western Governors University
Bachelor of Science in Nursing (BSN) -
Mercer University College of Nursing
LEADERSHIP HIGHLIGHTS
Lead multi-state operational functions supporting Medicare populations across complex healthcare markets, Consistently achieved and maintained 95%+ regulatory audit performance and operational quality benchmarks, Built and scaled teams across multiple business functions while developing future leaders through coaching and succession planning, Led implementation and operational integration of enterprise technology platforms, including Carelon (MyNexus) and Optum (naviHealth), Designed and launched new workflows and operating models that improved efficiency, quality outcomes, and stakeholder experience, Recipient of multiple Humana Star Awards for leadership excellence and organizational impact
License
Georgia Registered Nurse License # RN198602