Stephanie Banks
Dalton
Summary
Professional with significant expertise in team leadership and operational management. Proven track record in driving team collaboration and delivering impactful results. Skilled in conflict resolution, process optimization, and strategic planning, with flexible approach to evolving business needs. Known for reliability, strong communication, and fostering productive work environment.
Overview
22
22
years of professional experience
Work History
Supervisor Care Management
Martin's Point Health Care
10.2025 - Current
- Supervised interdisciplinary care management team (nurses, social workers, coordinators) to ensure quality member care.
- Oversaw daily operations for Medicare Advantage and USFHP programs, ensuring compliance with CMS, NCQA, and DoD standards.
- Directed case management activities including assessments, individualized care plans, and proactive outreach for high-risk members.
- Monitored performance metrics (HEDIS, STAR ratings, TRICARE quality measures) and implemented improvement initiatives.
- Partnered with providers, hospitals, and community resources to coordinate care and resolve complex cases.
- Led staff development through coaching, mentoring, and performance evaluations, improving engagement and retention.
- Enhanced workflows and processes to reduce avoidable hospitalizations and improve member satisfaction.
- Oversaw daily operations of the department, ensuring smooth workflow and timely completion of tasks.
- Applied strong leadership talents and problem-solving skills to maintain team efficiency and organize workflows.
BSN Nursing Adjunct/Instructor
Chattanooga College
10.2025 - Current
- Managed online classroom effectively to maintain a positive learning environment for all students.
- Maintained accurate records of student attendance, assignments, and grades, ensuring timely communication with stakeholders regarding academic progress.
- Participated in professional development opportunities to stay current on best teaching practices and industry trends.
- Monitored student progress through regular assessments, providing constructive feedback for improvement.
- Engaged students with insightful and compelling classroom discussion of topics relevant to coursework to boost student learning and retention.
- Consistently communicated with students to acknowledge and reward positive strides and discuss areas of improvement.
Clinical Management Supervisor (BlueCare Plus, Dual Special Needs Plan/FIDE)
Blue Cross Blue Shield
07.2024 - 10.2025
- Manages, hires, mentors, and evaluates clinical staff to ensure optimal team performance and high-quality clinical service delivery
- Oversees productivity, audits performance metrics, and identifies trends to drive continuous quality improvement in alignment with departmental KPIs
- Leads development, implementation, and upgrades of clinical policies, workflows, and documentation standards to improve compliance, efficiency, and outcomes
- Analyze clinical documentation and coding data to identify performance trends and improvement opportunities
- Manages cross-functional projects aimed at optimizing clinical operations and ensures successful execution within scope, budget, and timelines
- Conducts routine audits and evaluations of clinical programs to ensure adherence to regulatory standards, payer guidelines, and internal protocols
- Serves as the primary clinical liaison with internal departments and external partners to coordinate service delivery, resolve escalations, and align strategic goals
Clinical Team Expert/Clinical Review Manager (BlueCare Plus, Dual Special Needs Plan/FIDE)
Blue Cross Blue Shield
01.2022 - 07.2024
- Provide direct hands-on guidance, education, and technical support to team while ensuring company benchmarks for quality, productivity, and proficiency are achieved and maintained
- Direct oversight of the queues, monitoring of daily workloads/assignments, TAT, and monitoring of staffing
- Subject matter expert, identifying trends, highlighting areas to be addressed and assisting to drive changes which will meet client and business expectations
- Train/Precept staff, provide educational material/workflows and development of staff
- Monitoring of expedite requests, various work groups
- Acts as an education resource to the clinicians and organizational leadership with regards to local, state and federal utilization issues. Prepares or assists with creating accurate presentation materials including but not limited to agenda, minutes, reporting, and process improvement as needed
Clinical Review Manager (Med Advantage)
Blue Cross Blue Shield
04.2018 - 01.2022
- Collaborate with medical staff, Case Managers, Medical Directors and other healthcare professionals to evaluate the medical necessity and appropriateness of treatment plans
- Performs medical necessity and clinical reviews of authorization requests to determine medical appropriateness of care in accordance with regulatory guidelines and criteria (CMS, URAC)
- Performing comprehensive provider and member appeals, denial interpretation for letters, retrospective claim review, special review requests, and UM pre-certifications and appeals, utilizing medical appropriateness criteria, clinical judgement, and contractual eligibility
- Monitoring of expedite requests, various work groups
- Involved in the initial onboarding process, providing new hires with an overview of the department's functions, the UM process, and relevant policies and procedures (trainer/mentor)
- Assist non-clinical staff in performance of administrative reviews
RN- Operating Room Circulator
Hamilton Health Care System
09.2016 - 03.2018
- Performed pre-op assessments and verified documentation, labs, and orders
- Circulated surgeries across multiple specialties (general, ortho, GYN, vascular, neuro)
- Ensured sterile field and monitored for aseptic technique compliance
- Managed safe patient transport to/from OR and PACU
- Served on Code Blue committee to improve resuscitation protocols
- Supported quality improvement through chart reviews and case analysis
- Pursued ongoing education to maintain perioperative care competencies
RN- Emergency Department
Clearview Regional Medical Center (Level III Trauma facility)
03.2015 - 09.2016
- Expert in triaging ESI 1–5 patients in high-volume settings
- Delivered care to multiple trauma/emergent patients with rapid stabilization
- Proficient in key procedures: IVs, EKGs, catheter/tube insertions, wound care, blood products
- Safely administered medications per orders and protocols
- Collaborated on bedside procedures with physicians
- Led support staff with accountability for care quality and workflow
- Educated patients/families on treatment, discharge, and health maintenance
RN- Emergency Department
St Marys Health Care System
09.2015 - 06.2016
- Triaged patients across all acuity levels (ESI 1–5) in a high-volume ED
- Managed care for multiple emergent/trauma patients, ensuring rapid stabilization
- Performed key procedures: IVs, EKGs, catheter/tube insertions, wound care, blood products
- Administered medications per orders and protocols
- Assisted with bedside procedures alongside physicians
- Supervised support staff and maintained care quality
- Provided patient/family education and coordinated discharge planning
LPN/Secretary
Naples Urgent Care
08.2013 - 12.2014
LPN School Nurse
Naples Community Hospital
09.2012 - 08.2013
LPN
Robert F Gomez, ENT
04.2012 - 08.2012
Medical Supervisor/Physician Substitute
Biotest
12.2011 - 04.2012
Pediatric Nurse-Team Lead/Medical Secretary- Care Coordinator
Medlink
08.2008 - 12.2011
Park Supervisor
Madison County Recreation Department
04.2004 - 12.2009
Administrative Assistant II
The University of Georgia Veterinary Teaching Hospital
11.2007 - 01.2008
Education
Master of Science - Nursing-Leadership and Management (MSN)
Western Governors University
01.2021
Bachelor of Science - Nursing (BSN)
Western Governors University
01.2020
Associate of Science - Nursing (ADN)
Florida Southwestern State College
01.2014
Diploma - Practical Nursing (LPN)
Athens Technical College
01.2009
Skills
- Training and mentoring
- Goal oriented
- Staff management
- Decision-making
- Complex Problem-solving
- Team building/motivation
- Processes and procedures
- Process monitoring and improvement
- Documentation and reporting
- Team leadership
- Problem-solving abilities
Websites
Timeline
Supervisor Care Management
Martin's Point Health Care
10.2025 - Current
BSN Nursing Adjunct/Instructor
Chattanooga College
10.2025 - Current
Clinical Management Supervisor (BlueCare Plus, Dual Special Needs Plan/FIDE)
Blue Cross Blue Shield
07.2024 - 10.2025
Clinical Team Expert/Clinical Review Manager (BlueCare Plus, Dual Special Needs Plan/FIDE)
Blue Cross Blue Shield
01.2022 - 07.2024
Clinical Review Manager (Med Advantage)
Blue Cross Blue Shield
04.2018 - 01.2022
RN- Operating Room Circulator
Hamilton Health Care System
09.2016 - 03.2018
RN- Emergency Department
St Marys Health Care System
09.2015 - 06.2016
RN- Emergency Department
Clearview Regional Medical Center (Level III Trauma facility)
03.2015 - 09.2016
LPN/Secretary
Naples Urgent Care
08.2013 - 12.2014
LPN School Nurse
Naples Community Hospital
09.2012 - 08.2013
LPN
Robert F Gomez, ENT
04.2012 - 08.2012
Medical Supervisor/Physician Substitute
Biotest
12.2011 - 04.2012
Pediatric Nurse-Team Lead/Medical Secretary- Care Coordinator
Medlink
08.2008 - 12.2011
Administrative Assistant II
The University of Georgia Veterinary Teaching Hospital
11.2007 - 01.2008
Park Supervisor
Madison County Recreation Department
04.2004 - 12.2009
Bachelor of Science - Nursing (BSN)
Western Governors University
Associate of Science - Nursing (ADN)
Florida Southwestern State College
Diploma - Practical Nursing (LPN)
Athens Technical College
Master of Science - Nursing-Leadership and Management (MSN)
Western Governors University
Clinical Experience
Supervising/Team leader, Care Coordinator, Medical Supervisor/Physician Substitute, Utilization Management/Data abstraction, Medicare Advantage, DSNP (Dual Special Needs Plan), Medicaid (TennCare), USFHP/Tricare, CMS, URAC, NCQA
Microsoft Works, Quickbooks, Google Doc, Tableau, Facets, Encoder Pro, Agent Workspace, MegaView, Citrix, EPIC, Meditech, eClinical, Amazing Charts, CareAdvance, TruCare, NexGen