Vernal Tiller

About Vernal Tiller

I am passionate about opportunities to initiate and implement new programs and services, develop policies and procedures, and prepare enterprises for accreditation, licensing, and regulatory surveys. I am known for my expertise in root cause analysis, process, and performance monitoring/improvement strategies, HEDIS, NCQA, Medicaid, Medicare/MMP. My CAREER HIGHLIGHTS are- Strategy/Vision: Partnered with Marketing to design targeted disease management programs for 5 employer groups aligning employees with a primary care physician, resulting in a 50% reduction in non-emergent emergency room visits- Operational Excellence: Designed healthcare equity, diversity, and transgender programs reducing impact of social determinants of health, leading to development of 3 chronic care programs addressing literacy and food insecurity- Transformational Leadership: Led cross-functional projects to redefine the scope and purpose of existing appeal, grievance, and customer experience teams and created a corporate regulatory audit function reducing turnaround time from 96 to 24 hours- Corporate Governance/Compliance/Risk Management: Led 25+ NCQA accreditation surveys/resurveys ensuring plan-wide compliance for Commercial, Medicare, Medicaid, MMP, PPO, and Marketplace products in multiple states. ADDITIONAL RELEVANT EXPERIENCEMOLINA HEALTHCARE PLAN, Director of Utilization & Case Management OMNICARE HEALTH PLAN, Vice President Medical Management DETROIT MEDICAL CENTER (DMC), Director of Quality, Utilization, and Case ManagementOAKWOOD HEALTH SYSTEM, Director Utilization and Case Management UNITED AMERICAN HEALTH CARE, Medical Service Administrator ST. JOHN HEALTH SYSTEM, Director Utilization/Resource Management, Director Nursing Medical-Surgical and Oncology NORTH OAKLAND MEDICAL CENTER, Director Ambulatory Services, Manager Oncology Services DETROIT RECEIVING HOSPITAL, Charge Nurse, Burn Intensive Care Unit Detroit Medical CenterTHE CHICAGO SCHOOL OF PROFESSIONAL PSYCHOLOGY, Adjunct Faculty UNIVERSITY OF THE ROCKIES, Adjunct Faculty SPECIALTIES Managed Care | Appeals and Grievance | Quality | Disease | Utilization | Case Management | Crisis Management | Interventionist | Operational Excellence | Compliance | Risk Management | Innovation

Experience

1. CEO & Founder

   Bianca\'s Haven

   Oct 2023 — Present · Troy, MI, US

   At Bianca’s Haven, I passionately stand united against human trafficking as a beacon of hope and healing for survivors, championing their journey toward a brighter tomorrow. As the founder of Bianca\'s Haven, I strive to break the chains of exploitation through a multifaceted approach in rebuilding lives, restoring dignity, and nurturing resilience.

Education

• Oakland University

  Bachelor of Science - BS

• Walden University

  Doctor of Philosophy - PhD

• Central Michigan University

  Master of Science - MS