1. MARY LISA CHRISTY R.N.
1230 S 3rd Rd SW
Fairfield, Montana 59436
406-467-3153
406-868-5453 (cell)
marychristy65@hotmail.com
EXPERIENCE
Referral Management Liaison
United Healthcare Military & Veterans – Malmstrom Air Force Base, Great
Falls, Montana April 1, 2014 to present
 Interact with Military Treatment Facility (MTF): Serve as the principal
point of contact for MTF staff on TRICARE operations to include all
clinical, claims and administrative matters; Facilitate and maintain
working relationships with MTF Commander, staff and providers on all
matters pertaining to TRICARE; foster a strong collaborative working
relationship with the TRICARE Operations and Patient Administration
(TOPA) Flight and referral management center.
 Ensure efficient and accurate completion of all clinical and
administrative activities with an emphasis on process improvement,
utilization management, case management and condition management;
Ensure operations are within the administrative and staffing budget;
monitor various management indicators to evaluate the effectiveness of
local operations. Complete referral and inpatient/outpattient authorization
processing in accordance with United Healthcare Military & Veterans policies and
procedures (myGuide), MCG criteria and TRICARE Policy Manual guidelines.
 Customer service:maintain a working environment focused on the provision of
prompt, courteous and professional customer service, ensuring that all customer
services are performed consistent with protocol and within the managed care
support contract performance standards. Demonstrate the ability to
independently identify, define and effectively resolve complex issues.
 Identify provider network problems/issues and correct or communicate
these to the Director Market Operations (DMO) and network services
 Identify and report potential risk management and quality of care issues to
the appropriate departments.
 Knowledge of TRICARE policies, procedures and claims processing, MCG
criteria, ICD-9-CM, CPT-4 and HCPCS coding; various computer programs
including Word, Excel, Power Point, Internet Explorer.

2. Manager, TRICARE Service Center
United Healthcare Military & Veterans – Malmstrom Air Force Base, Montana
February 1, 2013 to March 31, 2014
 Management TSC: Manage all aspects of operations in order to maintain a
working environment focused on the provision of prompt, courteous and
professional customer service, ensuring that all customer services are
performed consistent with protocol in a caring, empathic manner and
within the managed care support contract performance standards.
Demonstrate the ability to independently identify, define and effectively
resolve issues impacting operations in a timely fashion.
 Interact with MTF: Serve as the principal point of contact for MTF staff on
TSC operations to include all clinical, claims and administrative matters;
Interact, facilitate and maintain working relationships with MTF
Commander, staff and providers on all matters pertaining to TRICARE and
TSC operations; foster a strong collaborative working relationship with the
TOPA Flight.
 Ensure efficient and accurate completion of all clinical and
administrative activities with an emphasis on process improvement,
utilization management, case management and condition management;
Ensure the TSC operates within the administrative and staffing budget;
monitor various management indicators to evaluate the effectiveness of TSC
operations.
 Staff supervision: Prepares annual performance evaluations and provides
staff feedback on a regular basis; ensure the staff appropriately implement
United Healthcare Military and Veterans policies and procedures; develop
TSC workflow processes to ensure maximum efficiency of assigned staff;
monitor workload of employees to assure accuracy, timeliness, efficiency,
and contract compliance; ensure that appropriate and timely coaching and
performance counseling is provided to support staff performance
improvement and provide DMO with recommendations for additional
training; conducts and/or coordinates staff development activities. Ensure
staff competencies are maximized through completion of all applicable
new and annual refresher training.
 Identify provider network problems/issues and correct or communicate
these to DMO and network services

3.  Identify and report potential risk management and quality of care issues to
the appropriate departments.
 Knowledge of TRICARE policies and claims processing, InterQual/Milliman
Criteria, ICD-9-CM, CPT-4, HCPC’s and American Dental codes; various
computer programs including Word, Excel, Power Point, Internet Explorer.
Clinical Liaison Nurse
TriWest Healthcare Alliance - Malmstrom, Great Falls, Montana – May 7,
2001 to February 15, 2013
 Supervision TSC: Manage all aspects of the TSC to maintain a working
environment focused on the provision of prompt, courteous, and
professional customer service, ensuring that all customer services are
performed consistent with protocol, and within the managed care support
contract performance standards. Demonstrate the ability to independently
identify, define and effectively resolve issues impacting day-to-day TSC
operations.
 Interact with MTF: Serve as the principal point of contact for MTF staff on
TSC operations to include all clinical and administrative matters; Interact
with MTF Commander and staff on all operational and clinical issues
concerning the operation of the TSC; Facilitate and maintain working
relationships with MTF Commander, staff and providers on all matters
pertaining to TRICARE and TSC operations; foster a strong collaborative
working relationship with the Contracting Officer Representative (COR).
 Ensure efficient and accurate completion of all clinical activities with an
emphasis on process improvement, utilization management, case
management and condition management; Complete referral and
inpatient/outpattient authorization processing in accordance with company
policies and procedures, InterQual criteria and TRICARE policy manual
guidelines. Complete clincal packets for medical director review. Provider
guidance/supervision to staff on completion of referrals and clinical
authorizations.
 Staff supervision: Prepare annual performance evaluations and provide
staff feedback on a regular basis; ensure the staff appropriately implements
policies and procedures; develop workflow processes to ensure maximum
efficiency of assigned staff; monitor workload of employees to assure
accuracy, timeliness, efficiency, and contract compliance; ensure that
appropriate and timely coaching and performance counseling is provided

4. to support staff performance improvement and provide Service Area
Director (SAD) with recommendations for additional training; conducts
and/or coordinates staff development activities. Ensure TRICARE Service
staff competencies are maximized through completion of all applicable
new and annual refresher training.
 Identify network provider problems/issues and correct or communicate
these to SAD and network subcontractor
 Identify and report potential risk management and quality of care issues to
the appropriate corporate office.
 Knowledge of TRICARE Policy Manual, InterQual Criteria, ICD-9-CM,
CPT-4, HCPC’s and American Dental codes and coding conventions;
various computer programs including Word, Excel, Power Point, Internet
Explorer.
Internal Case Management Supervisor
Spectrum Medical, Inc., Great Falls, Montana – January 10, 2000 to May
2001.
 Internal Case Manager (home health, private duty, durable medical
equipment, oxygen services, rehab services) relations. Coordination of care
of clients using multiple services. Daily review of current clients
hospitalized. Research and perform customer service call backs for quality
assurance.
 Home Health: Receiving referrals from Benefis Healthcare, physicians and
clients for skilled nursing, physical therapy, occupational therapy or
speech therapy. Create admission packet for staff. Scheduling of nursing
staff to meet plan of care for each client. Admit clients and provide
nursing care on an as needed basis. Maintain daily census statistics.
Maintain home health utilization statistics. Data entry of Home Health
client data into Haven.
 Employee Health: Coordinate and maintain current employee health files
on all employees. Administer tuberculosis testing, Hepatitis B vaccinations,
flu shots, latex allergy questioning and other necessary screenings – keeping
accurate records for all tests/vaccines administered. Provide monthly
education to all employees on mandatory topics i.e. infection control, blood
born pathogens.
 Private Duty: Receiving referrals from Benefis Healthcare, physicians and
clients for personal care, nursing care. Complete EPSDT application for
pediatric nursing care. Receive physician orders and schedule phlebotomist
for at home blood draws. Admit clients and provide nursing care on an as

5. needed basis in absence of Private Duty Coordinator.
 Home and Community Based Services (HCBS) Case Management Team: case
manager responsible for 21 HCBS clients.
Pediatric Staff Registered Nurse
Benefis Healthcare, Great Falls, Montana - October 1987 to December 1989.
 Full-time nurse on 20-bed unit that included pediatric nursing and
education for children and families
Office Nurse
Mark A. Kelly, D.O., Cut Bank, Montana - March to November 1986.
 Office nurse with miscellaneous office duties including nursing, laboratory,
ordering supplies, filing, dictation, scheduling.
Shift Supervisor
Toole County Hospital & Nursing Home, Shelby, Montana - August to
December 1985.
 Full-time supervisor for a 45-bed long-term care facility.
Staff Registered Nurse
Toole County Hospital & Nursing Home, Shelby, Montana - January to March
1986.
 Full-time staff at a 23-bed rural hospital.