Honor Society® member
Paris Dukes, MA, BSN, RN
Manager, UM Operations at • Oversight over 650+ onshore/offshore contracted contingent workforce (clinical/non clinical) plus and internal team comprised of two program managers and two quality auditors specialists for Utilization Management across Medicare, Medicaid and Ambetter Health plans. • Liaison connecting internal and external teams across the enterprise to support evolving business needs • Duties consistent of but are not limited to the management of the following: Service of Work ( external contract) detail consultation/review in partnership with the finance team, day-to-day operations for the contracted contingent workforce including coordinating new staff requests, access request/configuration /troubleshooting, coordination/follow-up of new hire onboarding, coordination of staff placement, performance metrics monitoring (to include Inter reliability Inter-rater reliability (IRR) /compliance training, management of UM Corp auditing /Enterprise staff roster
- Advanced practice nursing
- Class of 2030
- Ofallon, Missouri
Member since February 2025
About
After fifteen years as a Registered Nurse and earning a Master’s in Management and Leadership, I am returning to my foundational calling to advance my practice as a Family Nurse Practitioner. This path has been my dream since childhood, but it became a concrete mission in 2004 when my grandfather fell critically ill. Following a myocardial infarction that left him unable to speak, I became an active member of his care team and witnessed firsthand the devastating impact of healthcare negligence. That experience ignited a lifelong passion for patient advocacy and exposed the urgent need for providers who marry clinical expertise with deep compassion.
My goal is to master the art of diagnosis and evidence-based treatment while contributing to the research that drives clinical innovation. By bridging my extensive leadership background with doctoral-level clinical training, I intend to increase my reach and impact, ensuring that every patient receives the knowledgeable, dignified advocacy they deserve.
Education
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Webster University
business management
2014 – 2017
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University of School of Missouri - Saint Louis
bachelor of science in nursing
2006 – 2009
Honors and awards
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high honors
Magnum Cum Laude
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high honors
Cum Laude
Goals and interests
- Career goal
Family Nurse Practitioner
- Graduate school interests
BSN to DNP program with a family focus
- Outside the classroom
Skatin,
Swimming
Meditation
Traveling
Experience
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Manager, UM Operations
• Oversight over 650+ onshore/offshore contracted contingent workforce (clinical/non clinical) plus and internal team comprised of two program managers and two quality auditors specialists for Utilization Management across Medicare, Medicaid and Ambetter Health plans. • Liaison connecting internal and external teams across the enterprise to support evolving business needs • Duties consistent of but are not limited to the management of the following: Service of Work ( external contract) detail consultation/review in partnership with the finance team, day-to-day operations for the contracted contingent workforce including coordinating new staff requests, access request/configuration /troubleshooting, coordination/follow-up of new hire onboarding, coordination of staff placement, performance metrics monitoring (to include Inter reliability Inter-rater reliability (IRR) /compliance training, management of UM Corp auditing /Enterprise staff roster
Feb 2022 – Present
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Manager, Learning and Development Operations, G & A-Medical Mgmt Training
I worked to inspire, motivate, mentor, and professionally develop staff. My duties included: scheduling and prioritization of training and associated curriculum/resources; Assisting with identifying information gaps through needs analysis methodology and developing appropriate training programs, including the selection and/or design of appropriate training resources; Conducting reviews on training quality trends and providing custom recommendations as needed; Collaboration on best practice for the training department policies and procedures; Completing special projects as assigned (i.e. Training for TruCare Cloud/TruCare 8.0, Medical Director, Quartet, Advance Care Planning (ACP) , Vendor (temporary staff), Quartet , Admission Discharge; Transfer (ADT), oversight over authorization guidelines/InterQual Custom Criteria (CCO) updates, Clinical Program work with SSFB and job aids support for Wellcare and Centene, etc.) Corporate Billing and Enrollment: I supervised activities related to training and quality programs; Reviewed and assessed training program effectiveness through examination and understanding of audit results inclusive of creating surveys, audits completion and pulling reports; Ensuring training and quality programs were continually enhanced to meet the evolving business needs. My overall role is to supported enterprise-wide initiatives to assist with staff alignment with current practices.
Mar 2021 – Feb 2022
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Supervisor, Learning and Development Operations, G & A-Medical Mgmt Training
Oversight over the following tasks: Completion training needs analyses to determine specific training needs for clinical staff, identify, select, or develop appropriate training programs, including the selection or design of appropriate training aids (i.e. TruCare Role Specific TruCare User Guides etc.), evaluated effectiveness of training programs and location including cost/benefit analyses, research, analyze, and recommend external training programs, maintain records of training activities and employee progress, assisted with revisions to policy and procedure and/or work process development, conducted auditing of work performed by clinical staff and present findings and recommendation for areas of improvement to management, under minimal supervision responsible for all aspects of difficult projects that are broad in nature and require originality and/or ingenuity, supported the implementation of new lines of business (training clinical & non-clinical staff on TruCare, InterQual, FileNet Content Navigator and Clinical Programs) and supported existing lines of business with continued education and refresher skill training.
Mar 2019 – Mar 2021
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Trainer, Learning and Development Operations, G & A-Medical Mgmt Training
My responsibilities were as follows: Conduct training needs analyses to determine specific training needs for clinical staff, identify, select, or develop appropriate training programs, including the selection or design of appropriate training aids (i.e. TruCare Role Specific TruCare User Guides etc.), evaluated effectiveness of training programs and location including cost/benefit analyses, research, analyze, and recommend external training programs, maintain records of training activities and employee progress, assisted with revisions to policy and procedure and/or work process development, conducted auditing of work performed by clinical staff and present findings and recommendation for areas of improvement to management, under minimal supervision responsible for all aspects of difficult projects that are broad in nature and require originality and/or ingenuity, supported the implementation of new lines of business (training clinical & non-clinical staff on TruCare, InterQual, FileNet Content Navigator and Clinical Programs) and supported existing lines of business with continued education and refresher skill training. I also have experience training clinical corporate staff for the Centralized Medicare Unit and Centralized Transplant Unit. I was the liaison between the Quality Review Department and the Medical Management Training team as well as the SME for TruCare work process. I also co-led the initiative to update the IRR policy to support all the following roles: medical directors, clinical staff inclusive of therapists.
Nov 2016 – Mar 2019
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Utilization Management Consultant for Prior Authorization Department
My responsibility as a prior authorization nurse is to provide patients, physicians and health team member services related to the appropriate utilization of the organization’s resources, identify, screen, coordinate and process referral determinations of requested services. I determined member eligibility, benefit coverage, medical necessity, location and appropriateness. I was also considered a “super user” and typically are called upon to complete trials of new department processes/software. I have been utilized to cover the supervisor’s coverage leadership team’s vacations and more etc. I am viewed as a mentor and have been successful at consistently exceeding department/company expectations.
Jul 2014 – Nov 2016
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Staff Nurse
I provided compassionate, professional, and ethical care while executing supplemental/contract services to agency clients. These services included: assessment, planning, implementation, and evaluation of the patients’ status, plan of care, and goal achievement. I rendered the preceding services to BJC Independence Center for approx. 3 months and received accolades for my work. “Independence Center focuses on providing programs and services that assist adults in the St. Louis metropolitan area with serious and persistent mental illnesses to live and work in the community, independently through rehabilitation, employment, education, social and housing opportunities.” (Extracted BJC.org). I was offered a permanent role but declined due to a prior acceptance of an opportunity with another employer prior to this offer.
Mar 2014 – May 2014
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Registered Nurse Complex Case Manager
My duties included: Functioning as the central coordinator of care for members/injured employees identified as having chronic disease processes or members/injured employees in selecting physician practices. My focus was disease management as well as implementing and coordinating all case management activities relating to catastrophic cases and chronically ill members/injured employees across the continuum of care including consultant referrals, home care visits, use of community resources, and alternative levels of care. I was responsible for developing and executing implementation plans with a physician practice to coordinate all case management activities. Use computer-based systems (i.e., IDX and Citrix) to review medical experience of members/injured employees and interact with staff. I also have had exposure to medical chart review. This position specialized within patients with COPD and CHF and assisted in monitoring any other comorbidities the patients may suffer from.
Sep 2013 – Feb 2014
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Registered Nurse- Neonatal Intensive Care Unit (NICU)
Functioning as the central coordinator of care for members/injured employees identified as having chronic disease processes or for members/injured employees in select physician practices. My focus was disease management as well as implementing and coordinating all case management activities relating to catastrophic cases and chronically ill members/injured employees across the continuum of care including consultant referrals, home care visits, use of community resources, and alternative levels of care. I was responsible for developing and executing implementation plans with a physician practice to coordinate all case management activities. Use computer-based systems (i.e., IDX and Citrix) to review medical experience of members/injured employees and interact with staff. I also have had exposure to medical chart review. This position specialized within patients with COPD and CHF and assisted in monitoring any other comorbidities the patients may suffer from.
Jan 2010 – Sep 2013
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Medical Review Nurse
Weekly nursing visitation, patient liaison, medical set-up, and 6-month nursing care plan review and submission
Sep 2009 – Apr 2010
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Certified Pharmacy Technician
Customer Service intravenous/chemotherapy/standard medication preparation, medication stock replenishment, stock order entry, and a participant in a Lean Sigma Six Implementation for the department.
Jan 2005 – Aug 2009
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Senior Certified Pharmacy Technician
Customer Service, medication preparation, prescription order entry with emphasis on insurance troubleshooting, and medication stock replenishment.
Nov 2004 – Jan 2005
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Certified Pharmacy Technician
Customer Service, medication preparation, prescription order entry with emphasis on insurance troubleshooting, medication stock replenishment, and new Hire training/precepting.
Nov 2003
Volunteering
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Customer Service, Entry/processing of electronic registration of new families and updating the records of current members to our Kids Rock Ministry. This supports the safety of our visitors and members during drop off and pickup of their children that are a part of the Kids ministry department. I have also supported nursey/ kids rock classroom supervision as needed. I still support in the kids ministry.
Church on the Rock
Apr 2016 – Dec 2025
Languages
- English (US) Advanced
- Spanish Beginner
