Well-organized Administrative professional bringing excellent multi-tasking abilities developed over 17 years of Health Industry experience. Commended for consistently driving team success with knowledgeable enforcement of company procedures. Proficient in Microsoft Office with expertise in database management. I posses a depth knowledge in administration of Medicare Network System, efficiently resolving disputes and identifying ways to improve processes. Communicative and detail-oriented individual with excellent interpersonal abilities.
Managed provider relations mailbox by triaging inquiries, facilitating resolution of incoming requests and forwarding requests to appropriate parties.
Developed and utilized metrics reports to assist leadership with key decisions and out performance of operational targets.
Fostered strong, positive relationships with key providers by coordinating, facilitating and leading partnership meetings to improves the goals.
Assist physicians over various departments communicating new improvement plans and expectation to reach objectives and politics in compliance of medicare insurance
Tracked and analyzed metrics reports to determine needed improvements.
Generated reports of findings to help providers with making key decisions.
Monitor status of individuals with chronic health concerns (metrics for Stars report)
Vice President of Medicare Network, 01/2011 - 11/2019 The Kemtah Group – Griffin, GA,
Managed agendas and calendars, boosting productivity and improving organizational initiatives.
Interpreted management directives to define and document administrative staff processes.
Adapted to workflow changes and implemented continuous process improvements to overcome obstacles.
Assisted group president in decision-making procedures by creating daily reports to advise executives leaders on corrective actions and process improvements.
Assess administrative personnel and his performance to implement and team-building events to boost morale.
Helped employees with day-to-day work and complex problems by applying motivational and analytical strategies.
Prepared daily Hospital Admissions and Discharge reports to assist health providers of the group with key decision making and strategic operational planning.
Networked with industry professionals to foster partnerships and identify new and improved best practices of health services as specialty health networks.
Support to the personnel of medical offices structures and processes to promote teamwork and performance.
Developed teamwork communications and information for providers meetings.
Organize and managed physicians contracted directly related to strategic mission of healthcare system.
Medical group administration that provides medical services to patients subscribing to the health plan of the government of Puerto Rico.
Managed agendas and calendars, in different departments inside of clinics boosting productivity and improving organizational initiative.
Conducted health programs such as Vaccinations, Dental Care Facilities and Medicaid Services Clinic.
Organized and facilitated weekly department meetings (medical staff, nurses, vaccination nurses, administrative assistants, and secretaries) discussing issues about medicaid health plan patients.
Recruited, hired and trained all staff, providing direct supervision, ongoing staff development and continuing education to employees.
Authorize and supervised scheduled cataract surgeries, managed pre certifications, and insurance coverage.
Developed and updated policies and procedures, maintaining compliance with statutory, regulatory and local, state and federal guidelines relating to HIPAA, benefits administration and general liability.
Coordination of health clinics, to offer vaccination services to the population, such as Influenza, Pneumonia and vaccines for infants.
Routine inspections of the facilities, identifying areas that need improvement and eliminating risks to personnel. In compliance with state and federal regulations (OSHA)
Sales Coordinator, 02/2003 - 07/2006 MCS - Medical Card System Of Puerto Rico – City, STATE,
Established working relationships with clients by organizing various events.
Compiled potentiality clients profiles and entered information into operating system to the team sales.
Revised and Organized sales paperwork, presented proposals and finalized new medicare members contracts.
Worked alongside representatives to boost sales by enhancing product presentations and advertising.
Produced reports, letters, and proposals for sales plan development southern region.
Daily meeting with the entire sales team and managerial. Coordination and delivery of possible prospect clients (leads) for visit and orientation of the benefits of the medical plan.
Maintained and organize inventory of marketing products such as benefit brochures, folders, and other informational documents.
Education
Bachelor of Applied Science: Liberal Studies, Expected in 05/2004 - Pontifical Catholic University of Puerto Rico - Ponce, PR GPA:
Phi Delta Gamma Fraternity
Student Society for Public Administration PCUPR
MBA: Human Resources Management, Expected in 05/2006 - University of Phoenix Puerto Rico - Guaynabo, P.R. , GPA:
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