Nicole Sanchez
Hidalgo,Texas
Summary
Detail-Oriented Healthcare Care Coordinator experienced in remote administrative care management for Texas Medicaid Star/CHIP program. Achieved high-compliance outcomes through effective navigation of complex case management platforms and leadership in state initiatives, including the Migrant Farm Worker project and AAPCA project. Focused on enhancing operational efficiency and compliance through precise data management and cross-functional collaboration.
Overview
14
14
years of professional experience
Work History
Care Coordinator ll
Superior Healthplan | Remote
Austin, Texas
04.2023 - Current
- Managed patient assessments to identify needs and implement tailored interventions.
- Responded promptly to inquiries from patients regarding their care plans.
- Navigated migration from TruCare classic to TruCare Cloud, establishing active member data tracking, care planning, and daily task routing.
- Data Integrity & Compliance: maintained 100% data accuracy when processing member health records, ensuring all documentation strictly aligned with Texas Medicaid service level agreements (SLAs) and state audit requirements.
- Oversaw operations of Casenet TrueCare Cloud and TruCare Classic to ensure seamless integration and functionality of healthcare systems.
- Programs & Compliance: Texas Medicaid (Star/Chip), HHSC Regulations, HIPAA socioeconomic Determinants of Health (SDOH)
- Employed remote tools like Microsoft Teams, SharePoint, and Advanced Excel to enhance collaboration and data tracking.: Microsoft Teams, SharePoint, Advanced Excel (Data Tracking & Metrics)
- Operational Skills: Administrative Care Coordination, Task Routing, Prior Authorization Tracking, High-Volume Data Entry.
- Responded promptly to inquiries from patients regarding their care plans.
Mobile Expert
T-Mobile
, Tx
07.2019 - 03.2023
- Generated new business leads through proactive outreach.
- Close Contracts on business leads.
- Met personal sales targets consistently each month.
- Assisted new customers in understanding service offerings to enhance their experience.
- Strived in a fast-paced sales environment.
- Use computers for various applications, such as database management or word processing.
Principal Secretary/High School Soccer Coach
, Tx
01.2013 - 01.2016
- Coordinated administrative tasks for senior management and board meetings.
- Oversaw staff correspondence, record tracking and data communications, resulting in improved automation of office operations.
- Developed and maintained filing systems for important documents and records.
- Streamlined file organization to enhance retrieval efficiency., developed spreadsheets, faxed reports and scanned documents, maintaining front desk and reception area in neat and organized fashion.
- Supported project management by tracking deadlines and deliverables across teams.
- Collaborated with various departments to streamline workflow processes effectively.
- Organized events and meetings, ensuring all logistics were handled efficiently.
- Set up workshops, conferences and meetings by scheduling and reserving rooms and preparing supplies.
- Performed regular maintenance on office equipment to ensure functionality. Supplies well-stocked to promote efficient operations.
Education
Diploma -
Nikki Rowe High School
McAllen, Texas06-2006
Skills
- Patient care coordination
- Regulatory compliance
- Patient advocacy
- Cross-functional collaboration
- Organizational skills
- Able to meet deadlines
- Multitasking
- Adapts under pressure
- Patient communication
- Strong interpersonal skills
Timeline
Care Coordinator ll
Superior Healthplan | Remote
04.2023 - Current
Mobile Expert
T-Mobile
07.2019 - 03.2023
Principal Secretary/High School Soccer Coach
01.2013 - 01.2016
Diploma -
Nikki Rowe High School