Andrea Chagolla
Riverside,CA
Summary
Experienced with managing patient care authorizations and approvals, ensuring compliance and efficiency in healthcare settings. Utilizes strong analytical skills and multidisciplinary collaboration to optimize resource utilization and improve patient outcomes. Knowledge of healthcare regulations and decision-making processes, ensuring effective and informed management of patient care resources.
Overview
9
9
years of professional experience
1
1
Certification
Work History
Utilization Management Specialist
Canyon Ridge Hospital
12.2023 - Current
- Managed a diverse caseload of patients, coordinating care across multiple service lines for optimal outcomes.
- Contributed to the development of evidence-based clinical protocols, promoting consistent decision-making across the organization.
- Established strong relationships with external stakeholders, fostering collaboration around shared goals of quality improvement and cost containment.
- Reviewed medical records meticulously to verify appropriate level-of-care determinations, reducing potential overpayments or denials.
Inpatient Therapist
Canyon Ridge Hospital
07.2023 - 12.2023
- Streamlined communication between inpatient therapists and referring professionals, enhancing coordination of care efforts.
- Adapted therapeutic interventions to suit the unique needs and preferences of each patient, demonstrating flexibility and creativity.
- Served as a liaison between patients, families, and clinical staff to ensure open communication lines for better collaboration in treatment planning.
- Upheld industry best practices by staying informed on the latest research findings and integrating new techniques into therapy sessions as appropriate.
Behavior Technician
Maxim Healthcare Services
03.2023 - 10.2023
- Implementing and monitoring treatment plans that teach clients coping skills.
- Recording data and progress of each client.
- Assessing client needs and reinforcing desirable behaviors, and ignoring negative ones.
- Building relationships with clients, families, and management to establish an effective environment that will help client progress.
- Motivating clients and families to reach milestones.
Social Worker
Tender Love and Care
01.2023 - 05.2023
- Interviewed clients, families or groups to assess situations, limitations and issues and implement services to address needs.
- Maintained regular contact with clients by calling and visiting clients’ homes.
- Maintained record of daily individual activities, behaviors and pertinent incidents for patient analysis and assessment.
- Assessed clients for abuse and neglect to compile documentation for court reports.
- Completed detailed charts to summarize interactions with patients and booked follow-up sessions.
Support Services
Thompson and Colegate
03.2022 - 01.2023
- Greeted guests at front desk and engaged in pleasant conversations while managing check-in process.
- Answered multi-line phone system to respond to inquiries and transfer calls to correct personnel.
- Maintained files and records.
- Monitored office supplies by checking inventory and placing orders.
- Retrieved mail, packages and documents on behalf of other employees, promptly verifying receipt.
Assistant Office Administrator
Royal Plaza Textiles
12.2020 - 03.2022
- Executed record filing system to improve document organization and management.
- Managed over 50 customer calls and over 100 emails per day.
- Restocked inventory and placed purchase orders to maintain adequate stock levels.
- Developed and updated spreadsheets and databases to track, analyze and report on performance and sales data.
- Processed invoices and expenses using QuickBooks to facilitate on-time payment.
Guest Services Coordinator
Mission Inn Hotel
07.2015 - 07.2020
- Maintained high employee satisfaction and performance with hands-on and collaborative style.
- Developed and implemented strategies to improve guest experiences and build loyalty.
- Handled guest complaints and offered complimentary services to maintain high guest satisfaction rates.
- Trained new employees, demonstrating best methods for serving clients and guests.
- Greeted over 200 guest per day and assisted guests by gathering information pertaining to reservations or requests.
Education
Master Of Science - Forensic Psychology
Arizona State University
Tempe, AZ05.2023
Bachelor Of Arts - Criminology And Justice Studies
California State University, San Marcos
San Marcos, CA05.2020
Associate Of Arts - Social And Behavioral Studies
Riverside City College
Riverside, CA06.2018
Skills
- Microsoft Office
- Outlook
- Word
- Excel
- QuickBooks
- Data collection
- Confidential information
- Analytical thinking
- Mandatory reporting procedures
Certification
- Behavior Technician
- CPR, First Aid, & AED
Internship
Internship, HOPE Collaborative, A child abuse prevention center.
Timeline
Utilization Management Specialist
Canyon Ridge Hospital
12.2023 - Current
Inpatient Therapist
Canyon Ridge Hospital
07.2023 - 12.2023
Behavior Technician
Maxim Healthcare Services
03.2023 - 10.2023
Social Worker
Tender Love and Care
01.2023 - 05.2023
Support Services
Thompson and Colegate
03.2022 - 01.2023
Assistant Office Administrator
Royal Plaza Textiles
12.2020 - 03.2022
Guest Services Coordinator
Mission Inn Hotel
07.2015 - 07.2020
Master Of Science - Forensic Psychology
Arizona State University
Bachelor Of Arts - Criminology And Justice Studies
California State University, San Marcos
Associate Of Arts - Social And Behavioral Studies
Riverside City College
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