Job Search Status
Open to workDesired start date: Open to discussion
Open To Work
Angelica Carbajal
Care Coordinator
Rio Rancho,NM
Work Preference
Summary
Knowledgeable Care Coordinator with thorough understanding of patient care coordination and support. Successfully facilitated comprehensive care plans, ensuring seamless communication between healthcare providers and patients. Demonstrated ability to manage complex caseloads and use problem-solving skills to improve patient outcomes.
Overview
20
20
years of professional experience
Work History
Care Coordinator
Health Care Service Corporation
Albuquerque, NM
12.2024 - Current
- Successfully coordinated care for patients with complex, chronic conditions, leading to better compliance with treatment plans.
- Achieved meeting 100% accuracy and efficiency with meeting deadlines.
- Managed a caseload of 50+ patients, ensuring optimal care services and reducing hospital readmission rates by 30%
- Collaborated with interdisciplinary teams to develop and maintain personalized care plans for over 40 patients, improving adherence
Program Coordinator
Western Sky Community Care / Centene
Albuquerque, NM
10.2018 - 07.2024
- Performed routine, health related assessments on adults and children
- Managed high-volume inbound/outbound traffic of 50+ calls daily
- Managed project timelines, ensuring alignment with organizational goals and compliance standards.
- Developed training materials to improve staff onboarding and operational efficiency.
- Mentored junior staff members, fostering professional development and knowledge sharing within the team.
- Earned 100% marks in all audits including average call handle time and call abandonment rates.
Medical Support Assistance / Pharmacy Help Desk
Prime Therapeutics
Albuquerque, NM
07.2017 - 09.2018
- Provide specific pharmacy benefit information for commercial and Medicare members.
- Managed high-volume inbound/outbound traffic of 50+ calls daily
- Research and troubleshoot claims that require prior authorization/denials. Assist pharmacy with overrides.
- Maintain a high-volume workload within a challenging environment.
- Earned 100% marks in all audits including average call handle time and call abandonment rates.
- Mentored new employees to learn systems and processes.
CMP Admin
Molina Healthcare
Albuquerque, NM
08.2014 - 05.2017
- Conducted health risk assessments and educated on HEDIS measures.
- Prepared file reviews for Care Coordination and Utilization Management for HSD and National Committee for Quality Assurance (NCQA) audits with passing 100% scores.
- Held committee positions on projects such as the Volunteer Committee and Propeller Project for Asthma.
- Ensure the integrity of peer support specialists by auditing for necessary documentation and timeliness.
- Assisted with day-to-day operations, working efficiently and productively with all team members.
Customer Service Representative
Presbyterian Healthcare Plan Contact Center
Albuquerque, NM
05.2013 - 08.2014
- Performed and met quality standards and performance measures.
- Managed over 50 customer calls per day regarding the following: eligibility and demographic changes, provider information, insurance benefits, with minimal wait times.
- Mentored new staff on best practices for handling customer interactions and queries.
- Resolved customer complaints with empathy, resulting in increased loyalty and repeat business.
Education
Medical Billing and Coding Certification - Health Information Management
University of Phoenix
Phoenix, AZ01-2024
GED -
Central New Mexico Community College
Albuquerque, NM01-2010
Skills
- Medicaid
- Medicare
- Commercial
- Knowledge of Insurance Policies
- Case management
- Patient education
- Patient advocacy
- Care planning
- Community outreach
- Needs assessment
Timeline
Care Coordinator
Health Care Service Corporation
12.2024 - Current
Program Coordinator
Western Sky Community Care / Centene
10.2018 - 07.2024
Medical Support Assistance / Pharmacy Help Desk
Prime Therapeutics
07.2017 - 09.2018
CMP Admin
Molina Healthcare
08.2014 - 05.2017
Customer Service Representative
Presbyterian Healthcare Plan Contact Center
05.2013 - 08.2014
Medical Billing and Coding Certification - Health Information Management
University of Phoenix
GED -
Central New Mexico Community College