Angelica Santillan
Whittier,CA
Summary
Aspiring professional with a passion for healthcare administration. Possess a comprehensive understanding of healthcare systems and management principles. Demonstrated success in health plan operations and process improvement. Skilled in development, instruction, and fostering an engaging learning environment. Seeking an entry-level adjunct professor position to apply expertise and contribute to the development of future healthcare administrators.
Overview
11
11
years of professional experience
Work History
Sr Manager, Business Consultant
Aetna Health Plan
06.2020 - Current
- Increased member satisfaction by implementing tailored solutions for business needs.
- Collaborate with key stakeholders for growth opportunities and successful partnerships.
- Streamline retention initiatives, including network, product, distribution channel, clinical, Stars, member experience, and operations to influence a culture of retention to enhance business performance
- Lead cross-functional teams to achieve project milestones and deliver high-quality results.
- Manage cross functional execution of retention operations and campaigns.
- Manage multiple projects simultaneously, maintaining strict deadlines and high-quality deliverables.
- Deliver dynamic presentations to facilitate learning and retention among diverse audiences.
- Educate internal colleagues on proper use of products and systems.
- Schedule and teach in class and online product trainings to increase learning opportunities.
- Develop customized training materials for various plan products, ensuring relevance to the target audience.
- Mentor junior staff members for skill development and career progression within the organization.
Manager, Training Program Strategy
Aetna Health Plan
06.2020 - 12.2022
- Developed and coached a team to ensure training strategies are aligned to business objectives and meet Enterprise Training standards
- Manages stakeholder relationships with business partners, subject matter experts, HR partners, and Enterprise Training colleagues to ensure continual alignment of prioritizes and business needs.
- Conducts performance and business analysis with stakeholders to determine the performance gaps, expectations and solutions.
- Develops performance-based training strategies using the latest industry-standard learning methodologies.
- Operationalized training programs based on business environment to ensure high levels of execution and adoption.
- Creates measurement plans and monitors results to ensure workforces are actively achieving identified program and performance outcomes.
- Collaborates with Enterprise Training partners to execute digital learning, multimedia design elements and program performance reporting (i.e., dashboard development).
- Utilized production tools (i.e. Quickbase) to track and document projects and programming.
- Evaluated and provided updates to senior leaders on programming impact on talent and business performance; adjusting strategies and solutions as needed.
- Takes strategic direction while working independently to simultaneously manage multiple, complex and/or high-profile projects
Provider Network Representative
PIH Health Physicians
07.2016 - 06.2020
- Conducted thorough audits of existing network configurations, identifying areas for improvement and recommending appropriate actions.
- Provided training and development to physicians and office staff, including orientation and education of providers on compensation packages, bonuses, and other resources or services offered
- Maintained all levels of communication with network providers, updating on new policies and procedures, network changes, and upcoming events
- Promoted membership growth and recruited physicians through strategic marketing initiatives, achieving a 15% increase in membership within two years.
- Developed highly empathetic client relationships and earned reputation for exceeding service standard goals.
- Trained new personnel regarding company operations, policies and services.
Network Development Representative
St. Vincent IPA
11.2015 - 07.2016
- Identified prospective provider partners, promoting organization compensation packages and services to recruit additional PCPs and specialists into the network
- Partnered with brokers and area health plans to coordinate targeted internal and external marketing events, enabling the achievement of network growth and development initiatives
- Consulted with physician offices, delivering provider support by developing a tool that enabled physicians to track progress within the medical group.
Special Investigation Unit (SIU) Investigator
Care1st Health Plan
09.2014 - 10.2015
- Conducted investigations into allegations of non-compliance by gathering information and evidence, conducting timely and thorough interviews with individuals at all levels, and documenting information relative to each incident; processed 100 cases in a single year
- Investigated and resolved allegations of non-compliance and discovered, investigated, and prevented fraud, waste, and abuse
- Prepared written incident reports to include incident details, status, resolution, root cause, and other pertinent information, and prepared SIU activity monitoring reports for management.
Physician Advocate
United Healthcare
03.2013 - 10.2013
- Collaborated in end-to-end provider relations, building strong relationships between providers, practice managers, and the health plan
- Provided support for programs designed to enhance provider relations, including provider network development and training for providers in available services and technology.
- Implemented evidence-based practices into daily work routine, enhancing overall effectiveness of clinical decision-making and patient outcomes.
Education
Master of Health Administration - Public Health
University of La Verne
La Verne, CABachelor of Arts - Sociology
California State Polytechnic
Pomona, CAAssociates of Arts - Administration of Justice
East Los Angeles College
Monterey Park, CACertified Medical Assistant -
North-West College
West Covina, CASkills
- Health Plan Administration
- Managing Practice Operations
- Process Improvement
- Insurance Practices
- Healthcare regulations
- Excellent verbal and communication skills
- Teaching and Mentoring
- Learner Engagement & Success
- Instructional Methods
- Group Instruction
- Learning Strategies
- Program Design
Timeline
Sr Manager, Business Consultant
Aetna Health Plan
06.2020 - Current
Manager, Training Program Strategy
Aetna Health Plan
06.2020 - 12.2022
Provider Network Representative
PIH Health Physicians
07.2016 - 06.2020
Network Development Representative
St. Vincent IPA
11.2015 - 07.2016
Special Investigation Unit (SIU) Investigator
Care1st Health Plan
09.2014 - 10.2015
Physician Advocate
United Healthcare
03.2013 - 10.2013
Master of Health Administration - Public Health
University of La Verne
Bachelor of Arts - Sociology
California State Polytechnic
Associates of Arts - Administration of Justice
East Los Angeles College
Certified Medical Assistant -
North-West College
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