BLANCA AGABO
Rialto
Summary
Dedicated and results-driven healthcare operations professional with over 15 years of progressive experience in health plan operations, care coordination, and team development. Proven track record of enhancing operational efficiency and improving member satisfaction through strategic initiatives and effective leadership. Committed to leveraging expertise to drive positive outcomes in a dynamic healthcare environment. Eager to contribute to an organization that values innovation and excellence in service delivery.
Overview
18
18
years of professional experience
Work History
Care Navigator 4 You Manager
Homebase Medical
02.2024 - 06.2025
- Lead and manage the Care Navigator 4 You (CN4U) team, overseeing daily case work, access escalations, and member support.
- Supervise case escalations, monitor quality of service, and ensure prompt resolution while meeting regulatory and clinical standards.
- Maintain a small caseload, supporting members with Health Risk Assessments (HRAs) and guiding them through gap closure.
- Conduct regular case audits, deliver coaching sessions, and support continuous staff development and training.
- Review and approve timesheets, ensure accurate documentation, and promote operational efficiency across the team.
- Coordinate and lead team capacity reviews and performance report-outs, aligning efforts with department goals.
MS Quality Assurance Specialist
SCAN Health Plan
10.2021 - 02.2024
- Conduct call monitoring and auditing to ensure compliance with regulatory and departmental standards.
- Identify coaching opportunities and collaborate with leadership on performance improvements.
- Deliver training and calibration sessions, and report on audit findings through detailed narrative summaries.
HR Trainer
SCAN Health Plan
06.2020 - 10.2021
- Led training for new hires in Member Services, including pharmacy modules and system navigation.
- Developed a seven-week onboarding curriculum and played a key role in transitioning to the SHELF knowledge platform.
Concierge
SCAN Health Plan
12.2018 - 06.2020
- Provided strategic support to a team of customer service representatives by overseeing real-time floor operations, conducting quality assurance through call reviews, managing customer escalations to resolution, and generating performance reports to inform leadership decisions and improve team efficiency.
MS Pharmacy Specialist
SCAN Health Plan
01.2015 - 12.2018
- Resolved complex pharmacy benefit and prior authorization issues by responding to high-volume inquiries and coordinating with internal departments, ensuring timely and accurate support for members and providers.
Member Services Advocate Senior/Representative
SCAN Health Plan
12.2014 - 01.2015
- Handled complex member service issues and supported the organization's 5-star initiatives by ensuring high-quality service delivery.
Correspondence Representative
American Medical Response
01.2011 - 12.2014
- Managed insurance verification and patient account resolution; served as liaison with collection agencies for payment coordination.
Collections/Medical Biller
DRSL
01.2007 - 12.2011
- Billed and followed up on medical claims, handled personal injury and workers' comp cases, and ensured HIPAA/FDCPA compliance.
Education
Rio Hondo Community College
12.2002
High School Diploma - undefined
John Glenn High School
12.1999
Skills
- Data analysis & reporting
- Project coordination
- Time management & prioritization
- Training design & facilitation
- Member services & advocacy
- Quality assurance & audit compliance
- Case management & escalation resolution
LANGUAGES
Spanish
Advanced
Timeline
Care Navigator 4 You Manager
Homebase Medical
02.2024 - 06.2025
MS Quality Assurance Specialist
SCAN Health Plan
10.2021 - 02.2024
HR Trainer
SCAN Health Plan
06.2020 - 10.2021
Concierge
SCAN Health Plan
12.2018 - 06.2020
MS Pharmacy Specialist
SCAN Health Plan
01.2015 - 12.2018
Member Services Advocate Senior/Representative
SCAN Health Plan
12.2014 - 01.2015
Correspondence Representative
American Medical Response
01.2011 - 12.2014
Collections/Medical Biller
DRSL
01.2007 - 12.2011
High School Diploma - undefined
John Glenn High School
Rio Hondo Community College
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