Cecilia Cruz
Henderson
Summary
Dynamic Program Administrator at Anthem BCBS with proven expertise in resource coordination and analytical skills. Successfully developed comprehensive databases to enhance tracking and care coordination, ensuring optimal member outcomes. Recognized for excellent interpersonal communication and meeting facilitation, effectively bridging gaps between departments to streamline operations and improve service delivery.
Results-driven professional with extensive experience in program administration. Adept at managing multiple projects simultaneously and known for improving operational workflows. Strong focus on team collaboration and achieving results, with excellent problem-solving skills and adaptability.
Overview
7
7
years of professional experience
Work History
Program Administrator
Anthem BCBS
02.2022 - Current
- Developed and maintained a comprehensive database of program participants, helping to track progress and ensure appropriate follow-up actions were taken as needed.
- Responsible for the transition for members from other health plan by initial health screening and care coordination to route member for appropriate level of care.
- Complete oversight of state reporting due on monthly and quarterly basis including preparing of data reports for departmental needs.
- Respond to state inquiries regarding member case management care and followup needs.
- Attend and participate in scheduled interdisciplinary meetings as well as Anthem community partners to discuss member needs and resources.
Medical Management Coordinator
Anthem BCBS
10.2017 - 02.2022
- Developed and maintained a comprehensive database of internal and external referral for equal allocation and tracking purposes.
- Gather clinical Information regarding member cases and determine if appropriate for case management from internal and external partners.
- Act as liaison between Medical Management and/or operations and internal departments.
- Prepare necessary reports and document actions.
- Prepare and direct weekly case rounds with interdisciplinary groups including Physical Health and Behavioral Health Medical Directors.
Education
Bachelor of Science - Business Management
Southern New Hampshire University
Hooksett, NH06-2025
Associate of Science - Business Managment
Community College of Southern Nevada
Henderson, NV01-2002
High School Diploma -
Independence High School
San Jose, CA07-1993
Skills
- Resource coordination
- Meeting facilitation
- Microsoft Word, Excel
- Excellent interpersonal communication skills
- Analytical Skills
Languages
English
Professional Working
Spanish
Native or Bilingual
Timeline
Program Administrator
Anthem BCBS
02.2022 - Current
Medical Management Coordinator
Anthem BCBS
10.2017 - 02.2022
Bachelor of Science - Business Management
Southern New Hampshire University
Associate of Science - Business Managment
Community College of Southern Nevada
High School Diploma -
Independence High School
Similar Profiles
Debra StewartDebra Stewart
Lead Customer Service Representative at Anthem BCBSLead Customer Service Representative at Anthem BCBS
Vivian GreenVivian Green
Member Services Advocate at ANTHEM BCBSMember Services Advocate at ANTHEM BCBS
Alisha NorwoodAlisha Norwood
Provider Recon Analyst at Anthem BCBSProvider Recon Analyst at Anthem BCBS