Summary
Overview
Work History
Education
Skills
Timeline
Generic

Danelly Mena

Everett,MA

Summary

Highly-ethical, qualified Non-Profit Professional armed with extensive experience developing and executing strategic plans to lead organizations business development, financial growth, and long-term sustainability. Superb ability to succeed in challenging, high-pressure, deadline-driven environments.entrepreneurial Organization as part of a great team. Core Qualifications Results-oriented Client-focused Quick learner Computer proficient Contract negotiation/review/draft Ability to work independently, manage multiple projects Strong Organizational skills and relationship Builder Strong working knowledge of Microsoft Office products\Bilingual capabilities

Overview

38
38
years of professional experience

Work History

Senior Outreach & Marketing Specialist, Commonwealth Care Alliance

, MA
08.2015 - Current
  • To promote Commonwealth Care Alliance's (CCA) - SCO (Senior Care Options) and/or other health products to individuals, responsible parties and groups at a variety of settings.
  • Responsible for executing our marketing and enrollment strategies, cultivating relationships with contracted sites, community organizations, senior centers, and elderly & disabled housing etc.
  • Interact effectively with a multidisciplinary team.
  • Presenting, promoting and marketing our programs to all interested; including individuals, groups, community organizations, healthcare professionals etc.
  • Develops presentations to various target audiences.
  • Cultivated and maintain collaborative relationships with contracted providers and primary care site partners.
  • Perform all enrollment related activities; such as identifying potential prospects, screening leads to ensure eligibility requirements, setting appointments, explaining the program, completing enrollment applications, submitting enrollments to CCA.
  • Develop a resource map of assigned territory, such as community based organizations, elder service agencies, elderly and disabled housing, food pantries, churches etc.; cultivates relationships with them and identifies potential collaborations efforts.
  • Plan and implement territory monthly action plan and consistently meet and or exceed enrollment and outreach targets.
  • Attend and assist with the planning of educational, outreach and other health related events.
  • Coordinate and interact with various roles within CCA, its primary care partners to ensure customer requests, questions and issues are handled appropriately and in a timely manner.
  • Assure compliance and adherence with Medicare & Medicaid enrollment and marketing policies and procedures.
  • Offers recommendations and suggestions for improvements in office, enrollments, marketing practices etc.
  • To enhance service delivery and customer satisfaction.

Senior Outreach & Marketing Specialist, Neighborhood Health Plan

Boston, MA
03.2008 - 07.2015
  • I was responsible for conducting various types of outreach activities for the purpose of educating potential members about Neighborhood Health Plan and Commonwealth Care products.
  • Responsible for follow through that leads to enrollment of individuals into Commonwealth care and Mass Health products.
  • Develop and manage relationships within community organization and community health centers for the purpose of identifying and enrolling members.
  • Responsible for multiple outreach projects simultaneously and effectively communicated and responded to a variety of individual and community contacts.
  • Ability to track effectiveness of activities by collecting and reporting on established metrics.
  • Highly experience conducting outreach activities, and the ability to recommend new markets and outreach opportunity within the community that may increase effectiveness.
  • Create and foster relationships with health centers and other key community organizations that provide services for low income adults and children in order to build awareness and enrollment in Mass Health and Connector care products.
  • Articulate spokesperson for Neighborhood Health Plan and Connector care products within the community.
  • I collaborated with the Marketing department on developing outreach activities with Community Health Centers and Community Base agencies.
  • I have the ability to make presentations to small and large groups.
  • I demonstrated the ability to work independently, manage multiple projects and prioritize in a fast paced business environment.
  • Strong Organizational skills, proved relations building skills and ability to maintain and follow standard quality, safety, environmental, infection control policies and procedures.
  • I am very comfortable collecting and reporting on simple data driven metrics.

Premium Billing Research Specialist

Maximus Inc
Boston, MA
03.2003 - 03.2003
  • Handle research of complex cases identified by CSR and escalated either as a live call, or follow up through Mass Serve system.
  • Provided assistance with resolution of enrollment issues, perform customer outreach.
  • Handle all requests for enrollment verification.
  • Perform manual assignment of customers to the managed care plans and customer's opt-out request within the connectors' time line requirements.
  • Ensure that all Mass Health and Commonwealth care enrollment forms are processed to completion error-free.
  • I provided high level of service to both internal and external customers.
  • Maintain and follow standard quality, safety, environmental and infection control policies and procedures.

Boston, MA
01.1999 - 03.2003
  • Community Outreach Health Benefit Advocate, Maximus Inc.
  • Develop relationships with various community base organizations (CBO), and agencies within Massachusetts.
  • Conducted Mass Health presentations to appropriate community -base organizations, clients and other interested parties.
  • Assisted in the development of and participated in schedule health fairs in designated areas.
  • Coordinated activities in a number of settings across the region, including local offices, community group location and hospitals.
  • Provided pertinent reports , relevant information regrading issues related to customer and all community involvement to supervisor training development.
  • Maintain updated knowledge of Medicaid regulations, covered services, and procedures.
  • Maintain updated knowledge of the Mass Health Enrollment process and provides members withal current Manage Care Organization and primary care Clinician Plan options available to promote client choice within the assigned network of manage care providers.
  • Access, read and interpret member and provider data elements on the manage care system.
  • Conducted a thorough health care needs assessment with members , including existing and anticipated needs of all eligible family members as needed.
  • Investigates all potential third party resources and complies with systems and administrative requirements.
  • Accurately perform all data entry functions to reflect member activity/ transactions.
  • Facilitated the resolution of non-clinical issues related to member and provider compliance all interactions with the public, members and providers in a discreet, courteous and professional manner.
  • Perform other duties as may be assigned by my manager.

Waltham, MA
02.1994 - 01.1999
  • Sales and Marketing Investment Banking, BayBank Manage relationships with business banking clients by providing service and support.
  • Responsibilities include overseeing maintenance of client accounts and ensuring clients needs are met.
  • Grows loans, deposits, and fee-based services for the Business Banking unit.
  • Promoted portfolio growth by implementing marketing and business plans.
  • Reported to top management, typically manages through subordinate managers and professionals in larger groups of moderate complexity.
  • Provides input to strategic decisions that affect the functional area of responsibility.
  • Assisted with input into developing the budget.
  • Capable of resolving escalated issues arising from operations and requiring coordination with other departments.

International Sales Manager

Kissimmee, FL
02.1987 - 10.1994
  • Marriott Residence Inn on Lake Cecile Negotiated contracts with travel agencies, wholesale agencies, Air-Carriers and ground transportation companies.
  • Assisted in the developments of new contracts with the South America, Europe and domestic markets.
  • Successfully generated new businesses through a program including the Marriott Sales mission, Trades shows General sales agents meetings and presentations to travel departments of major cities, corporations and agencies.
  • Specialized in foreign travel as well as domestic.
  • Increased sales volume by more than 47% each year in a highly competitive market.
  • I became a resource person, trouble shooter and closer for the sales department.
  • Initiated a telemarketing program including staffing and training personnel.
  • Created and wrote individualized strategies.
  • Collaborated and assisted in the design of brochures and demonstration kits for advertising and direct mail.
  • Represented the company at conventions and meetings.

Education

MBA - undefined

Springfield College
Dec. 2017

Master of Science - Mental Health

Springfield College
Dec. 2015

Bachelor of Science - Health and Human Services

Springfield College
1997

Skills

  • Senior Care
  • Community Health
  • Training and development
  • Policy adherence
  • Research and reporting

  • Infection control
  • Patient needs assessment
  • Presentations
  • Primary care

Timeline

Senior Outreach & Marketing Specialist, Commonwealth Care Alliance

08.2015 - Current

Senior Outreach & Marketing Specialist, Neighborhood Health Plan

03.2008 - 07.2015

Premium Billing Research Specialist

Maximus Inc
03.2003 - 03.2003

01.1999 - 03.2003

02.1994 - 01.1999

International Sales Manager

02.1987 - 10.1994

MBA - undefined

Springfield College

Master of Science - Mental Health

Springfield College

Bachelor of Science - Health and Human Services

Springfield College

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Danelly Mena