Elena Baca-Gaytan
Chandler,AZ
Summary
Dynamic Provider Relations Representative with a proven track record at Gold Kidney Health Plan, excelling in data integrity and cross-functional communication. Expert in credentialing systems and compliance standards, I drive operational improvements and enhance provider onboarding processes, ensuring seamless workflows and robust network expansion.
Overview
10
10
years of professional experience
Work History
Provider Relations Representative - Remote
Gold Kidney Health Plan
Scottsdale, AZ
03.2023 - 03.2025
- Collaborated with cross-functional departments to align provider onboarding and compliance efforts with organizational production timelines.
- Validated and updated provider data to ensure accuracy and readiness for audits and claims processing.
- Tracked issues in provider systems and ensured resolution to maintain workflow integrity.
- Provided leadership in planning and conducting recurring MSO meetings, ensuring consistent communication and follow-up.
- Maintained documentation and processed data changes to support provider network updates.
- Monitored and tracked inventory for provider distribution merchandise
Provider Relations Analyst - Remote
Bright HealthCare, Inc.
Tempe, Arizona
01.2022 - 01.2023
- Analyzed data discrepancies and resolved issues related to credentialing, contracts, and provider records.
- Ensured proper documentation for provider changes and communicated updates to internal teams.
- Participated in auditing cycles and maintained system data integrity across provider platforms.
- Worked closely with national provider networks to address escalated concerns efficiently.
- Updated internal systems with real-time data to support workflow continuity and decision-making
Provider Networks Operations Coordinator - Hybrid
Equality Health, Inc.
Phoenix, AZ
01.2021 - 12.2021
- Maintained and monitored multiple internal workflows, inboxes, and data records for provider management.
- Supported process improvements related to provider documentation and operational readiness.
- Executed real-time updates to keep systems current and aligned with operational changes.
- Delivered training and support for onboarding and compliance requirements.
- Coordinated data transfers and updates to maintain provider work queues.
Provider Recruiting Specialist - Remote
Tivity Health, Inc.
Scottsdale, AZ
03.2017 - 11.2020
- Managed provider onboarding process, including contract setup, credentialing, and document validation.
- Conducted weekly data audits and reconciled discrepancies to ensure operational consistency.
- Supported ongoing improvement initiatives and trained new staff on updated protocols.
Contract Coordinator & Compliance - Remote
Tivity Health, Inc.
Scottsdale, AZ
01.2015 - 02.2017
- Released and monitored work items related to provider access, credentials, and payment processing.
- Coordinated contract setup and system entries to support network expansion and vendor readiness.
- Performed quarterly audits and addressed issues in provider documentation and system workflows.
- Collaborated in Kaizen events focused on enhancing data accuracy and workflow efficiency.
Education
Associate Degree - Culinary Arts
Le Cordon Bleu
Scottsdale, AZ01.2010
Associate Degree -
Chandler Gilber Community College
Chandler, AZ01.2009
Skills
- Production Scheduling
- Work Order Management
- MRP Analysis
- Requirements Planning
- Order Implementation
- Inventory Management
- Work In Progress Monitoring
- System Data Integrity
- Vendor Coordination
- Consignment Build Coordination
- Microsoft Excel Reporting
- Documentation
- Cross-Functional Communication
- Compliance Standards
- Regulatory Standards
- HIPAA
- CMS
- Microsoft Excel
- Microsoft Word
- Microsoft Outlook
- Oracle
- Agile
- Credentialing Systems
- Contract Management Systems
Other Qualifications
- U.S. Citizen
- Experience supporting R&D-style operational environments
Affiliations
- Serve as Catechist, leading faith formation classes and supporting spiritual development for youth at St. Mary's Catholic Church.
- Assist as a Funeral Coordinator, providing compassionate support to families and helping organize and manage funeral services.
Languages
Spanish
Native/ Bilingual
Timeline
Provider Relations Representative - Remote
Gold Kidney Health Plan
03.2023 - 03.2025
Provider Relations Analyst - Remote
Bright HealthCare, Inc.
01.2022 - 01.2023
Provider Networks Operations Coordinator - Hybrid
Equality Health, Inc.
01.2021 - 12.2021
Provider Recruiting Specialist - Remote
Tivity Health, Inc.
03.2017 - 11.2020
Contract Coordinator & Compliance - Remote
Tivity Health, Inc.
01.2015 - 02.2017
Associate Degree - Culinary Arts
Le Cordon Bleu
Associate Degree -
Chandler Gilber Community College
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