Elizabeth Kellam
Irvine,California
Summary
A highly motivated, detail-oriented team player with strong organizational skills. Ability to handle multiple projects simultaneously with a high degree of accuracy.
Overview
4
4
years of professional experience
1
1
Certification
Work History
Sr. Provider Relations Representative
Children’s Hospital of Orange County - CHOC Health Alliance
04.2022 - Current
- Maintain and enhance relationships with over 30 physicians and office staff within CHOC Health Alliance's (CHA) network
- Monitor performance of each physician and practice to collaborate with offices for quality improvement, HEDIS, and bonus program training
- Perform targeted outreach related to project deliverables and collaborate with internal departments to help resolve any provider network issues
- Collaborate with CHA analytics team to implement quality improvement projects
- Coordinate and participate in office staff and physician meetings regarding provider satisfaction, HEDIS, health network updates, and member satisfaction.
Medical Management Program Assistant
Children’s Hospital of Orange County - CHOC Health Alliance
09.2020 - 04.2022
- Execute excellent administrative support to CHA's Medical Management team on multiple projects.
- Remain up to date on CCS guidelines to ensure proper execution of Annual Redetermination and Quality Improvement responsibilities.
- Analyze monthly and weekly reports, and pull data accordingly using multiple databases for Care Coordination and Annual Redetermination
- Independently manage multiple Quality Improvement measures (HEDIS), while maintaining collaboration
- Increased CHA's compliance with the state for Annual Redetermination medical record submissions
Patient Care Coordinator
Children’s Hospital of Orange County - CHOC Health Alliance
08.2019 - 09.2020
- Assist members and families of CHOC Health Alliance to navigate the health network efficiently by operating as a team
- Stay knowledgeable on health plan regulatory requirements and provide excellent customer service to help ensure quality of care and family coordination
- Acquire other responsibilities to support CHA's Program Supervisor on multiple projects to hit deadlines.
Education
Masters of Health Administration -
University of Phoenix
Online10.2019
Bachelor of Science, Kinesiology -
California State University, Fullerton
Fullerton, CA05.2016
Skills
- Health Plan Operations
- Workflow Analysis
- Strategic Business Relationships
- Improvement Plan Knowledge
- Provider Relationship Management
- Provider Orientations
- On-Site Visits
- Educational Presentations
- Performance Monitoring
- Quality Improvement
Certification
- Performance Excellence Program Coach Certification- December 2022
Timeline
Sr. Provider Relations Representative
Children’s Hospital of Orange County - CHOC Health Alliance
04.2022 - Current
Medical Management Program Assistant
Children’s Hospital of Orange County - CHOC Health Alliance
09.2020 - 04.2022
Patient Care Coordinator
Children’s Hospital of Orange County - CHOC Health Alliance
08.2019 - 09.2020
Masters of Health Administration -
University of Phoenix
Bachelor of Science, Kinesiology -
California State University, Fullerton
- Performance Excellence Program Coach Certification- December 2022
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