Fatima Cortez
Simi Valley
Summary
Results-driven project manager with expertise in regulatory compliance, document management, and effective communication. Proven track record of leading implementation projects that enhance operational efficiency and ensure adherence to federal and state regulations.
Overview
21
21
years of professional experience
Work History
Project Manager II
Centene Management Company LLC
01.2023 - Current
- Manage correspondence initiatives for the Medicare Line of Business (LOB), overseeing document and letter template updates across multiple Medicare markets and plans.
- Lead end-to-end implementation of regulatory and business-driven changes to member and provider communication templates, ensuring accuracy, consistency, and timely delivery.
- Partner with business stakeholders, Compliance, Marketing, and Communications teams to review, revise, and secure approvals for member-facing and provider-facing correspondence.
- Ensure all communications comply with federal and state regulations, including CMS requirements and internal compliance standards.
- Coordinate with system configuration and technology teams to implement approved template changes into production systems and validate successful deployment.
- Serve as the primary liaison between internal departments and external vendors, ensuring all parties have the most current template requirements and business information.
- Established effective communication among team members for enhanced collaboration and successful project completion.
- Provided detailed project status updates to stakeholders and executive management.
- Track project timelines, risks, dependencies, and approvals to ensure regulatory and business deadlines are met.
- Support continuous process improvement efforts to streamline correspondence management and improve operational efficiency.
Compliance Coordinator
Health Net, LLC
07.2019 - 12.2022
- Reviewed company forms, marketing materials, and communication procedures to ensure compliance with applicable laws and regulatory guidelines.
- Assisted with inquiries, audits, reviews, and change requests related to letter templates.
- Created, updated, and maintained manual letter grids across all lines of business, including Commercial, Medicare, Cal MediConnect, Medi-Cal, CHW, and CalViva Health.
- Continuously developed new skills and applied them to daily tasks to enhance efficiency and productivity.
- Served as the primary point of contact for initiating and coordinating compliance-related projects.
- Consistently exceeded performance goals through effective prioritization and a strong work ethic.
- Conducted research, compiled information from multiple sources, and presented findings clearly and effectively.
- Regularly monitored regulatory websites for updates impacting letter templates and member/provider communications.
- Maintained up-to-date knowledge of regulatory standards and internal company procedures.
Referral Specialist
Health Net, LLC
11.2015 - 07.2019
- Generated and distributed Notices of Action to members and healthcare providers in accordance with established procedures.
- Prioritized and managed daily workload fluctuations by assessing task urgency and adhering to departmental standards and policies.
- Maintained strict confidentiality of sensitive information in full compliance with HIPAA regulations.
- Utilized Microsoft Office Suite (Word, Excel, Outlook) to support administrative and reporting functions.
- Consistently completed assigned tasks within established performance standards and deadlines.
- Provided technical support to staff and assisted with ongoing training and system usage guidance.
- Ensured compliance with organizational policies, procedures, and management directives.
Medical Assistant
Family Practice and Urgent Care
07.2005 - 04.2014
- Verified insurance eligibility, collected co-pays, and maintained accurate patient records in EHR systems
- Answered multi-line phone system and communicated patient needs to providers and clinical staff
- Assisted physicians with patient exams, procedures, and in-office treatments
- Recorded vital signs, medical histories, and chief complaints in electronic health records
- Performed clinical tasks including EKGs, injections, specimen collection, and basic lab testing (as applicable)
- Prepared and sterilized exam rooms and maintained medical supplies and inventory
- Provided patient education regarding medications, treatment plans, and follow-up care instructions
- Ensured compliance with HIPAA regulations and maintained strict patient confidentiality
- Coordinated referrals, prior authorizations, and follow-up appointments for continuity of care
Education
Certified Medical Assistant - Health Care
Harrison Career Institute
Oakhurst, NJSkills
- Project management
- Project planning
- Project planning and development
- Project scheduling
- Team collaboration
- Project tracking
- Relationship building
- Document management
- Analytical thinking
- Documentation review
- Staff training
Timeline
Project Manager II
Centene Management Company LLC
01.2023 - Current
Compliance Coordinator
Health Net, LLC
07.2019 - 12.2022
Referral Specialist
Health Net, LLC
11.2015 - 07.2019
Medical Assistant
Family Practice and Urgent Care
07.2005 - 04.2014
Certified Medical Assistant - Health Care
Harrison Career Institute