Geraldine Barrios Moreno

Supports administrative care management activities including performing outreach, answering inbound calls, and scheduling services. Serves as a point of contact to members, providers, and staff to resolve issues and documents member records in accordance with current state and regulatory guidelines.

• Provides outreach to members via phone to support with care plan next steps, community or health plan resources, questions or concerns related to scheduling and ongoing education for both the member and provider throughout care/service
• Provides support to members to connect them to other health plan and community resources to ensure they are receiving high-quality customer care/service
• May apply working knowledge of assigned health plan(s) activities and resources
• Serves as the front-line support on various member and/or provider inquiries, requests, or concerns which may include explaining care plan procedures, and protocols
• Supports member onboarding and day-to-day administrative duties including sending out welcome letters, related correspondence, and program educational materials to assist in the facilitation of a successful member/provider relationship
• Documents and maintains non-clinical member records to ensure standards of practice and policies are in accordance with state and regulatory requirements and provide to providers as needed
• Knowledge of existing benefits and resources locally and make referrals to address Social Determinants of Health (SDOH) needs
• Performs other duties as assigned
• Complies with all policies and standards

• Develop job descriptions and post on major job boards, ensuring broad candidate reach.
• Recruited and assessed qualified candidates for apartment industry roles, enhancing client satisfaction.
• Managed project to increase sales by 19.8%, boosting revenue.
• Streamlined recruitment by adhering to U.S. government procedures, including I-9 and E-Verify.
• Partnered with local businesses to source and place top talent in the apartment industry.

• Guided patients through State and Federal program applications, ensuring eligibility and documentation.
• Maintained accurate records in the CUBS system, consistently meeting productivity goals.
• Advised on assistance programs, building positive patient relationships.
• Secured benefits through diligent follow-ups, achieving significant application success.
• Screened patient needs, initiating appropriate application processes.

• Handled customer calls on benefit eligibility and prescription status, ensuring accurate resolutions.
• Educated customers on prescription benefits and plan usage, enhancing their understanding and satisfaction.
• Documented customer interactions in computer systems, ensuring precise and thorough record-keeping.
• Resolved issues by communicating solutions to customers, pharmacies, and physicians, improving service efficiency.
• Maintained detailed records of customer interactions, ensuring accuracy in data collection and follow-up.

• Managed sales and operations, ensuring smooth business functions and client satisfaction.
• Enhanced onboarding training, boosting client engagement by 55%.
• Oversaw supply orders and deliveries, maintaining essential stock levels.
• Represented the company at events, traveling with the CEO.
• Exceeded client expectations, leading to the renewal of 15 annual contracts.
• Monitored and optimized operational processes, ensuring compliance and quality standards.
• Led a team of 30, fostering a collaborative and dynamic work environment that drove performance.