GRACE GARCIA
Human Resource Business Partner
Santa Clarita,CA
Summary
Human Resource professional with a background in Psychology and Organizational Leadership. Proven track record of collaborating with leadership to implement HR strategies that enhance team dynamics and employee satisfaction. Experienced in analyzing HR metrics to inform decision-making and drive initiatives that positively impact organizational culture.
Overview
10
10
years of professional experience
1
1
Certification
Work History
Human Resource Business Partner
Northrop Grumman
04.2024 - Current
- Collaborated with leadership to align HR strategies with business objectives.
- Advised managers on employee relations, performance management, and conflict resolution, enhancing team dynamics and communication.
- Guided organizational policies and procedures to ensure compliance with applicable laws and regulations.
- Participated in investigations into complaints of workplace harassment or discrimination.
- Coached managers on best practices for effective team management, fostering a supportive leadership culture.
- Partnered with teams to create a positive workplace culture and engagement initiatives.
- Analyzed HR metrics to identify trends and inform strategic decision-making.
- Implemented employee recognition programs that celebrate achievements, boosting morale and engagement across departments.
- Advised supervisors on appropriate disciplinary actions according to company policy.
- Conducted employee relations investigations into safety complaints, allegations of harassment and civil rights issues.
Grievance and Appeals Coordinator
Meritage Medical Network
09.2021 - 04.2024
- Resolved appeals through negotiations with insurance companies, attorneys, and other parties.
- Investigated appeals to validate claims, ensuring thorough examination of all relevant details.
- Reviewed documentation for compliance with regulatory standards, enhancing accuracy of appeal processes.
- Communicated with healthcare providers about the outcomes and procedures related to appeals.
- Collaborated with cross-functional teams to resolve complex cases.
- Acted as an intermediary between insurance companies and customers, researching and assessing information to validate claims.
- Trained new staff on appeal protocols and best practices.
- Analyzed data related to denials, recoupments, and adjustments to identify patterns and discrepancies.
Grievance and Appeals Coordinator
Health Net
02.2020 - 09.2021
- Fully investigate each case by finding the root cause of the problem and apply its appropriate solution.
- Utilized strong judgment skills to identify if grievance has clinical components and should be elevated.
- Coordinated with stakeholders to secure timely responses and resolutions, ensuring compliance with regulations.
- Analyzed and reported member and provider complaints, grievances, and appeals to identify trends and inform process improvements.
- Enhanced member trust in the organization by ensuring transparency, fairness, and accuracy throughout every stage of the appeals and grievances management process.
- Monitored deadlines and maintained accurate records to ensure timely submission of regulatory reports.
Behavioral Interventionist
Autism Response Team/California Psych Care
06.2016 - 01.2020
- Completed Applied Behavior Analysis training in-services and delivered one-to-one applied Behavior Analysis interventions to students in home settings.
- Modified intervention strategies to align with unique learning styles and needs of students, enhancing their potential for success.
- Trained staff on best practices for addressing problem behaviors, enhancing overall effectiveness in promoting positive change.
- Designed engaging lessons that incorporated social-emotional learning components, increasing self-awareness and interpersonal competence among students.
- Recorded student progress and shared insights with stakeholders, supporting informed decision-making.
Education
Bachelor of Arts - Psychology, Organizational Leadership
BRANDMAN UNIVERSITY
Irvine, CA01-2023
Associates Degree - Psychology
COLLEGE OF THE CANYONS
Santa Clarita, CA01-2019
Skills
- Customer support
- Employee engagement
- Performance evaluation
- Regulatory Knowledge
- Data analysis
- Strategic planning
- Team leadership
- Collaboration skills
- Cross-functional collaboration
- Conflict management
- Microsoft Office proficiency
- Attention to detail
- Multitasking
- Employee relations
- Problem solving
- Talent management
- Legal compliance
- Policy implementation
Certification
- CPR Certification
- Crisis Prevention Intervention (CPI) Certification
References
Available upon request
Languages
Spanish
Full Professional
Timeline
Human Resource Business Partner
Northrop Grumman
04.2024 - Current
Grievance and Appeals Coordinator
Meritage Medical Network
09.2021 - 04.2024
Grievance and Appeals Coordinator
Health Net
02.2020 - 09.2021
Behavioral Interventionist
Autism Response Team/California Psych Care
06.2016 - 01.2020
Bachelor of Arts - Psychology, Organizational Leadership
BRANDMAN UNIVERSITY
Associates Degree - Psychology
COLLEGE OF THE CANYONS