Imelda Hoskin

• Manage and support scheduling activities for 20+ mid-level practitioners based on availability and patient needs across operations, case management, clinical and high-risk departments.
• Direct 10 medical assistants to prepare charts, training them on patient care, electronic medical record use, medical procedures, and operational workflows.
• Oversee and support virtual visits performed via telehealth platforms such as Zoom, Doximity, and facetime.
• Oversee field and clinic operations (home, drop-in scheduling, and virtual visits) for Medicare patients enrolled in company's insurance healthcare plan across the regions of Los Angeles, Orange County, San Bernardino, and San Diego.
• Coordinate cross-functional launch of scheduling platforms, patient outreach programs, and virtual patient visits.
• Manage patient flow and assist team members as needed.
• Blocking and opening schedules for the providers template as needed.
• Conduct daily audits of orders, review completed charts for patient appointments and reconcile appointment statuses.
• Manage and conducts member outreach phone calls and/ or receiving inbound phone calls within the department’s goal timeframe, manage the member’s communication preferences as possible, which may include time of day, channel, and language. Utilize interpreter service as needed. High-volume calls reaching out to patients for annual wellness visits. Personally, I have set multiple company records of successful appointments scheduled per day (40+ per day), with a call success rate of 50% vs the company’s wide 25% success rate.
• Monitored metrics, including available capacity, utilized capacity, scheduled visits, no show cancellations, and completed visits to make improvements.
• Oversee and leads activities to maintain compliance with state requirements, federal and/or NCQA quality requirements, as appropriate collaboration with quality leadership with implementation of Health Plan quality program management and performance activities.
• Collaborate with internal and external stakeholders to ensure HEDIS and CAHPS initiatives are fully integrated throughout the organization, maximizing opportunities to improve outcomes for members
• Provide Continuous monitoring of quality measure data (numerators and Denominators), identify data irregularities, monitor the HEDIS team and their projects.
• Evaluates quality measure data information and assists in establishing priorities for outreach efforts so that goals are achieved.
• Supports the development and implementation of new programs that may be innovative in their approach to maximize success with member outreach, closure of quality measure gaps and member satisfaction scores (HOS, CAHPS).
• Directs and supervises outreaches and activities regarding quality measures.
• Ensures accuracy and compliance with all CMS guidelines regarding quality measure sets.
• Assist partner primary care physician (PCP) offices with contract setup. Educate them on existing plans and member benefits to increase patient adherence, and patient care gap closures.
• Managing insurance contracts, prior authorization and reimbursement.
• Monitor market productivity goals and help within budgetary constraints.
• Managing customer expectations and developing training/ plans to consistently exceed organizational targets for member experience.
• Assist with development, implementation, and monitoring of new Care Center systems, policies, and procedures.
• Analyze daily office operations and utilization of resources.
• Assists in managing, interviewing/hiring/training/monitoring and supporting the managers for a team of approximately 40 employees.
• Assists on boarding clinicians and staff training new hires, e.g., computer programs, materials, equipment.
• Review and approve payroll information for each member of staff.
• Manage facility issues daily including security alarms, facility cleanliness, damaged items, shipping and receiving, etc.
• Resolves all facility needs and requests. Ensures facilities are in working order.

• Manage and support scheduling activities for 12+ physicians and mid-level Practitioner’s, based on availability and patient needs across operations, case management, clinical, and high-risk departments with Medicare Advantage insurance.
• Direct 10 medical assistants by preparing charts and confirming appointments. Implement new workflow and training in any new procedures.
• Oversee field operations (home, drop-in scheduling, and virtual visits) for patients enrolled in company insurance plans across Santa Clara County.
• Create agendas and assist in facilitating IDT meetings, Facility Care Event conferences, and Clinical Care team meetings.
• Assist in supervision and management of clinical teams: Field Clinical, Quality Improvement, and Patient Concierge.
• Drive HEDIS outreach, coordinate drop-in visits using Geo mapping, and offer preventive services, increasing STAR ratings.
• Manage overall daily operations to ensure office processes are efficient, support care center goals, and enhance patient satisfaction.
• Assist with development, implementation, and monitoring of new Care Center systems, policies, and procedures.
• Departmental Budget Management including preparation, schedule of expenditures, analyzing variances, and initiating corrective action.
• Analyze daily office operations and utilization of resources.
• Hire, train, direct, coach, counsel and evaluate performance of direct reports.
• Conducts onboarding the new hire orientation and training.
• Manage logistics and pre-planning for the new office and location.
• Manage patient flow and assist team members as needed.
• Maintain medical and office supplies at an acceptable level.
• Managing inventory to ensure adequate supplies are available for the patient.
• Maintain proper equipment placement to create a safe environment for patients and employees.
• Maintain all appropriate infection control protocols.
• Blocking and opening schedules for the providers as needed.
• Manage facility issues daily including security alarms, facility cleanliness, damaged items, shipping and receiving, etc.
• Resolves all facility needs and requests. Ensures facilities are in working order.
• Maintain appropriate staffing levels and morale.
• Monitor market productivity goals and help within budgetary constraints.
• Review and approve payroll information for each member of staff.
• Managing customer expectations and developing training/ plans to consistently exceed organizational targets for member experience.
• Trained and presented on clinical model and member benefits to educate local partners, such as health plans, PCPs, and medical group.
• Managing insurance contracts, prior authorization and reimbursement.
• Coordinate the Tele psych visits virtually and in person.

SERVICE LINE MANAGER-INTERNAL MEDICINE

Palo Alto Medical Foundation Sutter Health -2017

• Managing patient care and information flow in a comprehensive manner along the patient’s journey of care.
• Manage and support scheduling activities for 10+ physicians and mid-level Practitioner’s.
• Direct 9 medical assistants by preparing charts and confirming appointments. Implement new workflow. Training in any new procedures.
• Staff and providers vacation approval coverage if needed.
• Addressed any patient and staff concern as needed.
• Managing and operating within the department budget within the assigned cost center.
• Responsible for maintaining appropriate staffing levels and final authority for approving overtime.
• Reviews and processes payroll information for each member of staff.
• Hire, train, direct, coach, counsel and evaluate performance of direct reports.
• Coaching and counseling employees, along with implementing disciplinary action up to termination as necessary. Conducts annual employee performance reviews, subject to the final approval of the manager or director. First-line for employee recognition and discipline.
• Implementing HR policies, and procedures during monthly meetings and weekly huddles.
• Maintain proper equipment placement to create a safe environment for patients and employees.
• Maintain appropriate staffing levels and morale.
• Manage facility issues daily including security alarms, facility cleanliness, damaged items, shipping and receiving, etc. Ensures facilities are in working order.
• Facilitate staff department meetings or projects as necessary.
• Check for clinic audits deadline & safety audits through IMQ.
• Lean Process for improvement management and operations by checking the counter measures Tier1 weekly, monthly meetings, Gemba Walk, 5S.
• Monitor productivity goals and help with budgetary constraints.
• Chart audit by providers completing within 48-72 hours.
• Monitor FTE’s providers and staff as needed.
• Conducts commercial, FAA, school and physical employment.

• Manage 3 Medical Assistant and 6 + Nurse Practitioners. Serve as technical and clinical resources for the patient and staff.
• Coaching and counseling employees, and disciplinary action up to termination as necessary. Conducts annual employee performance review.
• Interview and hire new employee.
• Review and approve payroll information for each member of staff.
• Facilitate staff meetings, along with other meetings and projects as necessary.
• Initiate ordering supplies, repairs, maintenance.
• Maintain proper equipment placement to create a safe environment for patients and employees.
• Supporting 2 Nurse Practitioners with an average of 32 patients a day, vitals, EKG, blood draw, Injections, spirometry, urinalysis.
• Assist minor surgery.
• Perform sports and commercial driving physicals.
• Check for Clinic audits deadline & Safety audits.
• Credentialing and Re-credentialing the nurse practitioners.