Jasmin Abdellatif
Chino Hills,CA
Summary
Network development professional with strong track record of contracting, managed care, business development, provider relations, health advocacy and patient care. Great at building and maintaining relationships with users and customers, aimed at providing high level customer service. Recognized for adaptability and proficiency in troubleshooting and problem-solving.
Overview
12
12
years of professional experience
Work History
Provider Network Development Manager
Providence
01.2021 - Current
- Recruitment into the Affiliate Network of Primary Care Physicians and Specialist
- Responsible for the growth and profitable development of the provider Affiliate Network (Orange County)
- Serves as single-point-of-contact to the Affiliate Network’s physicians and is accountable and responsive to physician needs
- Addresses primary care and specialist network specific issues
- Responds to provider issues, works with other groups/central departments to resolve issues and updates providers and office staff regularly through to resolution
- Collaborates with hospital ministries to achieve strategic objectives
- Maintains awareness of providers interested in further aligning with Providence on new business opportunities, and on shifting market/competitive dynamics that would impact the Network
- Responsible for managing the interested providers (PCP and SPC) process
- Leading monthly meetings with Affiliate Medical Directors to review candidates
- Responsible for additions to contracted groups
Provider Network Administrator
AltaMed Health Services
04.2017 - 12.2020
- Recruitment of Primary Care Physicians and Specialist, filling GAPS/DMHC ratios
- Developing and managing relationships with Providers, Hospitals, Specialists, Ancillary Providers, Health Plans and MSO’s
- Examine and interpret contract language, LOAs and terminations
- Work closely with internal departments to ensure onboarding of new providers
- Educate and train providers and staff on portal/systems
- Compile and present information on progress, increase brand awareness, bring in new customers and collaborate with public relations effort
- Promote enrollment growth by working with the health plan representative, community organizations, providers and AltaMed marketing representatives
- Report operational issues, statistics progress toward goals and potential barriers to the Director of Network Operations/Regional Vice President on a monthly basis
- Provide support by handling queries regarding claims, eligibility, authorizations, complaints and credentialing
Provider Relations Representative
HealthCare Partners
02.2016 - 04.2017
- Build positive relationships between health plans, providers and practice managers
- Responsible for the operations of the provider networks, direct interface between the organization and assigned networks
- Assist providers in setting up and utilizing provider portals and networks, provide continuous education to providers and their staff on policies and procedures
- Work closely with HCP’s marketing team to help IPA offices grow, attend health fairs and other community outreach programs when necessary
- Assume lead for special projects by assisting with mail expansions and tracking spreadsheets
- Provide support by handling queries regarding claims, eligibility, authorizations, complaints and credentialing
Health Advocate/Managed Care
HealthCare Partners
10.2014 - 02.2016
- Primary point of contact between patient and care team members to anticipate and appropriately address questions and concern
- Confirm patients understanding of HCP Primary Care Physician assignments, educate patients of available tools, resources and benefits
- Initiates data gathering and completes documentation of Health Risk Appraisal (HRA) information for hand-off to Care Manager, ensures timely completion and review of HRA by Care Manager and facilitates availability of completed document for PCP
- Facilitate communication with patient and caregiver and coordinates patient care with appropriate resource allocations, referrals and notifications that are purposeful, supportive and interconnected with Care Team Members to ensure ongoing coordinated management of patient care
Medical Assistant/Urgent Care
PIH Health
01.2013 - 10.2014
- Vital/room patients, prep patients for physical examinations
- Injections, Medical clinical procedures comprehension
- Sterilization techniques/Autoclave
- Injections, Venipunctures, HA1c, Run CBC count
- Laboratory testing (UA's, HCG, EKG) Specimen collection/process
- Wound cleaning/care expertise, bandaging
- Coordinate/lead customer service committee
Education
Masters of Science - Healthcare Management
Cal State Los Angeles
05.2021
Bachelor of Science - Health Administration with a concentration in Health Management
University of Phoenix
05.2018
Certified Medical Assistant -
ABC Adult School
05.2011
Skills
- Contracting
- Credentialing
- Claims Management
- Utilization Management
- Provider Relations
- Complaints Investigation
- Resolution
- Incentive Programs Facilitation
- Quality Management
- HEDIS
- STAR
- P4P
- Training
- Education
- Provider Compliance
- Managed Care
- IPA
- Patient Care
- Patient Satisfaction
- Marketing
- Membership
- Growth
- Retention
- Customer Service
- Relationship Building
- Personable
- Friendly
- Customer Support
- Network Troubleshooting
Performancesummary
Detail-oriented and highly organized professional with experience in Managed Care, Business Development, Provider Relations, Contracting, Health Advocacy and Patient Care. Great at building and maintaining relationships with users and customers, aimed at providing high level customer service.
Languages
English
Spanish
Timeline
Provider Network Development Manager
Providence
01.2021 - Current
Provider Network Administrator
AltaMed Health Services
04.2017 - 12.2020
Provider Relations Representative
HealthCare Partners
02.2016 - 04.2017
Health Advocate/Managed Care
HealthCare Partners
10.2014 - 02.2016
Medical Assistant/Urgent Care
PIH Health
01.2013 - 10.2014
Bachelor of Science - Health Administration with a concentration in Health Management
University of Phoenix
Certified Medical Assistant -
ABC Adult School
Masters of Science - Healthcare Management
Cal State Los Angeles