Summary
Overview
Work History
Education
Skills
Timeline
Generic

Jeaxa Castro Gonzalez

Summary

Dedicated, organized, and solutions-driven Program Coordinator with over 15 years of experience in Health Care Administration. Focusing on member and provider management, product, projects, and company regulations in compliance with Florida State Department of Health and Department of Children and Families guidelines.

Overview

17
17
years of professional experience

Work History

Pediatric Care Coordinator

CMS, Sunshine Health
02.2022 - Current

• Coordinate and manage housing and wellness benefits assistance with the Finance Department minimizing overpaying.

•Audit and monitored workflow to improve employee time management and increase productivity.

• Handle members and vendors complaints, resolve issues and provide final resolution.
• Providing training, mentoring, and guidance to team members.
• Collaborate in the creation of new process and job aids.
• Participated in several projects resolving and helping to meet the department goals.

• Outreach members identified by the Florida State Department of Health with critical conditions to ensure coordination of care with Case Managers.

• Completing assessment for critical condition members unable to reach.


Member Service Representative II

Sunshine Health
02.2017 - 08.2022
  • Assist with large volume of customers every day with positive attitude and focus on customer satisfaction.
  • Manage member services for different products: MMA, Healthy Kids, CW and Ambetter.
  • Verified customer identification and documentation for compliant transactions.
  • Served as a mentor for new hires sharing best practices contributing towards increased productivity among team members.
  • Trained new team members by relaying information on company procedures and safety requirements.
  • Coached team members in techniques necessary to complete job tasks.
  • Enhanced overall team performance by providing regular coaching, feedback, and skill development opportunities.
  • Collaborated with other department leads to streamline workflows, improve interdepartmental coordination, and achieve business goals collectively.
  • Conducted regular progress reviews with individual team members to identify areas for improvement and provide guidance on career development opportunities.

Member Advocate I

Sunshine Health Plan
09.2019 - 02.2022
  • Maintained up-to-date knowledge of industry trends and best practices, adapting processes as needed to deliver exceptional support services for all members and providers.
  • Consistently exceeded performance metrics related to response times, issue resolution rates, and overall customer satisfaction scores.
  • Collaborated with team members to identify areas for improvement and implement new strategies for better member support.
  • Identified potential risks or conflicts within member accounts, taking proactive measures to prevent future complications.
  • Managed escalated cases effectively, working closely with supervisors to ensure successful outcomes for all parties involved.
  • Served as a role model for the team by demonstrating commitment to excellence, professionalism, and adherence to company values at all times.
  • Coached team members in techniques necessary to complete job tasks.
  • Worked different stations to provide optimal coverage and meet production goals.

Assistance Office Manager

Dr. David Storer Blasini
08.2007 - 12.2012
  • Handled sensitive information with discretion, maintaining confidentiality of company documents and personnel records.
  • Provided exceptional customer service when addressing client inquiries or concerns via phone calls or email correspondence.
  • Enhanced team productivity by delegating tasks effectively and overseeing daily workflow.
  • Coordinated office events and meetings, ensuring timely execution and optimal scheduling for all participants.
  • Assisted in the recruitment process, conducting interviews and onboarding new employees to promote a seamless integration into the team dynamic.
  • Served as a liaison between upper management and staff members, facilitating open channels of communication to address concerns or issues promptly.
  • Coached new hires on company processes while managing employees to achieve maximum production.

Education

BBA - Human Resources Management

University Interamericana of Puerto Rico
Ponce, PR
06.2019

Skills

  • Production Monitoring
  • Team Supervision
  • Quality Improvement
  • Staff Training
  • Mentoring
  • Process Development
  • Data Analysis and Reporting
  • Finance Management and Audits

Timeline

Pediatric Care Coordinator

CMS, Sunshine Health
02.2022 - Current

Member Advocate I

Sunshine Health Plan
09.2019 - 02.2022

Member Service Representative II

Sunshine Health
02.2017 - 08.2022

Assistance Office Manager

Dr. David Storer Blasini
08.2007 - 12.2012

BBA - Human Resources Management

University Interamericana of Puerto Rico
Jeaxa Castro Gonzalez