Joaquin Chavez
Mission Hills,Ca
Summary
Detail-oriented, efficient, and diligent work ethic professional. 16 years’ experience in Management Administration with extensive knowledge of Medical, Basic Life, Supplemental Life and Disability Insurance. Proven ability to recognize and interpret suite of medical plans available in specific markets. This includes but is not limited to HMO, PPO, POS, and High Deductible plans. Dedicated commitment to clients and internal constituents to attain a positive and progressive relationship. Passionate and experienced in Community Coordinating with over twenty years of experience skilled at planning, and executing community events and fundraisers, resulting in accomplished goals.
Overview
16
16
years of professional experience
Work History
L.A. Care Health Plan- Community Resource- Representative II
10.2022 - Current
- Reported directly to the manager and supported all administrative functions for the center which includes assisting in special projects/assignments and generated graphs along with reports to meet department goals and objectives
- Assisted manager with preparing documentation/ correspondence for all projects and activities
- Maintain and organized quality record keeping for the Center
- Increased Community Center awareness by building, maintain relationships with internal and external stakeholders
- Identified and maintained relations with community stakeholders provided feedback to center manager to implement integrated approaches to the communities needs and targeted member engagement
- Responsible for communicating with the Sales & Marketing Department to increase member traffic
- Identified and targeted contracting providers to implement promotions and encourage referral services of members to Resource Center
- Created, developed, and implement Promotional Assets marketing tools to expand Community Center outreach efforts and community engagement activities
- Increased member traffic and partner health plans to participate into the CRC services and programs
- Attended and presented in community meetings (CBO’S) to increase Community Center visibility and promoted health, wellness and fitness programs, and enrollment services.
California Citizens Redistricting Commission- Outreach Coordinator
08.2021 - 02.2022
- Assist in identifying venues for in person public input meetings/hearings, and available venue services and hotel accommodations for commission hearings and business meetings
- Contact venues to ascertain availability and equipment, physical setup, and personnel necessities are available
- Provide support prior and during meetings with physical setup and logistics
- Facilitate communication between venue staff, local meeting services, commissioners, and commission staff; ensuring positive communications and problem-solve any issues that arise during the meeting
- Support Field Staff Lead in outreach, organization research, spreadsheets, and database collection
- Assist Field Staff Leads with the interpreter line during meetings for participants who speak a foreign language
- Distribute Commission materials and resources to promote Californians to participate in the Redistricting process
- Provide administrative support to Field Staff Lead and outreach, including note-taking efforts
- Participate in staff meetings, providing feedback and recommendations for improving the operating procedures for scheduling and holding commission meetings.
UCLA Operation Mend
03.2017 - 09.2020
- Under the Program Director and Director of Psychological Health Programs, I served as a liaison responsible for identifying, screening, educating, and recruiting post 9-11 military veterans and their families who met eligibility requirements: including physical injuries PTSD and TBI
- Set priorities by working with clinical staff to support the needs of the case management team and physician case reviewers
- Proactively assisted with moving patients through case review by collecting medical records, tracking patient progress, and streamlining process improvements
- Provided regular and detailed feedback to UCLA doctors and administrators on progress, challenges, and recruitment of eligible veterans within a given population
- Provided on going patient and family contact and documentation in Salesforce, Outlook, Calendars, EPIC, and other platforms to facilitate case management in maintaining contact with UCLA providers to coordinate treatment efforts and the continuity of care
- Managed stressful situations, communicated empathetically and professionally with all staff and veterans
- Accompanied veterans to UCLA and worked with patient navigators, volunteers, and other members of the UCLA Operation Mend care team to keep appointments so the veteran can continue the journey to recovery.
UCLA Medical Center- Santa Monica, Ca.-Administrative Specialist
11.2016 - 03.2017
- Served as a resource and point of contact for the UCLA Medical Procedure Unit for information and referral sources to the UCLA Gastroenterology Department
- Provided a high level of patient and analytical services over the telephone utilizing the EPIC system to communicate patient care, scheduling, registration and provided confirmation calls effectively and efficiently
- Assisted patients by identifying their needs and provided the knowledge and ability to guide the callers to clinic/services, medications, and physician orders
- Multi-tasked between identifying areas for improving patient relations, ensuring that quality standards are met while providing extensive personalized customer service and executing proper phone etiquette, active listening skills and data entry.
Anthem Blue Cross- Woodland Hills, Ca.-Medical Management Support Team
03.2008 - 10.2016
- Supported the medical review board where I was responsible for generating approval and denial letters
- Employed use of internal utilization management database to directly support physician review staff
- Continually reviewed and operated under strict compliance with Federal Mandates regarding HIPAA and ERISA regulations
- In addition to maintaining strict adherence to both company timelines and Utilization Review Accreditation Committee guideline
- Thoroughly documented inquiry outcomes for tracking and analysis
- Assisted providers with appropriate clinical guidelines regarding pre-determination requests and provided claim resolution techniques
- Responded and placed out follow up telephone calls/ e-mails and determination letters.
Education
High School Diploma -
Oxnard High School
Oxnard, CA01.2000
Skills
- Team Building
- 16 years Customer Service
- Collecting data
- Documentation
- 13 years Excel
- Applying Policies/Regulations
- Spanish
- Special Projects
Timeline
L.A. Care Health Plan- Community Resource- Representative II
10.2022 - Current
California Citizens Redistricting Commission- Outreach Coordinator
08.2021 - 02.2022
UCLA Operation Mend
03.2017 - 09.2020
UCLA Medical Center- Santa Monica, Ca.-Administrative Specialist
11.2016 - 03.2017
Anthem Blue Cross- Woodland Hills, Ca.-Medical Management Support Team
03.2008 - 10.2016
High School Diploma -
Oxnard High School
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