Julia Sanders
Fullerton,CA
Overview
22
22
years of professional experience
Work History
Program Assistant PQI
CalOptima Health
02.2018 - Current
- Receive and process clinical PQI files for Nurse Reviewers in the electronic system
- Request medical records and clinical responses from health networks, physician medical groups, and/or providers
- Obtain and file copies of medical records in the electronic system
- Document and log PQI information in the electronic system.
- Collect pertinent information and prepare files for review by the Nurse Reviewer and/or Physician Reviewer.
- Run weekly productivity reports and report data to the team
- Prepare and distribute quarterly health network reports
- Prepare and submit files for external review and retrieve files once review is completed
- Assist with communication status of activities with the nurses, medical directors, leadership, CalOptima departments and/or health networks.
- Training new PQI staff in the electronic system, policies and desktop procedures
Personal Care Coordinator-SPD
CalOptima
03.2017 - 01.2018
- Schedule members for and attend Interdisciplinary Care Team meetings
- Guide members in understanding and accessing the benefits
- Data entry of HRAs received via mail
- Interview members to determine problems, functional status, goals and need for specific services/resources
- Maintain documentation of member’s case, care plan and interdisciplinary care team within CalOptima’s medical management system.
Administrative Assistant-PCC
CalOptima
04.2014 - 03.2017
- Sort and distribute call lists for Personal Care Coordinators
- Generate and send letters to PCP offices
- Scan and attach mailed HRA forms/ enter as needed
- Prepare and send various correspondence to members and medical groups.
Radiology Department Supervisor, X-Ray Technician / Medical Assistant
Primary and Multispecialty Clinics of Anaheim
01.2002 - 01.2012
- Maintain medical records, prepare records for chart audits, release information to persons and agencies according to regulations
- Plan, develop, maintain and operate a variety of health record indexes, storage and retrieval systems to collect, classify, store and analyze information
- Prepared patients for x ray examinations and performed x ray examinations with accuracy and precision in a timely manner
- Enter demographic characteristics, history and diagnostic procedures and treatment into computer.
Education
Health Information Technology-Associate Degree -
Cypress College
Cypress, CA12.2012
Skills
- Excellent organizational skills
- Strong problem solving skills
- Effective communication skills
- Excellent time management skills
- Able to effectively multitask
- Ability to quickly learn new tasks
- Proficient with MS Office products
- Knowledge of HIPAA regulations
Timeline
Program Assistant PQI
CalOptima Health
02.2018 - Current
Personal Care Coordinator-SPD
CalOptima
03.2017 - 01.2018
Administrative Assistant-PCC
CalOptima
04.2014 - 03.2017
Radiology Department Supervisor, X-Ray Technician / Medical Assistant
Primary and Multispecialty Clinics of Anaheim
01.2002 - 01.2012
Health Information Technology-Associate Degree -
Cypress College
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