Kady Giselle Pena
New York
Summary
Results-oriented healthcare professional with over 15 years of experience in managing Medicaid and Medicare populations, specializing in case management and member retention. Demonstrated success in training teams, improving quality, and engaging members effectively. Bachelor's degree in Healthcare Administration with Leadership specialization. Bilingual in English and Spanish, seeking a trainer or managerial role to enhance care coordination and equity.
Overview
7
7
years of professional experience
1
1
Certification
Work History
SPECIALIST, GROWTH & RETENTION | TEAM TRAINER
Molina Healthcare
New York
03.2025 - Current
- Spearheaded outreach and support for Medicaid recertification and eligibility resolution of complex member cases.
- Trained and mentored new hires on systems, deescalation techniques, documentation, and call quality standards.
- Led retraining initiatives for tenured staff to improve overall performance.
- Created and managed training resources, and led internal projects to enhance onboarding and retention processes.
- Provided bilingual support and facilitated member engagement at live events and outreach sites.
- Collaborated with leadership to deliver insights on member experience and workflow efficiency strategies.
MEMBER NAVIGATOR – RETENTION SPECIALIST
EMBLEMHEALTH
New York
02.2022 - 11.2024
- Supported Medicaid and Medicare members with eligibility, recertification and enrollment in LIS/MSP programs.
- Trained new hires while coaching team on member engagement and quality assurance.
- Closed care gaps by coordinating member referrals to clinical and nonclinical services.
- Delivered culturally competent support in English and Spanish across phone, mail, and portal channels.
- Managed diverse caseload of over 70 members, facilitating post-acute and behavioral health transitions.
- Facilitated SNAP, Medicaid and housing applications while guiding members toward self-sufficiency.
- Set SMART goals and monitored outcomes for health and wellness progress.
- Participated in onboarding and cross-training peers in case management workflows.
CASE MANAGER
Cityblock Health
New York
05.2019 - 10.2021
- Managed a diverse caseload of over 70 members, supporting post-acute, behavioral health and social service transitions.
- Facilitated SNAP, Medicaid and housing applications while coaching members toward independence.
- Set SMART goals and monitor outcomes to ensure progress toward health and wellness objectives.
- Participated in new hire onboarding and cross-trained peers in case workflows.
Education
Master of Healthcare Administration -
Western Governors University
Salt Lake City, UT01-2027
Bachelor of Healthcare Administration - Specialization in Leadership
CAPELLA UNIVERSITY
New York City, NY07.2025
Associate Degree in Health Sciences -
GOODWIN UNIVERSITY
East Hartford, CT01.2019
Skills
- Team leadership and staff development
- Program outreach and retention strategies
- New hire training and quality coaching
- Application processing and state portals
- Salesforce proficiency
- Customer care assistance (CCA)
- Genesys expertise
- 834 transaction processing
- QNXT system knowledge
- Engagement events and outreach initiatives
- HIPAA compliance expertise
- EHR system management
- Bilingual support services
- Medicaid and Medicare recertification education
Websites
Certification
- Lean Six Sigma Yellow Belt, Molina Healthcare, 06/25
- Bilingual Certification, Transperfect, 06/19
Accomplishments
Trailblazer Award, 2025 - Acknowledged for proactive leadership efforts
Timeline
SPECIALIST, GROWTH & RETENTION | TEAM TRAINER
Molina Healthcare
03.2025 - Current
MEMBER NAVIGATOR – RETENTION SPECIALIST
EMBLEMHEALTH
02.2022 - 11.2024
CASE MANAGER
Cityblock Health
05.2019 - 10.2021
Master of Healthcare Administration -
Western Governors University
Bachelor of Healthcare Administration - Specialization in Leadership
CAPELLA UNIVERSITY
Associate Degree in Health Sciences -
GOODWIN UNIVERSITY