Lena Molina
Yachats,Washington
Summary
Customer service and program specialist professional with robust experience working with internal and external stakeholders as well unit staff members and customers/clients. Adept at fostering team collaboration and leading teams through evolving programs to include 3 system replacement implementations. Expert execution of Medicaid pharmacy drug policy implementations.
Overview
23
23
years of professional experience
Work History
Health Care Program Specialist
The Washington State Health Care Authority
03.2020 - Current
- Received incoming phone calls and contact form submissions and provided timely responses to inquiries.
- Conducted thorough needs assessments to identify gaps in service delivery and inform program development efforts.
- Improved overall program effectiveness through comprehensive data analysis and evaluation of key performance indicators.
- Evaluated program operations, successes and deficiencies to identify concerns and recommend strategies to enhance processes and elevate results.
- Worked alongside other professionals to outline and implement program plans and objectives.
- Ensured compliance with relevant Washington Administrative Code (WAC) throughout all stages of program implementation by closely monitoring adherence to established guidelines.
Regional Medical Enrollment Supervisor (MAS5)
The Washington State Health Care Authority
01.2014 - 02.2020
- Oversaw daily operations of 10 remote staff, ensuring smooth workflow and timely completion of tasks.
- Traveled extensively to multiple counties through south central Washington State to provide coaching and evaluate staff performance.
- Applied strong leadership talents and problem-solving skills to maintain team efficiency and organize workflows.
- Improved customer satisfaction with timely response to inquiries, addressing concerns, and finding effective solutions.
- Increased team productivity by implementing efficient workflows and setting clear expectations for staff members.
- Conducted performance evaluations for staff members, identifying areas of improvement and guiding professional development plans.
- Managed diverse team, promoting inclusive work environment that leveraged individual strengths.
Pharmacy Authorization Services Lead (MAS4)
The Washington State Health Care Authority
02.2010 - 12.2013
- Self-motivated, with a strong sense of personal responsibility.
- Worked effectively in fast-paced environments.
- Skilled at working independently and collaboratively in a team environment.
- Provided instruction and guidance to staff when needed.
- Proven ability to learn quickly and adapt to new situations.
- Assisted with day-to-day operations, working efficiently and productively with all team members.
- Trained and and assisted staff to ensure proper adjudication of pharmacy authorization requests.
- Resolved complex complaints, problems and conflicts with pharmacies and prescribers.
Call Center Representative (MAS3)
Dept of Social & Health Services/Washington State
11.2006 - 05.2009
- Managed high call volumes while providing exceptional customer support and maintaining professional composure.
- Handled escalated calls professionally, effectively resolving complex issues and ensuring client satisfaction at all times.
- Mastered multiple software systems for seamless navigation during calls, improving efficiency and reducing hold times for customers.
- Enhanced customer satisfaction by efficiently addressing and resolving inquiries in a timely manner.
- Used and maintained knowledge of multiple computer programs to provide the most current information to Medicaid enrollees.
- Successfully navigated business software conversion from MMIS to Catamaran Point of Sale system.
- Established trust with clients by accurately addressing their concerns and offering appropriate resolutions based on their needs.
Patient Service Representative Supervisor
Clarus Eye Centre
05.2002 - 10.2006
- Participated in ongoing training programs related to HIPAA compliance, maintaining up-to-date knowledge on regulatory requirements.
- Verified insurance eligibility and coverage for patients.
- Handled sensitive patient concerns with professionalism and empathy, fostering an atmosphere of trust within the clinic.
- Filed and maintained patient records in accordance with HIPAA regulations.
- Supervised daily activities of 8 patient service representatives and monitored for quality control.
- Coached team to improve performance.
- Trained staff on HIPAA (Health Insurance Portability and Accountability Act) regulations and requirements for implementation 4/14/2003.
- Built and maintained positive working relationships with patients and staff.
Education
High School Diploma -
Verden High School
Verden, OK05-1991
Skills
- Prioritization
- Efficient use of multiple programs to complete tasks
- Builder of strong relationships with staff, internal and external partners
- Conflict resolution
Timeline
Health Care Program Specialist
The Washington State Health Care Authority
03.2020 - Current
Regional Medical Enrollment Supervisor (MAS5)
The Washington State Health Care Authority
01.2014 - 02.2020
Pharmacy Authorization Services Lead (MAS4)
The Washington State Health Care Authority
02.2010 - 12.2013
Call Center Representative (MAS3)
Dept of Social & Health Services/Washington State
11.2006 - 05.2009
Patient Service Representative Supervisor
Clarus Eye Centre
05.2002 - 10.2006
High School Diploma -
Verden High School