Lina Hoyos
Plantation,FL
Summary
Dynamic Client Solutions Director with extensive experience at OncoHealth, driving operational excellence through process automation and compliance. Proven leadership in managing cross-functional teams and enhancing workflow efficiency. Skilled in project management and conflict resolution, consistently delivering exceptional results in complex healthcare environments. Passionate about improving patient care and operational outcomes.
Overview
14
14
years of professional experience
Work History
Client Solutions Director
OncoHealth
07.2023 - Current
- Lead operational workflow processes for new and existing UM and Iris clients, ensuring alignment with operational policies and compliance requirements
- Drive process improvement through automation, training, and documentation, improving operational efficiency
- Collaborate with internal teams and clients to ensure continuity in UM and Iris business operations
- Manage UAT testing processes, including schedules, artifacts, and issue tracking via Zendesk and Azure DevOps
- Work with Product Management and Engineering teams to anticipate and implement changes, ensuring smooth transitions
- Develop training materials and document workflows for case review teams in Mainland and Puerto Rico
Director of UM Operations
OncoHealth (formerly Oncology Analytics)
09.2021 - 07.2023
- Delivered operational SOPs, policies, and procedures, optimizing workflow and compliance
- Partnered with cross-functional teams to address operational gaps and ensure compliance with URAC, NCQA, and CMS guidelines
- Managed vendor relationships and participated in payer audits, ensuring adherence to regulatory standards
- Oversaw implementation of new operational workflows for clients and internal teams
- Managed UAT testing and ensured smooth client transitions during new project rollouts
Director of Case Management
Oncology Analytics
04.2018 - 09.2021
- Provided oversight and guidance for all member and provider case review processes
- Managed a team of case management professionals, ensuring staffing needs were met and performance was optimized
- Collaborate cross-functionally to streamline processes, enhancing efficiency for both clinical and non-clinical teams
- Led efforts to ensure compliance with contractual obligations and healthcare regulations
- Coordinated with the implementation team during the contract lifecycle, from discovery to successful project go-live
Manager – Case Review Specialist (Puerto Rico/Mainland)
Oncology Analytics
11.2016 - 04.2018
- Managed remote and in-house employees, providing leadership and oversight on case reviews
- Implemented and monitored performance metrics, offering coaching and development to improve team output
- Successfully rolled out two Puerto Rico client implementations, building strong relationships with external and internal stakeholders
Chemotherapy Review Specialist
Oncology Analytics
02.2013 - 11.2016
- Collected and maintained medical records, collaborating with oncologists to request necessary information
- Acted as a liaison between clinical and non-clinical teams to ensure the execution of the care plan
- Maintained confidentiality in all aspects of medical information, ensuring compliance with HIPAA standards
Referral Coordinator Breast Oncology
MD Anderson Cancer Center
01.2011 - 01.2013
- Coordinated multidisciplinary care for breast cancer patients, ensuring seamless communication among healthcare providers
- Managed patient appointments, facilitating access to medical oncologists, surgeons, and specialists
- Delivered exceptional customer service, ensuring patients received timely, compassionate care during challenging times
Education
Bachelor of Science - Health Services Administration
Keiser University
Orlando, FL01.2012
Associate of Science - Health Administration
Keiser University
Miami, FL01.2006
Skills
- Microsoft Office (Excel, Word, PowerPoint)
- Project Management & Process Improvement
- Conflict Resolution & Problem Solving
- Leadership & Team Management
- Customer Service Excellence
- Documentation & Compliance Knowledge
- Workflow Development & Training
- Adaptability & Organizational Development
- Azure DevOps, Zendesk, Confluence, SmartSheets
- Process Automation & System Implementations
- Quality Assurance & Audit Management
Languages
Spanish
Professional
Timeline
Client Solutions Director
OncoHealth
07.2023 - Current
Director of UM Operations
OncoHealth (formerly Oncology Analytics)
09.2021 - 07.2023
Director of Case Management
Oncology Analytics
04.2018 - 09.2021
Manager – Case Review Specialist (Puerto Rico/Mainland)
Oncology Analytics
11.2016 - 04.2018
Chemotherapy Review Specialist
Oncology Analytics
02.2013 - 11.2016
Referral Coordinator Breast Oncology
MD Anderson Cancer Center
01.2011 - 01.2013
Bachelor of Science - Health Services Administration
Keiser University
Associate of Science - Health Administration
Keiser University
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