Lorie Michele Leon Santos
Kea‘au,HI
Summary
Seeking an Administrative position to best utilize experience and skills. Detail-oriented individual dedicated to improving policies and procedures in all business areas. Hardworking and driven with quality-focused and proactive approach.
Overview
23
23
years of professional experience
Work History
QA/Compliance Officer
Ali`i Health Center
Kailua-Kona, HI
07.2021 - Current
- Maintain Compliance Program and Policies & Procedures; monitor compliance adherence
- Provide staff with on-going Compliance Training resources and educational materials
- Maintain Compliance Training and OIG Exclusion Screening of staff
- Participate in compliance oversight with various departments and committees
- Conduct HIPAA /Privacy Investigations, risk management and corrective action plans
- In conjunction with Medical Director, assists with developing and implementing organization’s quality improvement plan in accordance with mission and strategic goals of organization, federal and state laws and regulations
- Developed Quality Assurance and Performance Improvement (QAPI) Committee to assist with and monitor systems, and procedures for identification, collection, and analysis of performance of quality measurement data; Responsible for maintaining quality management documents, case files and correspondence in an organized, confidential and secure manner
- Maintained up-to-date knowledge of current and emerging compliance regulations.
- Respond to employee inquiries regarding compliance regulations and procedures.
- Developed and maintained compliance database, tracking all compliance activities and documents.
- Prepared and submitted regulatory filings in timely manner.
- Managed relationships with regulators, maintaining open lines of communication to ensure transparent operations.
- Identified, investigated and documented compliance violations and recommended corrective measures.
- Reviewed, revised and updated compliance policies and procedures to confirm continual compliance with applicable laws.
- Promoted a culture of continuous improvement through ongoing evaluation and refinement of compliance program elements.
- Investigated and documented all violations of compliance regulations to determine necessary improvements.
- Collaborated with cross-functional teams to address compliance concerns, fostering a culture of shared responsibility.
- Mitigated legal risks by proactively identifying gaps in existing policies and recommending improvements.
- Developed comprehensive training programs to increase employee awareness of compliance requirements and expectations.
- Leveraged technology solutions for efficient tracking and reporting of compliance-related activities and metrics.
- Advised senior management on strategic planning initiatives, incorporating compliance considerations into decision-making processes.
- Conducted periodic compliance audits and reviews to identify areas of improvement.
Compliance Coordinator
Brandman Health Plan
Reseda, CA
09.2020 - 06.2021
- Assisted in creation of Compliance Program and Policies & Procedures
- Compiled Compliance Training program for staff and contracted providers
- Maintain Compliance Training and OIG Exclusion Screening of staff and providers
- Assisted with creation of health plan website, ongoing maintenance of website compliance
- Maintain Health Plan’s CMS account through HPMS
- Conduct HIPAA /Privacy & Security Investigations, risk management and corrective action plans
- Participate in compliance oversight with various department committees.
Compliance Auditor
Regal Medical Group
Northridge, CA
01.2017 - 08.2020
- Conduct FDR Compliance Audits; Assist with internal audits and site audits
- Analyzed all audit results and resolved all compliance issues.
- Assessed third-party vendor relationships for compliance concerns, minimizing potential risks associated with external partnerships.
- Conducted regular follow-up audits to verify that previously identified issues were effectively resolved or mitigated.
- Conduct HIPAA /Privacy & Security Investigations, risk management and corrective action plans
- Collaborated with cross-functional teams to ensure timely implementation of corrective actions, mitigating potential compliance issues.
- Supported development of company-wide policies and procedures in alignment with industry standards and legal requirements.
- Promoted ethical decision-making within organization by serving as a trusted resource for addressing complex compliance questions or concerns.
- Prepared reports for templates and maintained compliance database.
- Delivered comprehensive training programs for employees on key compliance topics, fostering a sound understanding of relevant regulations and best practices.
Executive Assistant
Regal Medical Group
Northridge, CA
09.2011 - 01.2017
- Handled confidential and sensitive information with discretion and tact.
- Managed executive calendars, scheduling meetings and appointments and coordinating travel arrangements to optimize time.
- Streamlined executive communication by managing emails, phone calls, and scheduling appointments.
- Served as liaison between departments to facilitate effective communication throughout company.
- Managed office inventory, tracking supplies and placing orders to ensure smooth daily operations.
- Coordinated events for staff members, promoting team-building activities and boosting morale within workplace.
- Provided professional administrative support during board meetings, including agenda preparation and minute-taking duties.
- Supported executives in decision-making processes by conducting research and presenting findings in clear formats.
- Prepared and edited presentations on behalf of executives for both internal meetings and external conferences.
- Assisted in development of company policies and procedures, contributing to a more organized work environment.
- Aided in recruitment process by screening resumes, scheduling interviews, and assisting with candidate selection.
- Facilitated training and on-boarding for incoming office staff.
- Supported business and hospitality needs of corporate partners and staff during meetings and company events.
- Transcribed meeting minutes to support sales, business development and senior management teams.
- Credentialing Coordinator
- Compliance Coordinator
Office Manager
The Heart Group
Van Nuys, CA
01.2009 - 01.2011
- Coordinated and maintained physicians’ professional and personal calendars
- Building management; Oversaw facility maintenance requests, coordinating with vendors to address repairs or improvements efficiently.
- Resolved staffing issues, facilitated workflow, employee performance reviews; designed, directed and implemented training and development procedures.
- Handled sensitive information with discretion, maintaining confidentiality of company documents and personnel records.
- Provided exceptional customer service when addressing client inquiries or concerns via phone calls or email correspondence.
- Developed and maintained successful relationships with vendors, suppliers and contractors.
- Developed comprehensive policy manuals outlining procedures and guidelines, contributing to a well-organized workplace culture.
- Enhanced team productivity by delegating tasks effectively and overseeing daily workflow.
- Improved employee retention rates by fostering a positive work environment and providing growth opportunities through training programs.
- Managed compliance to keep organization operating within legal and regulatory guidelines.
- Contributed to workplace safety by ensuring compliance with established emergency protocols and conducting regular equipment inspections.
Executive Assistant
Kenneth Kleinman, M.D. Inc.
Tarzana, CA
07.2001 - 01.2009
- Coordinated and maintained the Doctor’s professional and personal calendar; reviewed resumes, conducted phone interviews, candidate callbacks
- Process patient applications, fee collections and maintaining billing records; wrote correspondence and appeal letters for the Doctor, patients, insurance companies and pharmacies; medical transcribing.
Education
B.A. Anthropology -
University of California, Santa Cruz
Santa Cruz, CA03.2001
Skills
- Compliance Monitoring
- Document Review
- Auditing processes
- Internal Audits
- Ethics management
- Policy analysis
- Risk Management
- Employee Relations
- Compliance Training
- Continuous Improvement
- Investigative reporting
Affiliations
- American Society for Health Care Risk Managment, ASHRM
Timeline
QA/Compliance Officer
Ali`i Health Center
07.2021 - Current
Compliance Coordinator
Brandman Health Plan
09.2020 - 06.2021
Compliance Auditor
Regal Medical Group
01.2017 - 08.2020
Executive Assistant
Regal Medical Group
09.2011 - 01.2017
Office Manager
The Heart Group
01.2009 - 01.2011
Executive Assistant
Kenneth Kleinman, M.D. Inc.
07.2001 - 01.2009
B.A. Anthropology -
University of California, Santa Cruz