Manuela Francis

New Haven,CT

Summary

Results-driven care coordinator with expertise in effective communication and team collaboration. Proven experience in documenting and analyzing member inquiries to improve service delivery and ensure compliance. Committed to enhancing healthcare outcomes through strategic coordination and support.

Overview

years of professional experience

Work History

Care Coordinator ||

Zelis Healthcare

Remote

12.2021 - Current

Answered inbound calls from ME&T Health Plan employer group clients and account groups.
Provided professional assistance to members planning elective surgical or medical procedures.
Documented and communicated information through inbound and outbound calls, emails, and chats.
Researched and analyzed member incentive inquiries, reporting issues to the appropriate I&E team.
Utilized internal databases to generate reports on consumer claim history and incentive check fulfillment status.
Applied analytical problem-solving skills to identify trends in member complaints and performance opportunities.
Collaborated with various departments to define inquiry trends and develop corrective action plans.
Implement new ideas, processes, and systems.

Contractor Administrative Assistant |

Pfizer Clinical Research Unit

New Haven, Connecticut

08.2021 - 12.2021

Managed health screenings for patients and staff to ensure safety protocols.
Tracked and documented adverse events, serious incidents, and violations to maintain research integrity.
Conducted outpatient screenings, including check-in and check-out processes for volunteers.
Documented and conveyed study data accurately within the system.
Monitored laboratories and research equipment for compliance and optimal functionality.
Coordinated communication by answering phones and efficiently directing volunteers to appropriate departments.
Collaborated with diverse teams to achieve goals and resolve product-related issues.

Education

Bachelor of Science - Health Sciences

Worcester State University

Worcester, Massachusetts

05-2021

High School Diploma -

Casco Bay High School

Portland, Maine

06-2016

Skills

Patient advocacy and health insurance knowledge
Medical terminology and documentation proficiency
Claims processing and data reporting
Database coordination and case management
Compliance management and effective communication

Attention to detail and analytical thinking
Team collaboration and workflow management
Customer relationship management
Conflict resolution and scheduling
Resource management

Timeline