Photography
Maria Nelson
Sacramento,CA
Summary
Accomplished Supervisor focused on meeting customer expectations and achieving company goals. Drives success by directing high-producing teams while developing lasting employee rapport. Exceptional knowledge of cost-reduction methods and streamlining production processes.
Overview
22
22
years of professional experience
Work History
IHSS Care Provider
California Department of Social Services
11.2023 - Current
- Prepared nutritious meals according to dietary restrictions and preferences for better overall health.
- Performed laundry, grocery shopping and other light housekeeping duties as instructed by client.
- Provided transportation for clients to medical appointments, social events, and other necessary outings.
- Ensured a safe and comfortable environment by maintaining a clean and organized living space.
- Assisted patients with dressing, grooming and feeding needs, helping to overcome, and adapt to mobility restrictions.
- Assisted clients with daily living activities, promoting independence and quality of life.
General Warehouse Associate
Amazon
04.2023 - 06.2024
- Loaded, unloaded, and moved material to and from storage and production areas.
- Sorted and delivered materials to different work areas and staff.
- Performed general housekeeping and cleaning tasks.
- Operated RF scanners to track merchandise and verify contents of containers.
- Consistently lifted materials weighing as much as 50 pounds.
- Exceeded daily productivity goals through efficient task completion and strong time management skills.
- Safely operated various warehouse equipment, including forklifts, pallet jacks, and hand trucks, to move products efficiently.
Medicare Appeals & Grievance Supervisor
Health Net Inc/Centene
04.2018 - 06.2020
- Led and managed teams of up to 40 analysts, in four states, serving over 40 insurance plans
- Collaborated with cross-functional teams to ensure timely resolution of customer appeals and grievances regarding denied claims, authorizations, benefits, eligibility and insurance premiums
- Oversaw daily operations of the department, ensuring smooth workflow and timely completion of tasks.
- 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.
- Reduced employee turnover by fostering a positive work environment and providing ongoing feedback to staff members.
- Oversaw compliance with industry regulations and company policies, ensuring safe and legal operational environment.
Medicare Materials Audit Supervisor
Health Net Inc/Centene
03.2015 - 04.2018
- Audit Health Plan written materials and approved for print
- Improve overall audit processes through introduction of new technology, process improvements and reporting to maximize resources
- Develop/modify Policies and Procedures on a regular basis and ensure all necessary policies are created
- Systematically collect and provide data in order to develop reports based upon quality monitoring results
- Delivering performance feedback to associates as outlined in unit's policies and procedures
- Monitor department workload and assign work accordingly to meet service level agreements
- Assisted in creating annual audit plans based on risk assessments to address key business objectives.
- Supervised and guided employees during audits to safeguard accuracy.
- Ensured compliance with regulations, identifying discrepancies and providing corrective action plans.
- Trained and mentored department staff on policies and procedures to establish strong foundation for client development and service activities.
Medicare Materials Audit Analyst
Health Net Inc/Centene
04.2010 - 03.2015
- Coordinated, managed and implemented auditing projects and prepared for evaluation.
- Contributed to cross-functional teams working on special projects.
- Supported external auditors during annual audits, providing requested documentation and addressing inquiries efficiently.
- Followed established auditing processes to meet internal and regulatory requirements.
Customer Service Call Center Lead
Health Net Inc/Centene
10.2002 - 04.2010
- Implemented effective coaching strategies to improve agent performance and customer experience.
- Championed change management initiatives within call center, spearheading new technology implementations and process improvements.
- Reduced call escalations by empowering agents with necessary tools, knowledge, and decision-making authority.
- Trained team members on performance metrics and consumer behavior identification.
- Investigated and resolved customer inquiries and complaints quickly.
Education
AA Business Administration -
Heald College
Rancho Cordova, CA05.2013
Skills
- Strong leadership and team management skills
- Ability to motivate and develop team members
- Team player
- Excellent time management skills
- Conflict Management
- Ability to work in a fast-paced environment
- Time Management
- Relationship Building
Work Availability
monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
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Interests
Reading
Timeline
IHSS Care Provider
California Department of Social Services
11.2023 - Current
General Warehouse Associate
Amazon
04.2023 - 06.2024
Medicare Appeals & Grievance Supervisor
Health Net Inc/Centene
04.2018 - 06.2020
Medicare Materials Audit Supervisor
Health Net Inc/Centene
03.2015 - 04.2018
Medicare Materials Audit Analyst
Health Net Inc/Centene
04.2010 - 03.2015
Customer Service Call Center Lead
Health Net Inc/Centene
10.2002 - 04.2010
AA Business Administration -
Heald College