Summary
Overview
Work History
Skills
Timeline
Generic

Marisol Roman

New Braunfels,TX

Summary

Provider Relations Advocate with expertise in implementing network expansion strategies and managing national business partner vendors to support high-quality, compliant medical services. Skilled in building and maintaining strong provider relationships, resolving network-related issues, and driving continuous improvements in service delivery. Experienced in strategic collaboration with cross-functional teams to enhance network performance, implement data-driven solutions, and ensure compliance with regulatory standards.

Overview

13
13
years of professional experience

Work History

Provider Relations Advocate SR

QTC Management Inc. - A Leidos
09.2022 - Current

    · Advocated for network improvements by partnering with 5 business partners and 350+ providers and office managers, collaborating with internal teams to resolve issues and ensure compliance with contractual obligations, leading to enhanced overall performance and service quality.

    · Utilized data analytics to identify trends across 350+ quarterly provider report cards, uncovering provider-related challenges and implementing strategic solutions. Established improvement plans to enhance service quality and meet timeliness metrics, resulting in measurable increases in provider satisfaction and overall performance.

    · Teamed with the project manager to foster strong networking skills, building and strengthening business partner relationships. Successfully expanded the network to 390+ providers, enhancing service capabilities across multiple lines of business.

    · Managed multiple workflows for business partners, tracking internal and external audits as well as VA site visits, ensuring streamlined processes and compliance. This proactive approach minimized operational disruptions and improved audit readiness, contributing to a more efficient and accountable network.

Provider Advocate

QTC Management Inc. - A Leidos
01.2020 - 09.2022
  • Utilized data analytics to identify provider-related challenges and implemented strategic solutions, resulting in a measurable improvement in service quality and provider satisfaction.
  • Partnered with utilization and operations teams to assess network strengths and weaknesses, driving network optimization efforts and ensuring alignment with company objectives.

Human Resources Recruiter

QTC Management Inc. - A Leidos
07.2018 - 09.2019

    · Led full-cycle recruitment efforts, sourcing and hiring top talent for diverse roles, reducing time-to-fill by 25% while maintaining high-quality standards.

    · Developed and implemented strategic recruitment plans, leveraging social media, job boards, and networking events to expand the talent pipeline and increase candidate diversity by 30%.

    · Collaborated with hiring managers to create targeted job descriptions and screening criteria, ensuring alignment with organizational goals and enhancing the quality of new hires."

Provider Recruiter SR.

QTC Management Inc. - A Leidos
04.2012 - 07.2018

Qualified and contracted medical providers nationwide for disability examinations, ensuring compliance with VA, OSHA, and ADA standards. Managed the end-to-end contracting process, including drafting and submitting agreements to the credentialing department. Maintained proactive communication with providers to build strong relationships, verify credentials, and negotiate reimbursement rates. Collaborated with senior personnel to address organizational needs, completed PR projects, and mentored new recruiters. Successfully maintained a network of providers to deliver timely disability exams, meeting a 2-3 week turnaround goal.

Skills

    Relationship Building and Account Management
    Data Analysis and Strategic Planning
    Cross-Functional Leadership and Collaboration
    OSHA and ADA Standards Compliance
    Talent Acquisition and Recruitment Strategies
    Project Management and Process Optimization
    Time Management and Multitasking Abilities

Timeline

Provider Relations Advocate SR

QTC Management Inc. - A Leidos
09.2022 - Current

Provider Advocate

QTC Management Inc. - A Leidos
01.2020 - 09.2022

Human Resources Recruiter

QTC Management Inc. - A Leidos
07.2018 - 09.2019

Provider Recruiter SR.

QTC Management Inc. - A Leidos
04.2012 - 07.2018
Marisol Roman