Melissa Garcia
Albuquerque,New Mexico
Summary
Experienced leader with a proven track record of optimizing operations to drive cost savings and enhance overall efficiency. Strong decision-making abilities and sound judgment contribute to the success of the organization by implementing strategic solutions. Committed to fostering a culture of innovation and continuous improvement, strives to deliver impactful results that align with company objectives. Demonstrates a proactive approach to problem-solving, dedicated to driving positive change and achieving sustainable growth within the organization.
Overview
16
16
years of professional experience
Work History
Manager, Provider Account Management Team
United Healthcare, UHG
Remote
05.2025 - Current
- Oversee the Arizona, Colorado, and New Mexico Markets PAM Team.
- Escalate and help team issues internally and externally
- Travel to meet with provider groups in multiple states, to establish great working relationships
- Coordinate and attend provider events in multiple states such MGMA’s and Primary Care Association Meetings
- Present and educate staff and provider groups in UHC Insights, Digital Efforts, and Provider Portal
Manager, Provider Engagement Experience Team
UnitedHealthcare
Albuquerque, NM
03.2024 - 05.2025
- Overseen five direct reports, that manage the New Mexico Provider Relations Team.
- Established go-live for New Mexico Medicaid, Dual Complete Medicare.
- Officiated several hundred providers onboarding provided training.
- Assisted with individual provider/ provider group credentialing and loading.
- Identify process improvement opportunities for the Provider Operations team to pursue and improve and increase quality and efficiency, and reduce costs.
- Coordinated provider training, with education targets in Medicaid, Medicare, and Commercial.
Provider Advocate Account Manager
UnitedHealthcare
Albuquerque, NM
02.2017 - 03.2024
- Managed and provided support to contracted provider types within the New Mexico market. Specializing in physician, hospital, and ancillary provider types.
- Established strong relationships with key stakeholders in the healthcare industry, positioning the organization as a trusted partner in patient care.
- Promoted a culture of continuous improvement within the provider relations team, regularly soliciting feedback from healthcare providers and incorporating suggestions into strategic plans.
- Coordinated educational events for providers aimed at increasing awareness of regulatory changes as well as best practices in patient care delivery.
- Reduced waste and pursued revenue development strategies to keep department aligned with sales and profit targets.
- Collaborated with cross-functional teams to address contractual issues, ensuring timely resolution and minimizing disruption to services.
- Fostered strong, positive relationships with key providers by coordinating, facilitating and leading partnership meetings and identifying on-site enrollment opportunities.
Supervisor of Provider Collections Revenue Cycle
Presbyterian Healthcare Services
Albuquerque, NM
11.2009 - 02.2017
- Spearheaded initiatives aimed at optimizing collection efforts for insurance payments, improving overall collection rates.
- Knowledge of all accounts receivables while understanding claim aging’s.
- Overseen vendor relations with four outside vendors who assisted with revenue collections.
- Met with vendors on a bi-weekly basis to review accounts receivables and address questions or concerns.
- Reviewed/ paid vendor invoices.
- Optimized charge capture processes, resulting in increased net revenue for the organization.
- Reduced outstanding accounts receivable balances through diligent follow-up and expert negotiation skills.
Education
BBA - Business Administration and Management
University of Phoenix
Online05.2015
High School Diploma -
American High School
Albuquerque, NM01.2003
Skills
- Knowledge of insurance regulations
- Knowledge in Accounts Receivable and AR reduction
- Staff training and development
- Analytical decision-making
- Collaborative team management
- Proficient in documentation and reporting
- Organizational strategy development
- Process optimization expertise
- Workflow optimization
- Statistical analysis
Timeline
Manager, Provider Account Management Team
United Healthcare, UHG
05.2025 - Current
Manager, Provider Engagement Experience Team
UnitedHealthcare
03.2024 - 05.2025
Provider Advocate Account Manager
UnitedHealthcare
02.2017 - 03.2024
Supervisor of Provider Collections Revenue Cycle
Presbyterian Healthcare Services
11.2009 - 02.2017
BBA - Business Administration and Management
University of Phoenix
High School Diploma -
American High School