Summary
Overview
Work History
Education
Skills
Timeline
Generic

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
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
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
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
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
Online
05.2015

High School Diploma -

American High School
Albuquerque, NM
01.2003

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

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