Motivated and results-driven Managed Care Specialist with 10 years of experience in healthcare administration and insurance coordination. Dedicated to improving the quality of care for patients, possesses strong communication skills and a passion for ensuring timely reimbursement. Proven track record of enhancing operational efficiency, committed to optimizing healthcare processes and delivering exceptional outcomes.
Overview
13
13
years of professional experience
Work History
Manage Care Specialist/Population Health Specialist II
Miami Beach Community Health Center
02.2016 - 02.2024
Developed and implemented care plans for complex patient populations in a managed care setting
Utilized data analysis to identify high-risk patients and implement targeted interventions
Collaborated with multidisciplinary teams to coordinate care and improve health outcomes
Provided disease management education and support to patients with chronic conditions
Conducted comprehensive assessments and evaluations to monitor and track patient progress
Facilitated referrals to community resources and support services for patients in need
Ensured compliance with quality measures and regulatory requirements in patient care
Participated in continuous quality improvement initiatives to optimize population health outcomes
Intake Coordinator/Correspondence Specialist
Simply Healthcare Plans, Inc.
12.2013 - 10.2015
Managed client intake process, including gathering necessary information and conducting assessments
Scheduled and coordinated appointments for clients, while maintaining accurate records and documentation
Responded to inquiries from clients and external parties, providing information and assistance as needed
Collaborated with other team members to ensure efficient intake processes and effective communication
Handled correspondence with clients, insurers, and healthcare providers in a professional and timely manner
Maintained confidentiality of client information and followed all relevant privacy regulations
Utilized electronic health record systems to input and update client information accurately
Provided excellent customer service and support to clients throughout the intake process
Facility Coordinator/Customer Service Representative
Logisticare Solutions
08.2011 - 08.2012
Managed facility operations and maintenance for a large commercial building
Coordinated event logistics and set-up for conferences and meetings
Provided exceptional customer service by responding to inquiries and resolving issues
Facilitated communication between vendors, staff, and clients to ensure smooth operations
Developed and implemented safety procedures to ensure a secure environment for staff and visitors
Scheduled and supervised maintenance tasks to keep facilities in optimal condition
Maintained accurate records of inventory and equipment for efficient resource management
Collaborated with cross-functional teams to plan and execute facility improvement projects
Education
GED -
State Board of Education
State Of Florida
11-2024
Skills
Medical Terminology
EMR
HEDIS
Multi-Line Telephone Systems
Quality improvement
Patient advocacy
Data entry proficiency
Languages
English
Full Professional
Spanish
Professional Working
Timeline
Manage Care Specialist/Population Health Specialist II
Miami Beach Community Health Center
02.2016 - 02.2024
Intake Coordinator/Correspondence Specialist
Simply Healthcare Plans, Inc.
12.2013 - 10.2015
Facility Coordinator/Customer Service Representative
Logisticare Solutions
08.2011 - 08.2012
GED -
State Board of Education
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