Michael Marquez
Pensacola,FL
Summary
Attentive and goal-focused brings successful approach to cultivating complex best practices to meet organizational and regulatory expectations. Detail-oriented focus on achieving expected outcomes. Enthusiastic hard worker with expertise in cultivating lucrative client relationships and implementing better processes and procedures.
Overview
7
7
years of professional experience
Work History
Health Development Network Manager
Island Doctors
09.2024 - Current
- Provider Relations and Contract Management:Conduct monthly meetings with Medicare Advantage plans such as Humana, Aetna, and Cigna to review financial and care gap reports, ensuring compliance and addressing non-compliant patients.
Negotiate and manage contracts with affiliate providers, focusing on financial performance and practice improvement.
Collaborate with local vendors to ensure that wholly owned clinics receive optimal support and resources. - Facilitated smooth transition to new EMR platforms through comprehensive training programs and ongoing guidance for medical staff.
- Strategic Planning and Development:Develop and implement strategies to expand and enhance the provider network, aligning with organizational goals and market needs.
Identify and pursue new business opportunities to increase market share and improve service delivery. - Operational Oversight:Monitor and analyze network performance metrics, implementing improvements to enhance efficiency and patient satisfaction.
Ensure compliance with healthcare regulations and organizational policies across the network. - Marketing and Community Engagement:Organize and host events to market the company's services, fostering community engagement and brand awareness.
Develop and distribute marketing materials to promote the organization's services and attract new patients. - Team Leadership and Collaboration:Lead cross-functional teams in the execution of network development initiatives.
Provide mentorship and guidance to staff, fostering a collaborative and high-performing work environment.
Senior Provider Consultant - Medicare
Better Health Group
07.2022 - 09.2024
- Provided guidance to healthcare professionals regarding Medicare regulations, billing practices, and compliance requirements
- Act as a liaison between providers health plans and Better Health Group resources and program monitoring providers to ensure delivery of high quality care to Medicaid , Medicare , and Medicare Advantage beneficiaries while reducing cost.
- Dynamic and results-driven professional with extensive experience in business development and marketing across Alabama, Florida, and Texas. Proven track record of driving growth, increasing market share, and building strong client relationships. Adept at developing and executing strategic marketing plans to meet organizational goals.
- Detail-oriented and efficient operations and project management professional with a proven track record in optimizing processes, enhancing operational efficiency, and driving continuous improvement in healthcare settings. Experienced in managing projects across various regions, ensuring compliance, and improving service delivery.
- Experienced in managing projects, conducting analytics, and performing risk analysis and revenue reports.
Physician Liaison
Tamara Lopez Diaz MD PA
03.2019 - 02.2024
- Stayed current with advances in medical knowledge, technology, and treatment modalities through continuous learning and professional development
- Contributed to developing and implementing clinical protocols, policies, and procedures for consistent and high-quality care delivery
- Participated in various practice management activities, such as staff meetings, quality improvement initiatives, and strategic planning sessions
- Developed a strong reputation for providing compassionate care and fostering long-term relationships with patients and their families
- Ensured compliance with applicable regulations when sharing information with outside parties.
- Developed and maintained relationships with physicians and other healthcare professionals to promote organization's services.
- Resolved conflicts between patients and families and healthcare providers when necessary.
- Identified new referral sources, developed marketing materials, and coordinated outreach activities.
- Conducted presentations at medical staff meetings to educate providers about organization's services.
- Prepared monthly activity reports outlining progress made towards achieving goals set forth by department head.
- Participated in budgeting process by providing input on costs associated with provider relations initiatives.
- Assisted in the development of physician referral network by meeting with existing and potential referring physicians.
- Attended health fairs, community events, seminars, conferences, and other networking opportunities to build relationships with providers.
- Maintained a database of contacts and tracked all interactions with key stakeholders.
- Advised physicians on best practices related to organizational processes.
- Managed multiple projects simultaneously while adhering to deadlines established by upper management.
- Created reports on referral patterns for management review.
- Utilized well-developed communication, active listening and persuasion talents when interacting with people.
- Participated in weekly meetings with professionals to discuss ways to build referral base and identify ineffective techniques.
- Maintained professionality and efficiency while working closely with leadership.
- Established or maintained cooperative relationships with representatives of community, consumer or public interest groups.
- Developed plans or materials to communicate organizational activities beneficial to environment, public safety or other important social issues.
Education
Bachelor of Business -
The University of West Florida
Pensacola, FL06.2025
Associate of Arts -
College of Central Florida
Ocala, FL05.2021
High School Diploma -
Hialeah High School
Hialeah, FL05.2014
Skills
- Healthcare Expertise: Medicare, Medicaid, Medicare Advantage, Health Insurance, HIPAA Compliance
- Consulting and Advisory: Strategic Advice, Performance Improvement, Provider Engagement
- Relationship Management: Contract Negotiation, Stakeholder Collaboration, Communication
- Data Analysis and Reporting: Data Analytics, Reporting, Healthcare Data Systems
- Project Management: Planning, Execution, Cross-functional Team Leadership
- Problem-Solving: Critical Thinking, Decision Making, Analytical Skills
- Leadership: Mentoring, Team Collaboration, Motivation
- Technology: Healthcare Management Software, EHR Systems, Telehealth Platforms
Additional Information
ACCOMPLISHMENT, Generated a 30% increase in revenue within the first year of consulting, Implemented cost-saving measures that led to a reduction in expenses by 20%, resulting in a significant improvement in company profitability
Languages
Spanish
Native or Bilingual
English
Native or Bilingual
Timeline
Health Development Network Manager
Island Doctors
09.2024 - Current
Senior Provider Consultant - Medicare
Better Health Group
07.2022 - 09.2024
Physician Liaison
Tamara Lopez Diaz MD PA
03.2019 - 02.2024
Associate of Arts -
College of Central Florida
High School Diploma -
Hialeah High School
Bachelor of Business -
The University of West Florida