Michelle Cruz
Bogota,NJ
Summary
Enthusiastic Servant Director eager to contribute to team success through hard work, attention to detail and excellent organizational skills. Clear understanding of change management and training in process improvement. Motivated to learn, grow and excel in the servant industry.
Overview
19
19
years of professional experience
Work History
Director Referral Management
Urban Health Plan
The Bronx, NY
01.2022 - Current
- Developed and cultivated lucrative relationships with both new and existing clients through effective communication and exemplary interpersonal skills.
- Operated in self-directed environment with minimal input to solve problems and implement resolutions.
- Oversaw training and onboarding process for all newly hired employees within Urban Health Plan.
- Collaborated with company leaders to support consistency and best practices.
- Evaluated medical guidelines and benefit coverage to determine appropriateness of services.
- Identified plans and resources required to meet project goals and objectives.
- Developed and initiated projects, managed costs, and monitored performance.
- Fostered relationships with vendors to promote positive working relationships.
- Established metrics and organization methods for training and team check-in sessions.
- Created, implemented and maintained training plans and schedules using internal and contracted resources.
Assistant Director Ambulatory Care
New York City Health And Hospitals/Belvis Gotham
The Bronx, NY
10.2018 - 01.2022
- Oversaw medical practices, Adult Primary Care, Women's Health Services, Dental, Podiatry and Ophthalmology; resulting in increase visits by 30% and decrease in denial claims by 40% over course of employment.
- Developed and updated policies and procedures, maintaining compliance with statutory, regulatory and local, state and federal guidelines relating to HIPAA, benefits administration and general liability,
- Recruited, hired and trained all staff, providing direct supervision, ongoing staff development and continuing education to employees, resulting in, decrease of employee turnover 20%.
- Championed all Patient Center Medical Home activities; resulting in achieving and maintaining level III status year to year.
- Conducted thorough investigations of employee activities to identify and target operational and behavioral discrepancies; resulting in increase of staff engagement by 30%, measured by conducting pulse surveyors quarterly.
- Conducted routine facility inspections, identifying areas needing improvement and eliminating hazards posed to staff and residents for continued compliance with associated regulations; resulting in implementation of building safety rounds
- Implemented successful healthcare program through professionalism, quality of care, medical teaching and patient satisfaction, resulting increase patient experience scores for overall experience, communication and moving through visit, by 20% over three quarters.
Associate Director Ambulatory Care
New York City Health And Hospital/ Harlem Hospital
New York, NY
06.2015 - 10.2018
- Trained and developed department leaders and management staff for specific projects and ongoing operational needs; resulting in increased practice access in Primary Care, Women's Services & Ophthalmology by 30 % month to month
- Oversaw large portfolio of projects to support teams, report progress and influence positive outcomes for key stakeholders, to include Patient Center Medical Home (PCMH), Delivery System Reform Incentive Payment. (DSRIP), Patient Access and Patient Experience; resulting in achieving PCMH level III status, collecting of DRSIP dollars for palliative care initiatives, improving patient access by 30% and making improvements in overall patient experience.
- Performed continuous evaluations of content and plans in order to enhance delivery and improve effectiveness.
- Tracked attendance and progress against goals for each participant.
- Identified and solved internal problems related to employee turnover by revamping training approaches.
Patient Experience Coordinator
Mount Sinai Health System
New York, NY
10.2012 - 06.2015
- Oversaw high profile projects for by planning, designing, and scheduling phases, to improve Patient Experience outcomes; resulting in assigned Medical Surgery Units achieving increase in all domains on Press Ganey Survey.
- Fostered relationships with vendors to promote positive working relationships.
- Drove team success through shared vision and recognition of quality performance. resulting in increased Patient Experience scores by 30%
- Updated operational methods, oversaw accounting procedures, tracked information and compiled data to improve efficiency.
- Tracked project and team member performance closely to quickly intervene in mistakes or delays.
- Mentored new hires, resulting in stronger staff development and increased productivity.
- Monitored participant workflow and behaviors throughout training process.
Assistant Director Managed Care
New York City And Hospital
New York, NY
03.2006 - 10.2012
- Worked closely with Site Directors to provide effective assistance for specific aspects of business operation, resulting increasing covered lives by 25% and reducing denial claims by 40%
- Trained and mentored new employees on industry practices and business operations.
- Worked with team leaders to arrange schedules based on production requirements and available resources.
- Created and updated physical records and digital files to maintain current, accurate and compliant documentation.
- Developed financial models, analytics and automated reporting and forecasting tools to increase productivity.
- Improved financial operations with careful, in-depth analysis and proactive recommendations for improvement.
- Compiled and coordinated financial data for analysis and reconciliation.
- Compiled data, reports and year-end audit information.
Hospital Care Investigator
New York City Health And Hospitals
New York, NY
03.2003 - 03.2006
- Maintained structured and timely contact with applicants and government agencies, managed over 100 inpatient cases monthly
- Protected patient rights by overseeing employee HIPAA education program.
- Communicated patient incidents or high-risk complaints to Chief Financial Controller; resulting in payments being received from contracted partners.
- Screened uninsured hospital patients to determine eligibility for federal, state and county medical or disability assistance, resulted in 20% of uninsured patients qualifying for health care coverage.
- Input gathered information and researched data on applicants into computer system OminPro Systems.
- Communicated with people from various cultures and backgrounds on application process
Education
Bachelor of Science - Health Administration
Monroe College
The Bronx, NY12.2005
Skills
- Change Implementation
- Continuous Improvement
- Team Development
- Business Planning and Strategy
- Change Management Process
- Excellent Interpersonal Skills
Timeline
Director Referral Management
Urban Health Plan
01.2022 - Current
Assistant Director Ambulatory Care
New York City Health And Hospitals/Belvis Gotham
10.2018 - 01.2022
Associate Director Ambulatory Care
New York City Health And Hospital/ Harlem Hospital
06.2015 - 10.2018
Patient Experience Coordinator
Mount Sinai Health System
10.2012 - 06.2015
Assistant Director Managed Care
New York City And Hospital
03.2006 - 10.2012
Hospital Care Investigator
New York City Health And Hospitals
03.2003 - 03.2006
Bachelor of Science - Health Administration
Monroe College
Reiki
Holistic meditation and self care expert
Reiki
Holistic meditation and self care expert
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