Myrna Muñoz
San Bernardino,CA
Summary
Experienced Administrative Healthcare Professional with over 15 years in program management, utilization review, and customer experience. Proven Consensus Builder with the ability to lead workgroups and implement process improvement initiatives across hospital operations. Track Record of Excellence in delivering exceptional customer service and managing high-stakes, sensitive cases.
Overview
29
29
years of professional experience
Work History
Care Experience Director
Kaiser Permanente
10.2018 - Current
- In collaboration with local area leaders, I lead and direct efforts aimed at optimizing care experience driven by evidence based practices
- Provide leadership in planning, promoting, integrating and administering care experience improvement initiatives and strategies in partnership with senior leadership
- Collaborate with senior leadership to align regional strategic plan elements into the medical center strategic plan
- Collaborate with and actively coaches senior leadership, department managers and staff to develop and implement strategies to improve Care Experience
- Serve as a visible, active and enthusiastic champion in providing leadership in implementing Care Experience improvement initiatives
- Partner with senior leadership, continuously evaluates progress and identifies and mitigates barriers to success in order to achieve targeted results
- Co-lead the Care Experience committee to ensure execution of the Care Experience action plan
- Serve as a Care Experience advisory resource for critical initiatives that impact the Care Experience
- Identify, develops and implement Care Experience improvement plan and initiatives directly related to enhancing CAHPS performance and other Care Experience metrics to reflect KP's commitment to an exceptional Care Experience
- Utilize and analyze Care Experience feedback from a variety of sources ( patient surveys/comments, focus groups, advisory councils, complaint information, direct observation, manager / staff perspective) to track and monitor patient satisfaction as the basis for developing recommendations for key initiatives
- Analyze Care Experience survey results and identifies, prioritizes, plans and oversees improvement efforts
- Report and interpret findings and progress in the form of formal oral and written presentations to the senior leaders, department managers/ directors and other end users
- Leverage customer segmentation and analyzes the diverse patient populations within assigned area and identifies the unique needs of different populations
- Provide Care Experience survey, resources, practices and data analytics education for targeted audiences
- Lead and support implementation of service excellence programs and education including behavior expectations and related initiatives
- Lead, educate and participate in leadership rounding programs
- Engage staff to continuously enhance the Care Experience by inspiring a culture of patient centered care and serving as a role model for Care Experience excellence
- Champion and ensure employee and department recognition of Care Experience excellence through use of recognition programs and development of informal approaches to team and individual recognition
- Become an expert in knowledge of industry best practices, trends and developments
- In partnership with the KP National team, ensure compliance with survey related governmental and regulatory agency standards, regulations and laws.
Executive Liaison / Senior Consultant
Kaiser Permanente
10.2016 - Current
- Coordinate high-level, sensitive grievances on behalf of the President and/or Executive Management
- Act as a liaison with the executive office to ensure a "closed-loop process" for issues raised by members and internal partners
- Define clear expectations and allocate resources to reduce conflicts and resolve grievances
- Establish performance standards for the service recovery model and clarify responsibilities
- Serve as a subject matter expert on health plan regulatory laws, policies, and procedures
- Review and implement grievance and service recovery models aligned with regulatory standards
- Project manager for executive leadership, developing and implementing performance improvement plans
- Lead the Complex Case Unit, providing guidance and direction to staff
- Conduct project briefings for executive leadership.
Senior Consultant (Complex Case Unit)
Kaiser Permanente
08.2015 - 10.2016
- Coordinate member grievances in compliance with federal, state, and health plan regulations
- Initiated investigative requests for Department Administrators, Chiefs of Service, and other key stakeholders to resolve complex cases
- Managed sensitive cases, mitigating health plan exposure
- Participated in the Member Issue Resolution Committee (MIRC) for member request decisions.
Hospital Customer Advocate
Arrowhead Regional Medical Center
06.2002 - 08.2015
- Managed daily operations of the Patient Advocacy Department
- Provided weekly trend reports to the Chief Executive Officer (CEO) and conducted daily rounds with the CEO
- Acted as a liaison between management, departments, and staff to address patient concerns
- Presented grievance trends to the Quality Review Board and participated in regulatory visits and audits
- Developed corrective action plans in response to audit findings and facilitated the grievance resolution process
- Chaired the Grievance and Customer Service Committees, identifying gaps and recommending process improvements
- Managed support staff, including interviewing, hiring, training, and conducting annual performance evaluations
- Organized and coordinated the annual Patient Advocacy Week activities for 5,000+ employees
- Delivered customer service training for all new hires and produced a monthly hospital-wide newsletter.
Financial Interviewer
Arrowhead Regional Medical Center
07.1998 - 06.2002
- Contacted insurance companies to obtain preauthorization and precertification for patient billing
- Interviewed self-pay patients to assess eligibility for public healthcare programs
- Managed a caseload of 50+ patients, prepared admission reports, and liaised with case management.
Utilization Review Technician
Arrowhead Regional Medical Center
04.1995 - 07.1998
- Screened patients for insurance eligibility and referred them to appropriate programs
- Maintained case load and submitted Treatment Authorization Requests to the State
- Managed the surgery schedule and confirmed Pre-Op and History appointments
- Ensured program compliance, taking corrective action when necessary.
Education
Bachelor of Science in Psychology -
California Baptist University Riverside
01.2013
Associate of Arts in Liberal Studies - undefined
San Bernardino Valley College
01.2006
Skills
- Project Management
- Strategic Planning
- Strategies and goals
- Issues Resolution
- Legal and Regulatory Compliance
- Creativity and Innovation
- Verbal and written communication
Additional Information
Served as President California Patient Relations 2012-2013
Timeline
Care Experience Director
Kaiser Permanente
10.2018 - Current
Executive Liaison / Senior Consultant
Kaiser Permanente
10.2016 - Current
Senior Consultant (Complex Case Unit)
Kaiser Permanente
08.2015 - 10.2016
Hospital Customer Advocate
Arrowhead Regional Medical Center
06.2002 - 08.2015
Financial Interviewer
Arrowhead Regional Medical Center
07.1998 - 06.2002
Utilization Review Technician
Arrowhead Regional Medical Center
04.1995 - 07.1998
Bachelor of Science in Psychology -
California Baptist University Riverside
Associate of Arts in Liberal Studies - undefined
San Bernardino Valley College
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