Osvaldo Alcazar Pulido
Summary
Dependable Provider Relations Advocate with track record of success in field, attention to detail and proactive mindset. Seeks opportunities to improve processes and workflows for team benefit. Conscientious, hardworking and excels at multitasking in fast-paced environments.
Overview
5
5
years of professional experience
Work History
Provider Relations Advocate
Optum, UnitedHealth Group
San Diego, CA
04.2022 - Current
- Facilitated the onboarding process for new providers, including verifying credentialing information and contracting.
- Compiled and maintained records of provider contracts, claims processing issues, authorizations, and other related matters.
- Developed and implemented strategies to improve provider relations by increasing communication with providers.
- Conducted outreach activities to engage providers in network development initiatives.
- Coordinated provider orientations to ensure a comprehensive understanding of company policies and procedures.
- Monitored provider performance metrics to identify areas needing improvement or corrective action plans.
- Responded promptly to inquiries from providers regarding authorization requests, payment issues, benefit coverage determinations.
Community Outreach Representative
UnitedHealthcare La Jolla
La Jolla
08.2021
- Connected individuals with available and relevant resources
- Conducted community workshops to promote different programs and educate the public on available services
- Developed presentations and media to promote community resources and UHC Medi-Cal plan information at seminars and other local events
- Developed long-lasting partnerships with local leaders, management team, and peers with active engagement, exemplary communication, and consistent issue resolution
- Networked with local organizations, leaders, and consumers, resulting in the establishment of new and lasting partnerships and relationships
- Acted as the main point of contact between management, clinical staff, and the external community
- Built partnerships with related organizations to develop support and gain greater attention for important issues.
Community Building Coordinator
Community HousingWorks San Diego
San Diego
06.2020 - 07.2021
- Served as point of contact for internal and external customers seeking support and information
- Directed vendors, facilities staff and service providers as required to create efficient and non-disruptive work environment
- Coordinated events and engaged residents/provided resources at two affordable housing apartment complexes (Maplewood)
- Community engagement (active listening)
- Engaged residents to organize, mobilize, and educate people to build a sense of community
- Referred and engaged residents to internal and external programs to support residents and their futures
- Recruited and encouraged resident participation in the planning, coordination, and implementation of regular resident and family events.
Member Relations Specialist
Community Health Group Chula Vista
Chula Vista
09.2019 - 06.2020
- Researched and rapidly resolved client conflicts to maintain key accounts
- Maintained updated knowledge of internal processes and industry best practices to optimize service delivery
- Learned internal systems (Medi-Cal) and related service role duties to provide skilled team backup in handling customer demands
- Trained and directed new employees in call script use, conflict resolution and data entry practices to boost customer satisfaction ratings
- Helped large volume of customers every day with positive attitude and focus on customer satisfaction
- Learned and maintained in-depth understanding of product (Medi-Cal) and service information to offer knowledgeable and educated responses to diverse customer questions.
Education
Communication (Business) -
University of California, San Diego La Jolla
06.2019
Skills
- Adaptability Expert
- Critical thinking and problem solving Expert
- Microsoft Office Expert
- Computer Skills Expert
- Ability to Multitask Expert
- Fast Learner Expert
- Ability to Work Under Pressure Expert
- Effective Time Management Expert
- Dedicated team player Expert
- Provider Relationship Management
Timeline
Provider Relations Advocate
Optum, UnitedHealth Group
04.2022 - Current
Community Outreach Representative
UnitedHealthcare La Jolla
08.2021
Community Building Coordinator
Community HousingWorks San Diego
06.2020 - 07.2021
Member Relations Specialist
Community Health Group Chula Vista
09.2019 - 06.2020
Communication (Business) -
University of California, San Diego La Jolla
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