Summary
Overview
Work History
Skills
Community Service
Languages
Key Skills And Core Competencies
Bilingual in Spanish
Timeline
Generic

Rachel Maldonado Madrid

McAllen

Summary

Experienced Clinic Administrator with 34 years in Medical Practice Management and 13 years in Medicare Advantage Managed Care. Proven track record in delivering high-quality patient care while effectively managing clinic operations. Skilled in staff coordination, appointment scheduling, and conflict resolution to enhance operational efficiency. Committed to achieving performance targets and fostering professional development among medical staff.

Overview

34
34
years of professional experience

Work History

Clinic Administrator

WellMed At Cross Roads
McAllen
01.2023 - Current
  • Ensured compliance with all relevant laws, regulations, and standards.
  • Coordinated the scheduling of patients for appointments.
  • Created reports on clinic performance metrics such as revenue or patient satisfaction scores.
  • Responded promptly to inquiries from patients or other healthcare organizations.
  • Developed and maintained clinic policies and procedures.
  • Organized employee training sessions on topics such as safety protocols or new software applications.
  • Oversaw hiring processes for new employees including interviews and background checks.
  • Managed communications within the clinic including emails, phone calls, interoffice memos.
  • Collaborated with physicians, nurses and other healthcare professionals to ensure quality care for patients.
  • Generated weekly and monthly performance reports for senior management review.
  • Maintained patient records in accordance with HIPAA guidelines.
  • Provided administrative support to physicians and other medical staff.
  • Monitored inventory levels of office supplies, medical equipment, and medications.
  • Implemented strategies to improve operational efficiency in the clinic setting.
  • Evaluated employee performance, completed written appraisals and assisted in developing individual performance goals as provided in company policy and procedural guidelines.
  • Developed work schedules for medical professionals and coordinated with client appointment requests to staff professionals appropriately and meet demand for specializations.
  • Collaborated with clinical partners and in-house team leads to develop and implement solutions for systems affecting daily clinic operations.
  • Reviewed company employee records to gain insight into individual learning patterns, recruitment, professional development and staff retention.
  • Worked individually with staff to facilitate problem solving and identify areas for personal improvements in daily operations and in-house career advancement strategies.
  • Attended professional conferences and public events to promote company presence within medical and broader community, connecting with prospective clients and other professionals.
  • Received and resolved personal complaints against clinic staff and questions or concerns regarding clinic policies and systems.
  • Scheduled and communicated staff meetings, using verbal and written communication to inform employees of requirement for attendance, time and subject matter.
  • Tracked, organized and counted clinic stock and supplies.
  • Analyzed clinic performance data to identify trends and areas for improvement.
  • Maintained a safe and clean environment in compliance with health and safety standards.
  • Collaborated with healthcare professionals to develop and expand clinic services.
  • Developed and implemented policies and procedures to comply with healthcare regulations.
  • Coordinated with medical staff to ensure adherence to clinical protocols and patient satisfaction.
  • Monitored clinic budget, controlled expenses, and optimized resource allocation.
  • Implemented policy changes and communicated information and procedures through organizational staff meetings.
  • Addressed operational issues promptly to minimize impact on clinic services.
  • Implemented patient satisfaction initiatives to improve service quality and address grievances.
  • Facilitated continuing education and professional development opportunities for staff.
  • Ensured clinic compliance with federal, state, and local healthcare regulations.
  • Oversaw daily clinic operations, ensuring efficient patient flow and high-quality care.
  • Oversaw ordering, purchasing and maintenance of clinical equipment.
  • Led staff meetings to communicate updates, gather feedback, and discuss strategies.
  • Assessed need for additional staff, equipment and services based on historical data and seasonal trends.
  • Coordinated work activities and scheduling of medical, nursing and physical plant staff.
  • Directed, supervised and evaluated medical, clerical or maintenance personnel.

Career Sales Broker/Agent

Humana Insurance
07.2021 - 12.2022
  • Attended trade shows, conferences and other networking events to promote company's products and services.
  • Established relationships with vendors in order to obtain best prices on supplies needed for sales activities.
  • Identified opportunities for cross-selling additional products or services.
  • Utilized CRM software tools such as Salesforce or Oracle Siebel CRM applications.
  • Collaborated with marketing team members in creating promotional materials such as brochures, flyers and emails campaigns.
  • Developed comprehensive knowledge of company's offerings in order to effectively respond to customer inquiries.
  • Generated regular reports that tracked progress against established sales goals and objectives.
  • Researched competitor activities, pricing structures, promotional offers and target markets.
  • Maintained relationships with existing clients by providing them with up-to-date information on new products and services.
  • Created presentations to demonstrate product features and benefits to prospective customers.
  • Analyzed customer feedback data to develop strategies for improving customer satisfaction levels.
  • Provided support to customers throughout the sales process, including answering questions, resolving complaints and handling disputes.
  • Applied strict company and regulatory standards when producing contracts and documentation.
  • Stayed up-to-date on marketplace trends and researched items in detail.
  • Crafted and implemented marketing strategies to attract new clients and expand market presence.
  • Provided personalized investment advice and strategies tailored to individual client risk profiles and financial goals.
  • Maintained strict compliance with industry regulations and ethical standards to protect clients and ensure transparency.
  • Managed high-stress situations effectively, making critical decisions under tight deadlines to safeguard client interests.
  • Utilized cutting-edge technology and financial software to streamline transaction processes and enhance client service delivery.
  • Educated clients on the implications of different investment vehicles and strategies in relation to their overall financial plan.
  • Participated in continuous professional development activities to stay current with financial products, market conditions, and regulatory changes.
  • Generated sales by prospecting leads, cold calling and negotiating advantageous deals.
  • Assisted customers during selection process and helped choose perfect products to meet individual needs.
  • Scheduled and attended weekly appointments with clients.
  • Built strong, professional relationships through identification of client needs, which increased overall sales and opportunities.
  • Communicated effectively with clientele to maintain customer satisfaction and loyalty.
  • Networked to build client base and promote products to new and existing clients.
  • Resolved customer issues and offered continual support throughout sales, delivery and processes.
  • Created detailed reports summarizing key performance indicators for management review.
  • Reported regularly to senior management on client activity and business development progress.
  • Analyzed performance data to identify areas for improvement and growth.
  • Responded to client inquiries and resolved issues promptly.
  • Kept abreast of regulatory changes and industry standards to ensure compliance.
  • Prepared and delivered sales presentations.

Clinic Administrator

WellMed At Cross Roads
McAllen
04.1991 - 06.2021
  • Ensured compliance with all relevant laws, regulations, and standards.
  • Coordinated the scheduling of patients for appointments.
  • Created reports on clinic performance metrics such as revenue or patient satisfaction scores.
  • Assisted with billing process and accounts receivable management.
  • Responded promptly to inquiries from patients or other healthcare organizations.
  • Developed and maintained clinic policies and procedures.
  • Performed data entry for patient demographics, insurance information.
  • Organized employee training sessions on topics such as safety protocols or new software applications.
  • Oversaw hiring processes for new employees including interviews and background checks.
  • Managed communications within the clinic including emails, phone calls, interoffice memos.
  • Collaborated with physicians, nurses and other healthcare professionals to ensure quality care for patients.
  • Generated weekly and monthly performance reports for senior management review.
  • Collaborated with external vendors to coordinate services such as laboratory testing or imaging studies.
  • Processed insurance claims for reimbursement from third party payers.
  • Maintained patient records in accordance with HIPAA guidelines.
  • Provided administrative support to physicians and other medical staff.
  • Conducted regular audits of financial documents to ensure accuracy and completeness.
  • Monitored inventory levels of office supplies, medical equipment, and medications.
  • Coordinated facility maintenance activities such as cleaning services or repairs.
  • Implemented strategies to improve operational efficiency in the clinic setting.
  • Evaluated employee performance, completed written appraisals and assisted in developing individual performance goals as provided in company policy and procedural guidelines.
  • Developed work schedules for medical professionals and coordinated with client appointment requests to staff professionals appropriately and meet demand for specializations.
  • Participated in development of strong medical team by evaluating applicants, interviewing applicants and training new hires on clinic policies and procedures.
  • Coordinated clinic activities to schedule appropriate teams together to meet requirements for uncommon procedures, verifying staff availability for clients needing special attention.
  • Collaborated with clinical partners and in-house team leads to develop and implement solutions for systems affecting daily clinic operations.
  • Reviewed company employee records to gain insight into individual learning patterns, recruitment, professional development and staff retention.
  • Worked individually with staff to facilitate problem solving and identify areas for personal improvements in daily operations and in-house career advancement strategies.
  • Attended professional conferences and public events to promote company presence within medical and broader community, connecting with prospective clients and other professionals.
  • Received and resolved personal complaints against clinic staff and questions or concerns regarding clinic policies and systems.
  • Scheduled and communicated staff meetings, using verbal and written communication to inform employees of requirement for attendance, time and subject matter.
  • Tracked, organized and counted clinic stock and supplies.
  • Strengthened and aligned daily operations with patient needs based on collected feedback and continuous improvement plans.
  • Implemented technology solutions to improve clinic operations and patient care.
  • Led quality improvement projects to enhance clinical outcomes and patient experiences.
  • Analyzed clinic performance data to identify trends and areas for improvement.
  • Supervised internal and external communications by answering queries and complaints.
  • Managed a team of healthcare professionals, including hiring, training, and performance evaluations.
  • Maintained a safe and clean environment in compliance with health and safety standards.
  • Collaborated with healthcare professionals to develop and expand clinic services.
  • Coordinated community outreach programs to promote clinic services and public health awareness.
  • Developed and implemented policies and procedures to comply with healthcare regulations.
  • Coordinated with medical staff to ensure adherence to clinical protocols and patient satisfaction.
  • Monitored clinic budget, controlled expenses, and optimized resource allocation.
  • Negotiated contracts with suppliers and service providers to secure cost-effective solutions.
  • Implemented policy changes and communicated information and procedures through organizational staff meetings.
  • Addressed operational issues promptly to minimize impact on clinic services.
  • Implemented patient satisfaction initiatives to improve service quality and address grievances.
  • Prepared and presented reports on clinic performance to stakeholders.
  • Ensured clinic compliance with federal, state, and local healthcare regulations.
  • Managed clinical budgets, billing systems and insurance negotiations.
  • Developed relationships with healthcare providers to sustain strong referral pipeline.
  • Oversaw daily clinic operations, ensuring efficient patient flow and high-quality care.
  • Managed patient records system to ensure accuracy, confidentiality, and legal compliance.
  • Oversaw ordering, purchasing and maintenance of clinical equipment.
  • Established and maintained relationships with insurance companies and other payers.
  • Led staff meetings to communicate updates, gather feedback, and discuss strategies.
  • Collaborated with multi-disciplinary staff to improve overall patient care and response times.
  • Explained policies, procedures and services to patients.
  • Maintained records management system to process personnel information and produce reports.
  • Managed changes in integrated health care delivery systems and technological innovations while keeping focus on quality of care.
  • Maintained communication and transparency with governing boards, department heads and medical staff.
  • Assessed need for additional staff, equipment and services based on historical data and seasonal trends.
  • Maintained awareness of government regulations, health insurance changes and financing options.
  • Coordinated work activities and scheduling of medical, nursing and physical plant staff.
  • Recruited, hired and trained new medical and facility staff.

Skills

  • Operations Management
  • Patient scheduling
  • Regulatory compliance
  • Performance reporting
  • Employee training
  • Budget management
  • Data analysis
  • Inventory management
  • Team collaboration
  • Customer service
  • Conflict resolution
  • Problem solving
  • Process improvement
  • Quality assurance
  • Communication skills
  • Office administration
  • Risk Management
  • Quality Assurance
  • Insurance and Billing Procedures
  • Claims Processing
  • Electronic Health Records
  • ICD10
  • CPT Codes
  • Medicare Guidelines
  • Medicaid Guidelines
  • Human Resources
  • Compensation
  • Payroll
  • Staff Training and Development
  • Business Operations Organization
  • Report Development and Presentation
  • MS Word
  • Excel
  • PowerPoint
  • Business Performance Improvement
  • Training and Development
  • Stars Measures
  • HEDIS
  • CAHPS
  • HOS
  • Medication Adherence
  • Network Experience
  • Network Contracting and Development
  • Clinical management
  • Corporate compliance
  • Employee recruitment
  • HIPAA compliance
  • Healthcare administration
  • Marketing
  • Goal attainment
  • Recruit well-qualified staff
  • Patient satisfaction
  • Employee performance evaluations
  • Performance monitoring
  • Organizational goal development

Community Service

  • Church Secretary for 7 years at Crossroads Baptist Church
  • Finance committee at Crossroads Baptist Church
  • Volunteer for orphanage in Progresso Mexico-coordinate food and clothes drives
  • Volunteer with Red Cross during disaster events

Languages

Spanish, Bilingual

Key Skills And Core Competencies

Managed office operations and workflow, office staff, including recruitment, performance management and training/development of staff. In charge of compliance of all Clinic Metrics, including Customer Service, Membership, and Retention. Providing continual process improvement including all Clinic processes and services. Ensured that Clinic was promoted through marketing and Community Relations., Provide support and performed regular Quality Assurance Reviews for patient intake, registration, and scheduling functions. Met guidelines for Joint Commission, OSHA, HIPAA, and Office Procedures manuals. Managed insurance and billing related procedures of the facility and solved queries of the patients regarding their insurance renewal and expiry. Managed our claims department ensuring end to end processing of claims. Electronic and paper health record. ICD10 and CPT Codes. Medicare and Medicaid Guidelines., Generated payroll. Personnel records maintenance. Maintained a check on the equipment used in the office and facilitated repair or replacement as per requirement. Staff training and development/hiring and retention., Ability to develop and present comprehensive reports. Proficiency with MS Word, Excel, PowerPoint. Business performance improvement, implementing training and development of providers through education programs. Identified gaps in clinic Metrix and developed teams to address action plans. Stars Measures HEDIS, CAHPS, HOS and Medication Adherence., Help implement training and development of external providers through education programs. Identify gaps in network composition and services to aid network contracting and development teams.

Bilingual in Spanish

English
Professional

Timeline

Clinic Administrator

WellMed At Cross Roads
01.2023 - Current

Career Sales Broker/Agent

Humana Insurance
07.2021 - 12.2022

Clinic Administrator

WellMed At Cross Roads
04.1991 - 06.2021

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Rachel Maldonado Madrid