RONDA BROWN

Led a team in the Molina Healthcare Services Department to deliver integrated care for high-need members, coordinating with providers and multidisciplinary team members.

• Maintained confidentiality of client records to comply with HIPAA guidelines.
• Contributed to the achievement of departmental goals through consistent adherence to established performance metrics and benchmarks for care review processing tasks.
• Enhanced the quality of care review processes by updating policies, procedures, and guidelines in accordance with industry best practices.
• Assisted in the development of training materials to enhance the knowledge and skills of new Care Review Processors within the organization.

• Increased efficiency in responding to provider inquiries about case status updates or clarifications needed in submitted documents through effective communication techniques.
• Ensured a high level of customer satisfaction among healthcare providers through prompt resolution of concerns or issues related to the care review process.
• Contacted physician offices to obtain missing information from authorization requests as requested by medical director.
• Assisted in the development of training materials to enhance the knowledge and skills of new Care Review Processors within the organization.