ROSARIO PATRON
La Puente,CA
Summary
Dynamic Program Manager with a proven track record at Molina Healthcare, driving operational efficiency and achieving 98% first-pass MARx acceptance. Expert in data analysis and team leadership, I excel in enhancing regulatory compliance and delivering audit-ready results, ensuring organizational success through strategic direction and effective communication. Results-oriented Program Manager enthusiastic about taking on new challenges. Successful at developing innovative strategies to capitalize on dynamic market conditions. Strategic planner and clear communicator with an adaptable approach. Accomplished Program Manager provides in-depth understanding of developing and implementing organizational strategies. Well-versed in spearheading new initiatives to support functional operations and project completion. Excellent aptitude for financial management, budgeting, procurement and contracting. Proficient in managing logistics analysis, including inventory, and supply chain performance. Results-driven Program Manager known for high productivity and efficient task completion. Skilled in strategic planning, risk management, and stakeholder communication. Excel at using leadership, problem-solving, and adaptability to deliver projects on time and meet objectives. Bring focus on continuous improvement and team collaboration to drive success in complex environments. Knowledgeable professional with several years of experience bringing planning and problem-solving abilities. Focused on maximizing resource utilization to support scalable operations and increase bottom-line profitability. Organized and systematic with natural relationship-building and leadership talents. Business-minded professional tackling any job task with gusto and precision. Determined Front Office Supervisor delivering exceptional service and responding to questions and inquiries quickly. Demonstrates positive attitude and readiness to adapt to different situations. Resourceful professional in management operations known for high productivity and efficient task completion. Possess specialized skills in strategic planning, team leadership, and operational improvement. Excel in communication, problem-solving, and adaptability, ensuring seamless execution of business strategies and enhancement of team performance.
Overview
20
20
years of professional experience
Work History
Program Manager
Molina Healthcare, Inc.
Long Beach, California
12.2022 - Current
- Achieved 98% first-pass MARx acceptance and reduced TRC errors by 42%.
- Increased CMS-to-internal alignment to 99%, reducing discrepancies by 38%.
- Cleared 1,200+ retro items; reduced retro cycle time from 21 → 8 days.
- Prevented $450K+ annual payment leakage.
- Delivered 100% audit-ready universes.
MPSS AR Manager, Premium Billing
L.A. Care Health Plan
01.2018 - 01.2022
- Improved reconciliation accuracy to 99.4%; reduced variances 58%.
- Achieved 100% on-time regulatory disbursements for 4 years.
- Reduced payment exceptions by 40%; improved SLA compliance to 96%.
- Managed 18 staff; increased retention to 90%.
Manager, Medicare & Reconciliation
Care1st Health Plan
01.2015 - 01.2018
- Improved alignment to 99.2%; reduced 600+ mismatches monthly.
- Cut reconciliation cycle time 50%; maintained 99% accuracy.
- Achieved 0 audit findings; reduced CAP time 62%.
Manager, Data Management
Citrus Valley Health Partners
01.2013 - 01.2016
- Improved data quality 45%; increased audit pass rate to 97%.
- Reduced turnaround times 50%; eliminated $250K+ annual data risks.
Manager, Medicare Membership
SynerMed
01.2011 - 01.2013
- Increased enrollment growth; reduced disenrollment rates.
- Improved QA scores 85% → 94%; reduced ASA 35%.
Manager, Medicare Operations
SCAN Health Plan
01.2010 - 01.2011
- Improved eligibility accuracy 93% → 99%; reduced pendings 55%.
- Achieved 100% CMS transaction timeliness.
Manager, Membership Accounting
Molina Healthcare
01.2006 - 01.2010
- Improved reconciliation accuracy to 98%+; increased first-pass acceptance to 97%.
- Achieved 0 audit findings across multiple cycles.
Education
BA - Business Administration
Capella University
Skills
- Medicare Advantage Enrollment & Reconciliation
- Data analysis
- Project management
- Regulatory compliance
- Operational efficiency
- Financial reconciliation
- Process optimization
- Stakeholder engagement
- Performance reporting
- Team leadership
- Effective communication
- Problem solving
- Attention to detail
- Conflict resolution
- Time management
- Onboarding and training
- Supply chain management
- Vendor sourcing
- Resource allocation
- Strategic direction
- Good judgment
- Partnerships and resource mobilization
- Financial analysis
- Effective negotiations
- Team leadership and direction
- Performance monitoring
- Flexible and adaptable
- CMS MARx Transactions
- PCUG Interpretation
- Audit Readiness
- Regulatory Compliance
- Data Governance
- Cross-Functional Leadership
- Payment Integrity
- Workforce Development
- Operational Optimization
Languages
- Spanish
- English
- Spanish
Core Leadership Competencies
- Medicare Advantage Enrollment & Reconciliation
- CMS MARx Transactions
- PCUG Interpretation
- Audit Readiness
- Regulatory Compliance
- Data Governance
- Cross-Functional Leadership
- Payment Integrity
- Workforce Development
- Operational Optimization
Timeline
Program Manager
Molina Healthcare, Inc.
12.2022 - Current
MPSS AR Manager, Premium Billing
L.A. Care Health Plan
01.2018 - 01.2022
Manager, Medicare & Reconciliation
Care1st Health Plan
01.2015 - 01.2018
Manager, Data Management
Citrus Valley Health Partners
01.2013 - 01.2016
Manager, Medicare Membership
SynerMed
01.2011 - 01.2013
Manager, Medicare Operations
SCAN Health Plan
01.2010 - 01.2011
Manager, Membership Accounting
Molina Healthcare
01.2006 - 01.2010
BA - Business Administration
Capella University