Ryan Shepherd
Temecula,CA
Summary
Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals. Seeking a position to leverage his skills in Health Informatics and Information Technology.
Overview
15
15
years of professional experience
Work History
CARE REVIEW PROCESSOR II
Molina Healthcare
10.2024 - Current
- Supported timely decision-making on case reviews by accurately maintaining case information within the database system.
- Maintained confidentiality at all times while handling sensitive patient information according to HIPAA regulations during the execution of daily tasks related to care reviews.
- Enhanced the quality of care review processes by updating policies, procedures, and guidelines in accordance with industry best practices.
- Notified care access, monitoring nurses and case managers of hospital admissions and changes in member status to facilitate up-to-date recordkeeping.
Utilization Management Coordinator
Riverside Medical Clinic
09.2022 - 06.2024
- Evaluated medical guidelines and benefit coverage to determine appropriateness of services.
- Performed prior authorization review of services requiring notification.
- Obtained authorizations from multiple insurance carriers for various levels of care.
- Submitted cases for criteria failures and helped facilitate resolutions and approvals.
Resource Analyst
University Of Phoenix
05.2022 - 02.2023
- Conduct regulatory scheduled progression checks with assigned students.
- Utilize the guidance system and students’ personal career plans to support local career achievement.
- Conduct proactive outreach to students to generate recommendations and follow up on internally generated reports of inquiries.
- Identify students at higher risk for not progressing through their program by reviewing internally generated reports.
- Assist in the development, coordination, and execution of internal and external events
- Open and Close Campus Student Resource Center.
IS Manager
Innovative Healthcare Solutions
11.2018 - 01.2022
- Assume responsibility for project tasks and ensure they are completed in a timely fashion
- Maximized performance by monitoring daily activities and mentoring team members.
- Evaluate, test, and recommend new opportunities for enhancing software, hardware, and information technology processes
- Monitored and analyzed business performance to identify areas of improvement and make necessary adjustments.
- Communicated clearly with employees, suppliers and stakeholders to keep everyone on same page and working toward established business goals.
- Controlled costs to keep business operating within budget and increase profits.
- Improved safety procedures to create safe working conditions for workers.
- Developed and implemented business strategies to achieve business goals and stay competitive.
- Maintained positive customer relations by addressing problems head-on and implementing successful corrective actions.
- Implement security measures
- Work with EHR vendor to provide onsite support
- Anticipate and report the cost of replacing and/or updating computer items
- Consult with the practice manager and clinical team on IS recommendations.
Operations Specialist
United States Navy
01.2010 - 12.2017
- Utilized computers, communication equipment, and personal navigation devices to complete tasks quickly and accurately.
- Professional training and development.
- Communicated daily operational status reports via verbal and written presentations to leadership.
- Analyze sensitive data and communicate key details to management.
- Installation of management and validation services.
- Verifies that computer and network operations are monitored.
- Consults on specific application issues.
- Interpreted and evaluated complex and tactical situations.
- Operate altitude and surveillance radars.
- Provide command technical information and assistance.
- Effectively troubleshoot and resolve complex operating system problems via telephone.
- Collected, arranged, and input information into database system.
- Tracked and analyzed reports to determine needed improvements.
- Motivated and trained employees to maximize team productivity.
- Assisted various departments with change by communicating new improvement plans and expectations.
Education
No Degree - Health Information Systems
University of Phoenix
2022
Bachelor of Science - Information Technology
University of Phoenix
2020
Skills
- Computer Hardware Knowledge
- Quality Assurance
- Team Collaboration
- Special Projects
- Documentation Management
- Leading Projects
- Hardware and Software Monitoring
- Epic, EMR Utilization
- Technology Evaluations
- Managing Multiple Projects
- Critical Thinking
- Daily Facility Operations
- Patient Records Documentation
Timeline
CARE REVIEW PROCESSOR II
Molina Healthcare
10.2024 - Current
Utilization Management Coordinator
Riverside Medical Clinic
09.2022 - 06.2024
Resource Analyst
University Of Phoenix
05.2022 - 02.2023
IS Manager
Innovative Healthcare Solutions
11.2018 - 01.2022
Operations Specialist
United States Navy
01.2010 - 12.2017
No Degree - Health Information Systems
University of Phoenix
Bachelor of Science - Information Technology
University of Phoenix
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