Summary
Overview
Work History
Education
Skills
Certification
Timeline
Generic

Stacie Soriano

Henderson,NV

Summary

Dynamic professional with extensive experience at Kaiser Permanente, excelling in regulatory compliance and policy oversight. Proven track record in managing complex appeals and grievances while fostering cross-functional teamwork. Adept at executive consulting and stakeholder engagement, driving successful outcomes through strategic leadership and effective communication. Recognized for enhancing compliance preparedness across diverse operations.

Overview

17
17
years of professional experience
1
1
Certification

Work History

Hospitality Plan & Benefits Administration Manager

Culinary Health Fund/Unite Here Health
Las Vegas, NV
12.2023 - Current
  • Championed regulatory, compliance, and policy strategies by coordinating cross-functional teams to meet strict deadlines.
  • Oversaw management of plan and contract documents, including SPDs, SBCs, and CBAs.
  • Served as liaison between internal stakeholders, Union representatives, legal counsel, employers, administrators, and vendors.
  • Managed appeal processes and provided strategic recommendations to the Board of Trustees.
  • Led onboarding initiatives and administered benefits for Union-sponsored health plans.
  • Guided Senior Benefits Specialists and Analysts through mentorship and professional development.

Regulatory Consultant IV

Kaiser Permanente
Pasadena, CA
03.2021 - 12.2023
  • Directed KP’s review and regulatory response to legislative bills.
  • Implemented regulatory changes across health plan, hospital, and medical group operations.
  • Facilitated training in new laws and regulations to enhance compliance preparedness.
  • Coordinated enterprise-wide regulatory filings and developed remediation strategies.
  • Collaborated with teams to implement regulatory changes effectively.

Regulatory Consultant II

Kaiser Permanente
Pasadena, CA
01.2017 - 03.2021
  • Led investigations into regulatory enforcement actions and managed response plans.
  • Partnered with legal teams, executives, and physicians to align on compliance strategies.
  • Represented department in regulatory committees and cross-functional workgroups.

Appeals Analyst III

Kaiser Permanente
Denver, CO
03.2016 - 01.2017
  • Managed complex benefit, claims, and medical necessity appeals.
  • Ensured adherence to Medicare/Medicaid regulations through detailed case analysis.
  • Prepared case files for audits and executive reports.

Complex Case Specialist (Marketplace/Division of Insurance)

Kaiser Permanente
Denver, CO
08.2014 - 03.2016
  • Functioned as SME for Individual Marketplace operations.
  • Led Division of Insurance investigations.
  • Developed member resolution training manual and process mapping tools.

Senior Case Manager

Kaiser Permanente
Rancho Cucamonga, CA
08.2013 - 08.2014
  • Oversaw grievance and appeals processes, focusing on Medicare Part D cases.

Appeals Analyst III

Kaiser Permanente
Denver, CO
09.2008 - 08.2013
  • Led end-to-end appeals processing and regulatory compliance reviews.
  • Delivered quarterly data reports to local and corporate leadership teams.

Education

Master of Healthcare Administration - Policy, organizational leadership, fraud detection

Colorado State University Global
Denver, CO
03.2022

Bachelor of Arts -

University of Wyoming
Laramie, WY

Skills

  • Regulatory compliance and policy oversight
  • Legislative analysis and audits
  • Appeals and grievances management
  • Policy implementation and monitoring
  • Leadership and stakeholder engagement
  • Executive consulting and collaboration
  • Cross-functional teamwork
  • Project management and communication
  • Technical documentation and audits
  • Emotional intelligence in leadership
  • Workgroup facilitation and communication
  • Policy writing and benefits administration
  • Contract management strategies
  • Data analysis techniques

Certification

Compliance Training (CHCO), 2011-2014, Completed certification in healthcare compliance, including ERISA, HIPAA, OSHA, billing, and fraud prevention.

Timeline

Hospitality Plan & Benefits Administration Manager

Culinary Health Fund/Unite Here Health
12.2023 - Current

Regulatory Consultant IV

Kaiser Permanente
03.2021 - 12.2023

Regulatory Consultant II

Kaiser Permanente
01.2017 - 03.2021

Appeals Analyst III

Kaiser Permanente
03.2016 - 01.2017

Complex Case Specialist (Marketplace/Division of Insurance)

Kaiser Permanente
08.2014 - 03.2016

Senior Case Manager

Kaiser Permanente
08.2013 - 08.2014

Appeals Analyst III

Kaiser Permanente
09.2008 - 08.2013

Master of Healthcare Administration - Policy, organizational leadership, fraud detection

Colorado State University Global

Bachelor of Arts -

University of Wyoming

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