Stephanie Onate
Newhall,CA
Summary
Versatile Project Manager possessing dynamic case management oversight, issue resolution and analysis skills. Offering 8 years of demonstrated experience and health care knowledge. Strong knowledge of MS Office and various project management software.
Overview
12
12
years of professional experience
Work History
Sr. Case Management Project Manager
Regal Medical Group
Northridge, CA
12.2021 - Current
- Acted as the primary point of contact for project scheduling and scope changes, ensuring on-time delivery across multi-disciplinary teams.
- Forecasted and monitored project timelines and resource allocation, optimizing team performance, and reducing delays.
- Created project plans with established timelines, assigned them to appropriate teams, and managed workflow throughout construction.
- Implemented scope adjustments and optimized program processes, ensuring compliance with health plan regulations, and CMS reporting requirements.
Complex Care Mgmt Coordinator(Oncololgy, CHF, CKD)
Regal Medical Group
Northridge, CA
01.2014 - Current
- Assisted Case Manager/RN
- Recorded patient data and medical records.
- Strictly followed all federal and state guidelines..
- HIPAA Privacy and Security Regulations knowledge.
- Coordinated transportation services for members.
- Assisted Case Managers with Physician order.
- Coordinated member medical appointment.
- Participates and assists in patient Interdisciplinary Discussions.
- Reported all Vital Care and Special Needs Member admission and discharges.
- Monitored compliance with regulatory requirements (SNP Model of Care, CMS, NCQA) and documented appropriately in the system of record.
- Conducted outreach calls for transitions of care, discharges, and readmission prevention.
- Documented member interactions, referrals, and interventions with accurate, timely narratives.
- Coordinated non clinical aspects of care, including DME requests, transportation, appointment scheduling, referrals, and community resource linkage.
- Assisted with transitions of care by contacting members post-discharge, verifying follow-up appointments, and escalating to case management when risk factors were present (e.g., readmission risk, medication concerns, lack of support)
- Collaborated with interdisciplinary teams including nurses, social workers, behavioral health coordinators, LTSS providers, and vendors to support individualized care plans
- Managed escalated calls involving grievances, appeals, appointment delays, or access-to-care issues, ensuring resolution within regulatory timeframes.
- Coordinated referrals and authorizations for oncology-related services such as radiation, infusion therapy, imaging, genetic testing, and specialty consultations.
- Assisted members in scheduling appointments across oncology networks, ensuring continuity between primary care, specialists, surgeons, behavioral health, palliative care, and supportive services.
- Supported members with complex oncology, hospice, and palliative care needs by coordinating non-clinical services, ensuring continuity of care, and acting as a central point of contact for patients, families, and providers
- Assisted families with understanding hospice benefits, continuity-of-care protections, respite services, advance directives, and coverage for palliative or comfort-focused care.
- Tracked membership, case assignments, outreach status, referral pipelines, and closure timelines using Excel dashboards, spreadsheets, and case management trackers to support compliance and reporting.
Sr. Data Analyst
Regal Medical Group
Northridge, CA
10.2020 - 12.2021
- Performed data quality assurance to ensure Cal MediConnect and SNP reporting met CMS Model of Care (MOC) standards.
- Tracked and monitored the delegated Cal MediConnect and Special Needs Program population to ensure compliance with CMS regulations and turnaround times.
- Performed root cause analyses on data variances, developing corrective actions that improved accuracy and operational workflows.
Medical Management Supervisor
Regal Medical Group
Northridge, CA
10.2016 - 10.2020
- Enhanced training programs to strengthen employee knowledge and promote new managers from within.
- Applied strong leadership talents and problem-solving skills to maintain team efficiency and organize workflows to meet any daily demand.
- Worked with management team to implement proper division of responsibilities.
- Audited processes and procedures for non-clinical staff.
Interviewed, hired and trained new employees for outpatient case management positions. (clinical & non clinical). - Measured team performance and reported metrics to management team members.
- Evaluated employee performance monthly and coached and trained accordingly, increasing quality of work and employee retention.
- Performed system analysis, documentation, testing, implementation, and user support for platform transitions.
- Recommended data standardization and usage to ensure data integrity.
- Collaborated with healthcare providers to ensure comprehensive service delivery.
- Coordinated care for high-risk members with chronic, behavioral, or functional needs, ensuring timely interventions and resource connection
Care Management Program Coordinator- Lead
Regal Medical Group
Northridge, CA
02.2016 - 10.2016
- Experience in creating pilot programs and data analysis (Post Discharge & Disease Management).
- Monitored service capabilities and collaborated cross-functionally to ensure needs were met and escalated issues were resolved.
- Demonstrated flexibility working with internal team members to remedy any issues and preemptively coming up with solutions
Provided administrative support to principal to management regarding data and metric presentations. - Participated in weekly team meetings to develop better plans and revise proper protocols to meet objectives.
- Developed processes for converting and refining raw data for new Medi-Cal LOB product SPD.
- Coached team and helped implement training programs to improve efficiency and productivity for the outpatient department.
- Monitored key dates to ensure information is obtained by deadlines
Collected data by identifying sources of information, including designing graphs and collection methods. - Provided training to teams who create or edit contracts, on proper responses and areas of flexibility within contracts.
- Performed various administrative functions, including filing paperwork, delivering mail, sorting mail, office cleaning and bookkeeping.
- Created analytical reports tailored to specific project and program needs.
- Assisted with HRAs, ICPs, ICT coordination, and follow-up on social and clinical referrals.
- Facilitated communication between providers, case managers, behavioral health teams, home health, and community partners.
- Identified barriers to care (transportation, food insecurity, housing, language, benefits access) and coordinated solutions.
Skilled Nursing Facility Coordinator
Regal Medical Groups
Northridge, California
08.2013 - 06.2014
- Facilitated coordinated care during skilled nursing stays by partnering with physicians, nurses, and key stakeholders.
- Monitored bed availability and updated electronic health records accordingly.
- Provided training to new staff on operational procedures and systems usage.
- Maintained communication with physicians and case managers regarding changes in patient condition or treatment plans.
- Attended daily SNF rounds to ensure the quality of care coordination and discharge planning.
- Knowledge of the Notice of Medicare Non-Coverage (NOMNC) notification process, and a detailed explanation of Non-Coverage (DENC).
- Knowledge of appeals and response process.
- Coordinate with insurance providers to verify benefits, secure authorizations, and streamline approval processes, reducing delays in service delivery.
- Assist the case manager in developing discharge plans by arranging follow-up appointments, community resources, and home health services.
- Verified insurance benefits and secured authorizations to streamline approvals, reducing delays in service delivery.
Education
High School Diploma -
Canyon High School
Canyon Country, CA06.2004
Skills
- Project development and lifecycle
- Performance improvements
- Systems implementation
- Interdisciplinary collaboration
- Work flow planning
- Microsoft Office Suite knowledge
- Root cause analysis
- Knowledge of CMS Guidelines & MOC
- Proficient with health plan audits and compliance reporting
- Experience with Inpatient, Skilled Nursing Facility, Outpatient Case Management and Coordination of Care
- Data review
- Presentations
- Healthcare regulations
- Prior authorization process
- Patient referrals
- Medical terminology
- Interpretation of Explanation of Benefits
- Claim research & Solution
Languages
Spanish
Native/ Bilingual
Accomplishments
- Created highly effective new reporting log that improved CMS compliance in care planning and enrollment processing over 80% in compliance improvement.
- Collaborated with VP of and enhanced current reporting software q.HMO features and reporting
- developed a reporting tool based on different reporting resources within our current program software q.HMO improved monthly and quarterly data speed and efficiency.
- Presented and conducted case reviews during live CMS and health plan auditing.
- Developed Program performance reporting tool which provides up to date data based on current membership status.
Timeline
Sr. Case Management Project Manager
Regal Medical Group
12.2021 - Current
Sr. Data Analyst
Regal Medical Group
10.2020 - 12.2021
Medical Management Supervisor
Regal Medical Group
10.2016 - 10.2020
Care Management Program Coordinator- Lead
Regal Medical Group
02.2016 - 10.2016
Complex Care Mgmt Coordinator(Oncololgy, CHF, CKD)
Regal Medical Group
01.2014 - Current
Skilled Nursing Facility Coordinator
Regal Medical Groups
08.2013 - 06.2014
High School Diploma -
Canyon High School