Valerie Cetino
Blue Sheild of California
Maywood,CA
1
Language
11
years of professional experience
Compassionate Care Coordinator experienced in patient advocacy, care planning, and effective communication. Enhanced health outcomes through strategic care coordination and support for expectant and new mothers. Managed complex caseloads while facilitating comprehensive care plans and ensuring clear communication between healthcare providers and patients.
Work History
Maternity Care Coordinator
1 Year 10 Months- Coordinated patient care plans to enhance overall health outcomes.
- Facilitated communication between healthcare providers and patients for effective service delivery.
- Managed referrals and authorizations to streamline patient access to necessary services.
- Assisted in developing educational materials for patients on healthcare resources.
- Guide expectant and new mothers through pregnancy, childbirth and postpartum
- Care navigation, Patient Education, Health Monitoring
- Maintain regular check in with patients and coordinate treatment plans between in network and community based providers and resources
- Coordinated patient care plans to ensure timely delivery of services and resources.
- Scheduled appointments and follow-ups, ensuring efficient use of clinic resources and staff time.
- Facilitated timely access to appropriate healthcare services by assessing patient needs and coordinating referrals to specialists.
Member Service Representative
4 Years 5 Months- Resolved member issues through effective communication and problem-solving techniques.
- Assisted members with inquiries regarding services, ensuring prompt and accurate responses.
- Streamlined membership onboarding process, improving overall efficiency and member satisfaction
- Provided exceptional service through active listening, understanding member needs, and offering appropriate solutions.
- Provided quality customer care services for Medi-cal platform, IHSS and healthy families line of business
- Medical Terminology and handled high call volume while maintaining timely accurate service
- Obtained Grievances provided benefit information to members and claim information to providers
Member Outreach Specialist
8 Months- Facilitated workshops and events to educate members on available healthcare resources and benefits.
- Developed community outreach strategies to enhance member engagement and awareness of health services.
- Collaborated with multidisciplinary teams to identify gaps in service delivery and improve outreach programs.
- Analyzed feedback from community members to refine communication materials and outreach initiatives.
- Reached out to new members regarding plans and benefits
- Assisted with inbound calls and answered members questions concerning benefits
Education
Medical Billing And Coding Certification - Medical
High School Diploma
Skills
Care planning
Case management
Patient education
Healthcare operations
Documentation proficiency
Medical terminology understanding
Documentation management
Patient safety
Workflow management
Strategic planning
Team collaboration
Verbal and written communication
Patient record management
Conflict resolution
Care coordination
Service delivery optimization
Critical thinking
HIPAA guidelines
Languages
Spanish
Timeline
Maternity Care Coordinator
Blue Sheild of California
04.2022 - 02.2024Read More
Member Service Representative
Local Authority Services
09.2014 - 02.2019Read More
Member Outreach Specialist
Citizens Choice Healthplan
08.2013 - 04.2014Read More
United Education Institute
Medical Billing And Coding Certification from Medical
Read More
Bell High School
High School Diploma
Read More