Summary
Overview
Work History
Education
Skills
Languages
Timeline
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Yvonne Medina

Chula Vista ,CA

Summary

Dynamic Utilization Review Coordinator at Magellan Health with a proven track record in regulatory compliance and customer service. Expert in managing approval processes and conducting thorough medical necessity reviews. Strong problem-solving skills and a commitment to teamwork drive successful outcomes in fast-paced environments.

Proactive and goal-oriented professional with excellent time management and problem-solving skills. Known for reliability and adaptability, with swift capacity to learn and apply new skills. Committed to leveraging these qualities to drive team success and contribute to organizational growth.

Overview

10
10
years of professional experience

Work History

Utilization Review Coordinator

Magellan Health
San Diego, CA
10.2022 - Current

Managed approval and denial processes for single case agreements.

Managed data entry tasks for received faxes.

Ensured compliance with HIPAA regulations.

Ensured timely completion of tasks.

  • Collaborated with clinical teams to ensure adherence to regulatory compliance and best practices.
  • Handled inbound and outbound calls with providers and members.
  • Conducted thorough reviews of medical necessity for healthcare services and treatments.

Insurance Agent

Fred Loya Insurance
San Diego, CA
01.2020 - 08.2021
  • Developed customized insurance solutions to meet client needs and preferences.
  • Conducted thorough policy reviews to ensure compliance and accuracy of coverage.
  • Trained new team members on best practices for customer service and policy management.
  • Built strong relationships with clients through consistent communication and excellent customer service.
  • Efficiently managed policy renewals, ensuring timely processing and accurate coverage updates.

Quality Control

Innovus Pharmaceutical
San Diego, CA
05.2018 - 12.2019
  • Supported quality control initiatives by thoroughly examining materials used in manufacturing processes.
  • Recognized potential issues with inventory and quality control and engineered changes.
  • Implemented quality control measures for consistent product output and reduced defects.
  • Conducted quality control checks to guarantee consistent product integrity for customers.

Retail Sales Associate

Fashion Q
Chula Vista, CA
06.2016 - 07.2018
  • Assisted customers in selecting apparel and accessories to enhance their shopping experience.
  • Maintained visual merchandising standards to ensure an appealing store presentation.
  • Processed transactions accurately using point-of-sale systems to enhance operational efficiency.
  • Handled inventory management tasks, including restocking shelves and organizing backroom supplies.

Education

High School Diploma -

Montgomery High
San Diego, CA

Skills

  • Customer service
  • Teamwork
  • Problem-solving
  • Teamwork and collaboration
  • Time management
  • Customer assistance

Languages

Spanish
Native or Bilingual

Timeline

Utilization Review Coordinator

Magellan Health
10.2022 - Current

Insurance Agent

Fred Loya Insurance
01.2020 - 08.2021

Quality Control

Innovus Pharmaceutical
05.2018 - 12.2019

Retail Sales Associate

Fashion Q
06.2016 - 07.2018

High School Diploma -

Montgomery High