Quality Assurance Customer Service

Yolanda Martinez

***** *. ***** ******* ** ( VON ORMY, TEXAS 78073

********@********.*** 210-***-**** c

Health Care Management Profile

Strategic Planning ( Administration & Operations ( Quality

Improvement

Repeated success leading substantial quality improvements for health care

operations, with a demonstrated talent for balancing business goals with

patient-focused service delivery and outcome objectives. Adept at leading

cross-functional patient support and practice administration teams,

directing end-to-end recruiting, hiring, on-boarding, and staff development

efforts to cultivate high-performance teams. Liaise seamlessly among

patients, providers, partners, insurers, vendors, and regulatory agencies.

Drive positive public image through community-focused outreach and service

initiatives.

CORE COMPETENCIES

HEALTH CARE BUSINESS STRATEGIES Revenue / Profit Generation

Program & Project Management Budget Projection &

Recruiting & Staffing Initiatives Administration

Insurance Reimbursement

Partner Relations / Negotiation Performance Metrics Analysis

Staff Training & Development Process Redesign & Automation

Professional Experience

ATASCOSA HEALTH CENTER, INC. - PLEASANTON, TEXAS

Practice Manager, Federally-Qualified Health Center (FQHC), January 2010 to

Present

Hold responsibility for all aspects of a multidisciplinary health center

providing medical(including family OB/GYN, pediatric, family planning, and

mental health(dental, and laboratory services, managing a team of 55

medical assistants, LVNs, lab technicians, dental technicians, and

administrative staff. Oversee an array of center operations and functions,

including budget administration, accounting and expense control, purchasing

and supply chain logistics, A/R and A/P, insurance reimbursement, patient

correspondence and relations, medical coding, and compliance with privacy /

confidentiality requirements such as HIPAA. Manage staff recruiting,

hiring, orientation, training, coaching, mentoring, and performance

evaluation; provide comprehensive resource planning, allocation, and

scheduling in alignment with center requirements and long-range staffing

model planning.

Key Contributions:

* Drove a 50% increase in cash collection within 6 months through

meticulous review of patient accounts to identify billing efforts and

negotiation of patient discounts for full payment within 45 days.

* Collaborate extensively with Medical and Dental Directors; serve as

pivotal member of team responsible for annual goal-setting and

performance measurement metric development surrounding a range of

benchmarks, including reimbursement, billing, collections, cashiering,

and denials.

* Pivotal in quality and risk management efforts; create incident

reporting and conduct peer-review analysis.

* Led implementation of an electronic health record (EHR) solution,

Nextgen, including development and presentation of training for all

staff and providers.

* Provide as-needed leadership for 2 regional campuses in Floresville

and Karnes.

* Perform ongoing process and business analysis toward development of

performance improvement strategies and initiatives, providing

recommendations to Site Operations Administrator.

* Launched community-focused outreach programs to improve practice

visibility and public image.

CHRISTUS Santa Rosa Health Care - San Antonio, Texas

Analyst, Quality Informatics, August 2008 to December 2009

Supported 5 regional campuses in collection, analysis, interpretation, and

presentation of clinical quality and patient safety data; performed

comparative analysis of industry trends and benchmarks(as well as leveraged

patient-focused regulatory compliance expertise(to inform quality goal

setting. Provided diverse administrative support, including multi-campus

payroll processing.

Key Contributions:

* Managed analytics for clinical respiratory disorder studies focused on

improving patient outcomes.

* Played instrumental role in project to develop and implement an

integrated tracer system for substantial performance improvement

against statutory frameworks.

* Spearheaded quality initiatives to better align processes and

operations with CMS regulatory requirements and best-practices in

patient care quality, including establishment of mortality measures

for acute myocardial infarction (AMI), heart failure (HF), and

pneumonia (PN).

Harland Clarke - San Antonio, Texas

Quality Assurance Coordinator, January 2001 to July 2008

Quality Assurance Technician / Quality Analyst, July 1990 to December 2000

Built progressively responsible tenure in product quality assurance within

integrated product / service solution provider, advancing into supervisory

role over shift of 8 QA personnel. Responded to and resolved customer

inquiries and complaints. Provided team orientation, training, and

mentoring to drive top performance.

Key Contributions:

* Consistently achieved and exceeded key performance indicator (KPI)

targets for product quality and customer complaint volume.

* Developed statistical data collection and analysis processes to enable

product performance assessment.

* Investigated quality-related issues across 10 facilities, performing

root cause analysis and implementing corrective actions; developed

process improvements to drive quality benchmarks.

* Collaborated extensively with the marketing team to develop and

finalize new product designs, ensuring product alignment with quality

standards.

* Earned the Superior Contributor Award for outstanding leadership and

customer service and contributed to organizational receipt of the

Texas Award for Performance Excellence.

Education and Credentials

ASHFORD UNIVERSITY - CLINTON, IOWA

Master of Arts in Organizational Management, ADG May 2011 - Health Care

Administration Concentration

Bachelor of Arts in Health Care Administration, 2009 - Graduated with 3.7

GPA

Language Skills: Bilingual in English & Spanish

PROFESSIONAL DEVELOPMENT: TRAINING IN QUALITY CERTIFICATION & FACILITATION

PRACTICE MANAGEMENT BOOT CAMP - THE AMERICAN ACADEMY OF MEDICAL MANAGEMENT

Health Care Management Continuing Education - Cleveland State University

Technical Proficiency: Microsoft Office Suite, Electronic Health Records

(EHR) / Electronic Medical Records (EMR), Nextgen, Meditech, NDNQI, Health

Grades, VIDAS Lab Testing, Medical Coding

COMMUNITY SERVICE: VOLUNTEER - CHILD ADVOCATES OF SAN ANTONIO (CASA)

ADVOCATE FOR ABUSED AND NEGLECTED CHILDREN WITHIN BEXAR COUNTY, PERFORMING

CASE REVIEWS WITH CHILD PROTECTIVE SERVICES TO PROVIDE RECOMMENDATIONS

WITHIN COURT SETTINGS.

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