Healthcare Management Consultant

Detailed results driven professional with extensive expertise in the healthcare industry. Presenting innovative customer solutions that ensure the best quality of care for patients and their families. Harnessing integrity to provide critical insights improving quality of service for clients and patients. Strong ability to identify issues and implement effective solutions.

Notable qualifications include:

Case Management

Medical Billing

Benefit Verification

Insurance Reimbursement

Medicaid, Medicare, Private Payer

Marketing/Strategic Planning

Project Management

Patient Advocacy

Customer Service

Cross-functional Team Leadership

Documentation/SOPs

HIPAA Compliance

Client Relationship Management

Home Healthcare/Hospice

Professional Experience

GCG Senior Placement, Consultant 2014 - present

Case management for senior patients. Liaison advocating for quality patient care. Providing coordination between patient, family, healthcare professional, insurance (Private Payer and Government programs), home health care facilities, hospice, and case managers.

Provide leadership orientation to new hires and assure all employee files are current and up to date with labor regulations.

Present healthcare education to families and patients. Providing them with knowledge and confidence so they can make the most informed quality of life care decisions.

Face-to-face visits to assess patient and develop the best healthcare plan for their future (Physical/Mental/Financial Assessments). Advocating for the patient every step of the way.

Order all durable medical equipment required and ordered by physicians. Not only ensure delivery but also providing education to the patient upon delivery.

Partner with physicians to review patients’ medical records, provide medication management when necessary.

Draft and provide flawless transition plan for home health care and hospice patients. Help patient acclimate to new environments and new care. Ensure the patient and family are properly informed.

Accountant management and bookkeeping. Responsible for creating, implementing, and maintain budgets for social workers.

Review physician records identifying issues, making sure CPT, NPI, ICD-10 codes are current and have been updated in records. Review medical billing for referral patients.

Advantage Health Systems, Community Liaison 2012– 2014

Created strategic marketing plan to promote lucrative business agreements. Responsible for business development and physician target segmentation.

Maintained existing relationships with physicians and case managers and networked to developed new relationships.

Responsible for budget management for team of 10+ liaisons. Conducted financial audits on expense accounts for liaison team ensuring budget guidelines and goals are kept and met.

Managed all marketing events promoting new business. Budgeting, making reservations, proving cross-functional team management, for proper execution of each event in the territory. On-site client visits to foster long-time trusting partnerships with physicians and case managers.

Emeritus-Carlsbad, Medical Records Director 2005 – 2012

Organized, planned, and directed medical records department in accordance with established policies and procedures.

Developed and maintained solid partnerships with inter-department personnel, as well as other departments within the facility, assuring medical records were property maintained.

Ensured HIPAA compliance for patient records. Executing proper completion, assembly, coding, indexing, and when needed transcribing reports for physicians.

Reviewed and authorized purchase order claims and contracts for company policy compliance.

Developed and implemented standard operating procedures (SOPs) for procurement/contracting management policies, and procedures.

Met with vendors to negotiate pricing, product quality, and delivery.

Negotiated and supervised supply contracts and formulated policies with suppliers.

Responsible for development of specifications for services, equipment, products, supplies or substitute materials.

Conduct internal product development meetings to identify new product demands, schedules, and procurement needs.

Technical Skills

Software

Microsoft Word, Access, Excel (Macros, Pivot Tables, VBA), PowerPoint, Outlook, Salesforce, CRM, SAP, SAS, SQL, Tableau

Project Manager Software

Microsoft Project, Teamwork Project Manager, Smartsheet, Podio, Zoho Project, Workfront

Healthcare Software

EMR, Care360, AllScripts, ECIN

Education

Bachelor of Science, Healthcare Administration

University of Phoenix, 2010

Bilingual, Fluent in English and Spanish

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