Customer Service Manager
Resume:
Jeanette Cruz
Los Angeles, Ca **032
**************@***.*********:**************@***.***
mailto:**************@***.***
Summary
●15+ years in Healthcare Network Management
●Physician & Specialist Recruitment
●Contract Negotiations Health plan, Specialists, Urgent Care
●Development of new networks into expansion areas
●IPA Acquisitions and Mergers
●Policy and Procedure Development
●Marketing and Collateral Development
●Bi-lingual English/Spanish
●Medical Terminology
●CMS and MIPPA Expert
●Dynamic Public Speaking-Presentation Skillset
PROFESSIONAL EXPERIENCE
St. Vincent IPA / Physicians Data Trust 5/14- 7/15
Marketing/Network Manager
●Created and executed marketing plan for the IPA with the goal of expanding the network of providers and IPA membership.
●Organized and participate in patient open enrollment events for the IPA
●Recruited and lead the recruitment processes of new Primary Care Physicians (PCPs) to the IPA
●Responsible for overall growth for both IPA membership and individual PCP base
●Website maintenance and oversight, production of member newsletter, & any physician updates
●Handled customer service calls from members (potential and current), Providers (current and potential) improving patient retention and provider satisfaction with the IPA
●Researched and maintained a working knowledge of current competitors in the IPAs respective community that includes compensation, bonuses and other offerings in order to assist in highlighting the value differences and advantages of the IPA, while maintaining the integrity of the IPA
●Prepare contract/amendments for providers and maintain working knowledge of compensation, bonuses, incentives as well as basic knowledge of HCC, 5 Star, P4P performance measures
South Bay Health and Insurance Services, Los Angeles 3/14-1/15
Manager, Business Development
●Recruited, Trained and Managed 30+ Career (Broker) Agents to ensure enrollment goals were achieved and exceeded
●Generated and developed sales leads for Brokers through Call Center
●Responsible for cultivating, maintaining and strengthening direct relationships with Medical Groups, Physicians, community based organizations and employers to create a pipeline.
●Conducted presentations to potential new business partners
●Provided updates on CalMediconnect and industry changes.
●Developed reporting system to track and trend all agents leads and enrollments
Prospect Medical, Santa Ana 07/06 – 03/13
Director, Business Development & Marketing
●Developed and executed open enrollment strategies for all product lines in Los Angeles, Orange and Riverside Counties.
●Responsible for Physician recruitment, identified exclusivity opportunities and development of new networks in expansion areas.
●Supported 5 IPA acquisitions, devised retention strategy, created new member programs, established Age-In Program
●Due to transition of efforts and emphasis on targeting key employer groups, increased commercial membership enrollment by over 25%.
●Implemented Marketing event calendar which included, health plan sales meetings, Chamber of Commerce events, health fairs, Hospital events, Open House
●Hired, Trained, and evaluated Marketing and Business Development Managers
●Served on Executive Presented “Prospect 101” quarterly workshops
Prospect Medical, Santa Ana
Manager, Marketing (promotion) 01/04-06/06
●Tracked and trended marketing events and campaigns to measure effectiveness and ROI
●Created company-wide marketing strategy for brand positioning (i.e. Physician directories, print ads, fact sheets, direct mail, print ads, outdoor media
●Oversight of Healthy Family Enrollments and Certified Application Assistant production
●Developed Policy and Procedure for newly created Marketing Department
●Identified enrollment trends and developed reporting systems for Executive Team.
EDUCATION _
●Rio Hondo Community College, Whittier, CA 9/86
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