Alberto E. Alaniz

***** ** ***

Sinton, Texas ***87

Mobile: 361-***-**** acyidl@r.postjobfree.com

Summary

Certified Medical Operations Manager with 15 years experience. Military nursing education and

civilian health care administration utilized in different settings i.e. IN/OUT PT, Chronic, Acute,

Family Practice, Managed Health Organization, Nephrology, Occupational Medicine, Physical

Therapy/Rehab and Health Information Management. I am Certified as a Medical Operations

Manager (CMOM). I am interested in pursing a Medical Operations Management position.

Experience:

Medical Operations Manager

Cedar Hills Family Practice

San Antonio TX

This family practice clinic offered family practice services to scheduled patients per day ( 30 to

45 patients per provider X 3 providers) along with "walk ins". Ancillary services: Weight Loss 20

scheduled, Ultrasound 20 scheduled, BoTox 5 scheduled and Allergy Testings 30 scheduled

totaling +/- 155 patients per day. I arrived in clinic at 0645 and departed 2000 working +/- 12

hours a day Monday through Friday. I was on call 24/7 and answered calls from the CEO and

providers as late as 0100.

Human Resources: Hired, fired, counseled, disciplined, evaluated, trained, oriented, coached,

mentored, and scheduled staff (1 physician, 2 Family Nurse Practitioners, 6 Medical Assistants 4

Ultrasound Techs, 1 contract Cardio Tech, 1 Phlebotomist, 1 Allergy Tech, 2 Front Office

Assistants, 2 Pre Auth/Insurance Verification Assistants, 3 externs). Shopped, negotiated and

administered benefits. Developed, maintained and administered personnel policies, wellness

programs, pay scales, job descriptions, and contracts. Resolved conflicts either staff, patient,

vendor, or payer. Maintained personnel files, and updated annual competencies. Documented

Workers Compensation injuries and implemented policies, procedures, and training to avoid

future injuries. Addressed unemployment inquiries.

Facilities and Machines: Shopped for, negotiated, recommended, and maintained buildings (2

locations San Antonio & Austin) or suites, telephones, hand-held dictation devices, copiers,

computers, physician after hour service, furniture, scanners, postage machines, specimen

refrigerators, injection refrigerators, patient refreshment refrigerators, staff lunch refrigerators,

medical equipment, printers, coffee machines, alarm systems, signage, cell phones, and lap tops.

Ordering and Expense Management: Shopped for, negotiated and recommended suppliers for

medical consumables, negotiated price reductions with current vendors and opened accounts

with 5 new vendors. I ordered or bought office supplies, kitchen supplies, magazines, printed

forms, business insurance, and malpractice insurance as well as services such as transcription, x-

ray reads/over-reads, consultants, CPAs, lawyers, benefit administrators, answering service,

water service, courier service,housekeeping, linen service, bio-hazardous waste removal,

shredding service, off-site storage and caterers.

Legal: Complied with all local, state and federal laws and guidelines including OSHA, ADA,

EOE, FMLA, CLIA, COLA, JCAHO, FACTA, HIPAA, Stark I, II & III, fire safety, crash carts

and defibrillators, disaster communication, sexual harassment, universal precautions, MSDS

hazards, confidentiality, security and privacy, and provide staff with documentation and training

in same. Made sure all clinical staff were current on licenses and CPR. Have downtime

procedures for loss of computer accessibility. Made sure risk management policies were being

followed. Alerted malpractice carrier to any potential liability issues immediately. Made sure

medical records were being stored and released appropriately (electronic and paper).

Accounting: Paid bills (clinic rent, taxes, utilities), produced payroll reports for approval and

released them for payment. I prepared compensation schedules/contracts for physicians, prepared

and paid taxes, prepared budget and monthly variance reports, made deposits, reconciled bank

statements, reconciled merchant accounts, prepared Profit & Loss statements, prepared refunds

to payers and patients, and filed lots and lots of paperwork.

Billing, Claims and Accounts Receivable: Performed eligibility searches on all scheduled

patients. Ensured that all encounters and legal work (depositions, etc.) were charged and all

payments, denials and adjustments are posted within pre-determined amount of time.

Transmitted electronic claims daily. Started tracking and sending patient statements weekly.

Created a payment plan for collecting on past due accounts as statements were never generated

or discussed with the patients. Negotiated payer contracts and ensured payers were complying

with contract terms. Dissolved a contract with a insurance company for non payment and breach

of contract. Appealed denials. Worked with payers due to our higher than average billing proving

the legitimacy of our billing practices. Had staff start collecting deductibles, co-pays and co-

insurance and I personally met those with an outstanding balance to discuss options and start

payment plans. I met patients with high deductibles or healthcare savings plans to clarify and

questions. Made sure scheduling staff knew which payers the practice was not contracted with.

Fired previous billing company and hired a replacement billing company within 3 days. I was

the liaison with billing service. Credentialed care providers with all payers within a month to

reduce a collection gap due to the change. Average time frame can range from 1 to 3 months.

Performed internal compliance audits. Loaded new RBRVS values, new CPTs and new ICD-10.

Ran weekly reports for physician production, aged accounts receivable, net collection percentage

and cost and collections per RVU. Attached appropriate codes to claims for e-prescribing and

PQRI. Had plan in place for receipt of Recovery Audit Contractor (RAC) letters. Met regularly

with the provider reps for out largest payers, vendors etc.

Marketing: Introduced new physicians; I fired one physician and negotiated the hire of 2 FNPs I

introduced new services to the community such as in house allergy testing. Recommended

sponsorship of appropriate charities, sports and events in the community. Thanked patients for

referring other patients. Tracked referral sources. Recommend use of Yellow Pages, billboards,

radio, television, newspaper, magazine, direct mail, newsletters, email, website, blog, and other

social media. Prepared press releases on practice events and physicians awards and activities.

Strategic Planning: Prepared ROIs (Return on Investment) and contracts for new physicians,

new services, and new locations. Forecasted potential effect of Medicare cuts, contracts in

negotiation or over-dependence on one payer. Discuss 5-year plans for capital expenditures such

as EMR, ancillary services, physician recruitment, and replacement equipment. Explored

outsourcing office functions or having staff telecommute. Always looked for technology that

could make the practice more efficient or productive.

Day-to-day Operations: Made rounds of the practice through out the day to observe and be

available for questions and assistance. Arranged for temporary staff or rearrange staff schedules

for shortages, meet or spoke with patients with complaints, and meet with vendors, physicians

and staff. Opened mail and recycled most of it. Assisted with seeing patients and minor

procedures.

Practice Manager II

Christus Spohn Medical Group

Family Medicine Academic Center

Corpus Christi, Texas

2013

Responsible for operations of the practice consisting of 4-6 staff providers, 16 residents, and 10

or more FTEs. I managed subordinate personnel, preparing clinic budget, ensuring data accuracy,

providing finical analysis, handling complex customer service issues, and provider/staff

communications.

Responsible for selecting, training, orienting and supervising clinic personnel in accordance with

established policies and procedures. Along with work assignments and daily operations.

Evaluated performances and recommended merit increases, promotions and disciplinary actions.

Interviewed and recommended hiring and termination of staff in accordance with approved

policies. Resolved problems in administrative areas and ensured compliance with regulations and

standards.Helped fiscal management and other administrative staff in implementing cost

effective policies and procedures for all operational areas including bookkeeping, billing,

insurance, fee schedules, credit/collections, purchasing, data processing and space planning.

Works in conjunction with Regional Director and corporate Marketing Department in practice

development. Ensured the effective implementation of job descriptions, personnel policies and

payroll practices. Monitored and controlled clinic expenditures within budget. Identified and

implemented cost reduction opportunities. Served as liaison between clinic and external

agencies. Worked with staff and providers to ensure quality patient care and services were

provided. Maintained effective communication with providers and staff; conducted monthly

meetings with providers and staff. Created a positive work place. Gathered and reported monthly

and annual data for fiscal, statistical and planning purposes. Developed and implemented

revenue enhancement strategies for existing practice(s). Participated in professional development

activities to keep current with health care trends and practices.Also responsible for assuring all

appropriate license, certifications and/or accreditation are secured according to policy.

Maintained strict confidentiality. Used oral and written communication skills to effectively

convey ideas in a clear, positive manner. Maintained established CHRISTUS Provider Network

policies, procedures, objectives, quality assurance, safety, environmental and infection control.

Implemented job responsibilities. Performed other related work as required.

Associate Medical Center Manager

Nova Medical Center

Corpus Christi, Texas

2012 - 2013

Associate Medical Center Manager charged with the daily operations of the clinic along with the

medical and physical therapy staff. Associate Medical Center Manager at Nova Corpus Christi

serving various employers with occupational health needs. I was responsible for operations of the

medical office; ensured that the medical office was running smoothly and proficiently. Ensured

company specific protocols were followed allowing for customer satisfaction. Other

responsibilities and duties include managing day-to-day operations, educating staff on new or

updated policies, and implementing the use of physical assets and human resources. I trained the

driver to assist the medical staff by cross training him to do audiograms, PFTs, RFTs, and urine

drug collection/testing. I used Timetrex for scheduling time and attendance/payroll, reviewing

time cards, and tracking hours worked, viewing vacation and sick time and requesting time off

for all nursing and physician staff. Billing was done in MediSoft, and scheduling was controlled

by Occuflex EMR where all appointments were made/tracked and TWC 73s were generated. I

was responsible for specialist referrals, communicating with insurance adjusters, and employers.

I oversaw the denial and appeal process and wrote letters of medical necessity as needed. I

worked closely with the clinic doctor to educate and train the supportive staff in better

documentation and clinical outcomes. I worked with four onsite industry directors to identify

areas of improvement and resolve any customer concerns.

Skills: Certified DOT UDS Collector, Certified DOT BAT Collector, Certified DOT UD Hair

Collector, Certified Audiometric Technician

ITC Medical Operations Manager

WellMed Medical Management Inc.

Corpus Christi, Texas

2010 - 2011

I worked for WellMed Medical Management as Clinical Supervisor. I was promoted to the

Medical Operations Manager position in 3 months after hired on. After assuming the manager

position I did not fill the supervisor position I managed both roles.

Integrated/Transition/Complex Care (ITC) Operations Manager at the Corpus Christi Senior

Clinic serving Physician Health Choice Managed Care Organization (PHC/MCO) members.

Responsible for overall operations of the medical office; ensure that the medical office ran

smoothly and proficiently. I constantly looked for ways to save the money by running more

efficiently and reducing operating costs. Additionally, developed and implemented processes and

procedures for the operation of the practice. Other responsibilities and duties included managing

day-to-day operations, formulating policies, and implementing the use of physical assets and

human resources. I used API for scheduling time and attendance/payroll, reviewing time cards,

and tracking hours worked, viewing vacation and sick time and requesting time off for all

nursing and physician staff. These resources are often too general and diverse in nature to be

easily categorized into any other specific area of administrative duties. This included overseeing

production, purchasing of capital equipment, hiring personnel, and other administrative services.

I worked closely on developing annual budgets, and reducing costs with the area market

manager, and sales manager. I worked with community groups to provide services like "Flu

Fair's" and donated time and resources to Community Action Centers of the Coastal Bend. I

reported to the VP of Operations located in San Antonio Texas. During my employment the

practice patient load was increased from 10 patients per week to +/- 45 in clinic and 30 offsite

total of 75+/- patients per week. I traveled by car every month for a week for manager meetings

in San Antonio Corporate Office. I opened a sister clinic in El Paso and flew weekly for 2 days

until I hired an onsite manager. I supervised the two clinics in the Rio Gran Valley, El Paso and

Corpus Christi. While with WellMed Medical Management I attended classes for Medical

Operations and received certification.

Health Information Management Supervisor/ Custodian of Medical Records

Methodist Dallas Medical Center

Dallas, Texas

2008 - 2010

I supervised the job functions of HIM staff in record retrieval/retention, coding/billing

assembly/analysis, ROI, equal access & loose report filing. I assisted the department director by

performing managerial duties including but not limited to the following: I participated in the

interviewing process to include staff orientation, development and training, developed/updated

job descriptions, performed counseling, and completing evaluations for all allied health i.e.

clerical, supportive staff, nursing and physician staff. As the supervisor I had the responsibility of

dealing with staff reporting directly to me, where I had the authority to interview, make

recommendation for new hire selection, orient, develop, train, recognize staff accomplishments,

counsel, evaluate, and terminate with the guidance of the director. I developed, & implemented a

weekly productivity tool, which helped monitor productive performances for trends and quality

improvement in HIM. I monitored productivity to assure workload performances were

maintained at the minimum or "meets" level. Productivity was evaluated to determine staffing

needs for the department. With the new productivity tracking tool, I found the staff to be

unproductive, and made a FTE redundant thus decreasing my budget expenditure, and increasing

the staffs productivity. I coordinated the receipt of user access and orient staff on appropriate

computer systems such as Meditech, and upgrade MPI/Locator, Image Silo, Doc-U- Data, Box

Inventory Tracking System (BITS), and Microsoft Outlook. I ensured that all new employees had

access and provided individual training on each system. I attended and participated in all

scheduled meetings, forums, department meetings, safety fairs, management meetings, process

improvement meetings etc. These meetings kept me abreast of issues/ concerns/ information

regarding the department in whole and its divided areas. Monthly department meetings were held

on the last Thursday of the month where new information, be it policy or other departmental

issues were open for discussion. I had my section meeting the first Thursday of the month where

are/section specific problems & concerns were identified and rectified. I supervised the record

retrieval process for nursing units and physicians. I also coordinated weekly locator audits to

maintain the integrity of our system. I participated with the JCAHO standard regarding open

record reviews for chart audits & data review. I supervised and monitored the filing of permanent

records and loose reports to avoid back logs. I reduced the filing from 45 feet to 4 feet in five

months time, also participated in reducing a back log of charts (from 2007 - 2009) over a six

month period. I coordinated and monitored the timeliness and quality of our ROI service. As the

custodian of medical records I went to court to enter subpoenaed charts into evidence on behalf

of MDMC. I imputed, corrected, & monitored time and attendance reviewed time cards, tracked

hours worked, viewed vacation and sick time and requested time off for all nursing and physician

staff in API.

Medical Operations Manager

Patient Place Clinics

Dallas, Texas

2007 - 2008

Clinic Manager for a private practice consisting of six locations. Family practice and Physical

Therapy/Rehab Clinic. Responsible for 3 physicians, 2 Chiropractors, 6 Medical Assistants, 1

phlebotomist, 2 receptionists and assisted the providers (1 D.O, 1 DM, 1 PA, & 1 FNP).

Responsible for all clinical needs including staff, supplies, & patient care. I was responsible for

providing quality health care services, maximizing productivity, and optimize customer service.

Provided patient health education (Diabetes, Weight Loss etc) and referrals, as needed, to meet

the immediate health care needs of clients. Worked in collaboration with a physician to diagnose

conditions and, as necessary, prescribe medications for patients, while maintaining compliance

within our scope of practice. Manage all aspects of clinic operations, while controlling labor

costs and clinic expenses. Assisted in recruiting, hiring, training, coaching and motivating

clinicians i.e. nursing and physician staff, clerical and medical assistant staff. Evaluated and

monitored job performance of all clinic staff. Write and deliver performance evaluations.

Organize staff scheduling Monday thru Saturday. Monitor clinic productivity through customer

complaints/ complements, daily financial reports & scheduling needs based on API scheduling

system software.

Travel Hemo-Dialysis Tech/GVN

Foundation Medical Management

Various locations

2004 - 2006

Traveled as a dialysis tech, I spent 9 months (three assignments) working in Spokane Washington

at three different dialysis units at the same time. I worked 2 units in Spokane and one in North

Idaho. After that I worked in Cape Gerado, Missouri for 6 months. General duties including

customer service, patient education on DM type I and II, counseling on diets and fluid

requirements. Weights done pre and post treatment, documentation done via computerized

medical record. Setup of dialysis treatment and initialization and discontinuation. Used Fresenius

"K" and "H" machines for hemodialysis.Facilitated maturation of new AV fistulas by

implementing a regular exercise program. Cannulated AV fistulas, and AV grafts, and requested

as per Doctors order to be one of two to cannulate all new AV Grafts/ Fistulas.

Clinic Manager

South West Dallas Family Medical Clinic

Dallas, Texas

2001 - 2002

I was the clinic manager for a family practice and therapy/rehab clinic. I saw patients when the

patient flow was high and was the liaison between the doctors and patients. I called in

medications or changed them as per standing orders for lab results. Created tacking logs for in

clinic procedures and made sure that billing was done correctly. Along with every day medical

duties I also helped coordinate a six clinic workshop to make sure all employees were up to date

on vaccines, new technology, and met CLIA requirements. I was working as the clinic nurse to

create new guidelines that were needed to help keep us in requirements with OSHA, and CARF.I

transitioned from an internal time and attendance system to KRONOS for scheduling time and

attendance/payroll, reviewing time cards, tracking hours worked, viewing vacation and sick time

and requesting time off for all nursing and physician staff (5 Physicians, 6 Medical Assistants, 3

Physical Therapy Techs, 1 Phlebotomist, 4 Referral Coordinators/Prior Auth Assistants, 3 Front

Office Assistants, 1 File Clerk, 2 Transportation Employees.

Hospital Corpsman (GVN)

Naval Medical Clinic London UK

Various Locations

1998 - 2000

As USN Hospital Corpsman I worked every position in several active duty & dependent

clinics/medical centers.Medical Admin: Where I composed, updated, and maintained all clinical

Standard Operating Procedure Manuals (SOP's). The following programs were used: Microsoft

Office, Excel, Word, Access, Power Point, and Outlook. Other Video software was used for

online meetings and Tele- Conferences. Medical Records Tech.: Maintained and created

complete and correct information on over six hundred active duty personnel in two computer

databases as well as in their medical record. Audiometric Tech.: Ensuring that the audio booth

was calibrated daily and functioning within all normal parameters. I administered the test,

interpreted, and imputed the information in a Navy Wide Hearing Conservation Data Base.

Immunizations: Giving injections in accordance with JHACO standards, and maintaining an up

to date knowledge of the used immunizations for both adult and pediatric. Research and ordering

of supplies and immunizations was done bi-weekly. Laboratory Assistant: Title "HIV

Coordinator for the United Kingdom. I collected HIV, DNA, and Rhfactor samples, and

packaged them for shipping to our contracted Lab. Reception: I dealt with customers both in

person and on the phone either booking future appointment or checking them in for current ones.

Also dealing with general concerns and inquires. Logistics: Helped down size our medical

supply warehouse and distribute excess medical supplies to neighboring "sister" clinics at no

cost; thus increasing our funds in the OpTarfor the next fiscal year. Scrub Tech, assisted in

procedures such as suturing application/removal.

Education:

Coastal Bend College

Vocational Nursing

2003 - 2004

University Of Maryland Eastern Shore

Some College Coursework Completed

Nursing

1999 - 1999

Hospital Corps School

Vocational Nursing

1998 - 1998

High School for the Health Professions

High School Diploma

Nursing, Health and Medical Administrative Services

1993 - 1997

Practice Management Institute:

Medical Operations, Healthcare Administration

Certifications:

Certified Medical Operations Manager

Graduate Vocational Nurse

Certified Clinical Hemodialysis Nurse

Certified Audiometric Tech

Registered Certified Medical Associate

Certified CPR Instructor

Certified DOT Urine Drug Collector

Certified DOT Hair Drug Collector

Certified DOT Breath Alcohol Tester

Professional Memberships/Awards:

Practice Management Institute

Naval Hospital Corps School

American Red Cross

Center for Nurse Education & Testing

Certified Medical Operations Manager

Graduate Vocational Nurse

CPR Instructor

Certified Clinical Hemodialysis Nurse

Interests:

Tennis

Books/Reading

Restoring Furniture

Painting

Skills:

Public Speaking (Expert)

Bi-lingual (Expert)

Microsoft Office (Expert)

Management (Expert)

Languages:

English (Fluent)

Spanish (Fluent)

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