Vanessa Muela

602-***-****

ad3qsg@r.postjobfree.com

Professional Objective: To continue my career with an organization that will utilize my Management, Lead & Administrative skills to benefit mutual growth and success.

Highlights of qualifications

•Level One Fingerprint Clearance Card

•Knowledge of Microsoft Office, 50 wpm

•Ability to multi-task

•Medical Management

•Interpretation and Translation

•Detail oriented, organized and team player

•Employee Orientation and training

Related Relias Completed Trainings

CRN Performance Management Training or Supervisors

Essentials of Communication: Navigating Conversations

Effective Communication

Essentials of Communication: Effective Listening

Effective Workplace Writing

Fundamentals of Management vs. Leadership

Fundamentals of Management: Setting the Stage for Success

The transition to Supervisor

Working with difficult people

Boundaries

Basic Supervisory Skills

CRN Absence Pro for Supervisors

Documentation for Supervisors

Effective Communication: What Supervisors Need to Know

Essentials of Communication: Communication Effectiveness

Education

General Equivalency Diploma

El Paso Community College 1996

Work Experience

Eligibility Specialist

Solari: Crisis and Human Services

February 2022 – Current

Coordinates all aspects of SMI determination process including review of assessment and evaluation documentation, requesting additional medical records from outside agencies and contacting referring party for clarifying information as needed. Prepares case files for review by Psychologist and ensures all determination timelines are met.

Manage caseload of applications for SMI services. Upon referral, review and collect all available member assessment and evaluation documentation, request medical records and contact referring party for clarifying information as needed. Monitor Cognos report to track actions taken. Update each step in the determination process as it progresses (50%)

Coordinate care with mental health treatment providers. Determine whether information is sufficient for Psychologist to make a SMI determination. Contact outside agencies for additional information as needed (20%)

Respond to requests for information and direct requester to entities such as the RBHA, mental health providers, mental health court, SSI, DDD, GMHSA, etc. (10%)

Assess applications to identify collateral information that will influence the SMI determination process (5%)

Track all aspects of the eligibility determination process to ensure mandated timelines are met (10%)

Maintain communication with other agencies on behalf of the organization and member (5%)

Perform duties in compliance with AHCCCS requirements

All other duties as assigned

Contact Tracer

Solari: Crisis and Human Services

December 16, 2020 – February 2022

Complete both inbound and outbound related calls specific to COVID-19 Contact Tracing. Document caller needs, provide appropriate resources and gather pertinent data as directed by project/funder. Ensure outreach and response/support occurs in a timely manner. Responsible for clear and consistent documentation, referrals and outcomes.

Provide phone-based high-quality confidential information, referral and advocacy related to health, social services and infectious disease. This may involve providing scripted information about symptoms, how to access medical care and connect to appropriate services.

Assisted with lead duties when needed. Conducted spot checks to verify documentation and phone calls were made to monitorees whom had been exposed. Assisted with merging monitoree files to a household onto Sara Alert. Assisted with daily chats for breaks and/or questions/concerns from staff.

Assisted with multiple lines such as: Immunization, Parent Hotline, Complaint line and Vaccine line.

Assisted leads with chats when needed

Merged monitoring households

Assisted supervisors with special tasks as assigned

Assisted lead with daily spot checks

Youth Caretaker

Caprock Home Health

October 2019 – November 2020

Help supervise the youth in our care

Act as a mentor and set a positive example

Oversee and encourage resident participation in group activities

Encourage completion of daily chores and personal hygiene tasks

Provide one-on-one supervision or support as needed

Document patient progress, immediately reporting any extreme changes in behavior

Report any incidents that may affect the safety or any resident

Maintain a safe and healthy environment

Assisted with meals

Spanish Interpreter

Cyracom International - Phoenix, AZ

July 2019 to October 2019

Responsible for handling calls on demand, rarely by appointment, and renders the meaning of conversations in the consecutive mode of interpretation between Spanish and English speakers. The interpreter processes information quickly and concisely, recognizes sensitive cultural differences and is always professional and courteous. The interpreter uses appropriate terminology and understands common industry procedures and practices. The calls may be technical or non-technical in the following fields: finance, healthcare, insurance, 911 and government agencies.

Ability for follow HIPPA guidelines.

Texas Works Advisor I

Texas Health and Human Services Commission - El Paso, TX

November 2018 to August 2019

Knowledge of interviewing techniques to obtain highly personal information, make inquiries, and resolve conflicting client statements

Ability to actively listen to clients, elicit, relate and evaluate information, and interpret terms and complete work within specific deadlines. Ability to work in a fast paced and constant changing environment.

Ability to read, understand, and apply a variety of interrelated instructions, such as those found in guidelines, regulations, and policies

Ability to establish priorities according to relative importance and deadlines, set goals, and manage time efficiently • Ability to identify conflicting information provided by the clients or their authorized representatives • Ability to operate computer equipment

Skill in establishing and maintaining effective working relationships, including the ability to work with people under pressure, negotiate among multiple parties, and resolve conflicts

Skill in organizing, prioritizing, writing, proofreading, editing, filing, record keeping, and interpersonal communication • Skill in communicating effectively both verbally and in writing.

Outreach Care Specialist

Amerigroup - El Paso, TX

September 2017 to July 2018

Responsible for ensuring that appropriate member treatment plans are followed on less complex cases and for proactively identifying ways to improve the health of our members and meet quality goals. Primary duties may include, but are not limited to:

Responsible for providing excellent customer service and accurately and detailed documentation

Assisted members with transportation needs both local and out of town.

Identifies barriers to plan compliance and coordinates resolutions.

Process transportation, pest control, PCP changes, ID card requests, referrals

Ability for follow HIPPA guidelines.

Human Resources/Office Manager

Atlantis Health Services - El Paso, TX December 2016 to July 2017

•Directly responsible for the coordination, marketing, recruiting, and Interviewing process of potential employees for positions within the organization

•Processed and managed new hire request/open position requisitions and conducted orientation for new employees

•Established organization policies and standard operating procedures for members within the organization spanning across three clinics.

•Managed employee personnel files, payroll, and administrative requests within the organization

•Create/communicate offer letters for potential employees

•Run and analyze background checks; including fingerprints (pre-employment and post), and credentialing packets for physicians and nurse practitioners assigned to the organization

•Responsible for the mentorship and supervision of 10 customer service employees; also seven nurse practitioners and three physicians.

•Facilitated, verified, and coordinated scheduling of patients for physicians, nurse practitioners, therapist, and case manager's within the organization.

Assistant Business Office Manager

Oasis Nursing & Rehab

November 2015 to February 2016

Assisted Manager in all business office matters.

Booking travel and accommodations and organizing physician work trips.

Helped residents and family members apply for Medicaid services and benefits.

Handled Trust Fund, withdrawals and deposits for residents and made runs to bank, post office and other locations as instructed by manager

Monitored delinquent accounts/collections for the company

Dealt with social security and HHSC office for Medicaid updates as well as update medical records. Updated census data on a yearly basis

Correspondence Coordinator

Super Health Plan - El Paso, TX

February 2009 to July 2014

Interviewing possible candidates for a position with our department

Responsible for explaining program benefits to our members and providers as well as verifying case information.

Responsible for preparing and submitting ID card requests daily and on timely basis to Business Ink(BI)

Responsible for "Contact Us" emails (member requests)

Responsible for placing (current) order and maintaining Provider Directories and Member Handbook inventory as well as distribution of directories to staff. Organizing and keeping enough inventory for future use.

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