Mecánico automotriz, driver forklift
Resume:
Lilien AlvaradoBarbaro Alejandro Alvarado
Lilien.alvarado@******.*************@*****.***
Summary of Qualificati
Education
Florida International University, Miami, Florida
Master of Public Administration, April 2017
Certificate in Homeland Security and Emergency Management
Bachelor of Arts in Political Science, May 2014
Minor in International RelaProfessional Experience:Experience
Cigna
Network Operations Senior Analyst 05/22 – Present
Ensure uninterrupted daily operations for Cigna’s contractors as they build and negotiate provider contracts within Cigna’s Contract Management System (Contract Manager).
Act as frontline support for all End User related to Contract Manager issues.
Manage all daily interactions with user community as well as assist with educational and technical needs as it’s relate to the process and application functionality.
Play a critical role in identifying any user access issues including, but not limited to, application outages, setting up of new user accounts and password management, as well as any new opportunities for process improvement.
Provide daily consulting, expertise and support to Contract Manager Users.
Manage Contract Compliance Unit (CCU) email box and 800# phone line.
Provide Ad Hoc consults to end users.
Provide assistance to end user with non-standard contract edits.
Root cause end user desktop issues.
Root cause application process failures e.g. broken approvals.
Serve as a voice of the customer for process and application enhancements.
Reassignment of existing contracts to other users.
Support departmental training initiatives.
Conduct WebEx Training Sessions on key topics.
Assist Training Team with training program document updates.
Support Post-Training New User Outreach Program.
Identify any issues with application from both a functional and process perspective.
Cigna-HealthSpring Houston, Texas
Network Operations Lead Analyst, 10/2017– P05/2022resent
Manage contracting for ancillary providers such as Skilled Nursing Facilities, Dialysis, Home Health, Durable Medical Equipment, Transportation and Ambulatory Surgery Centers
Build and maintain relationship with providers
Maintain effective communication with different matrix partners such as claims, health services, and legal
Partner with internal and external customers such as Claims Operations, Medical Management, Credentialing, Legal, Medical Economics, Compliance, Governance, Sales and Marketing and Service
Manage the agreement and amendment request and drafting processes
Facilitate and/or support negotiations, legal review and signature processes.
Coordinate appropriate business and legal review/response of negotiated documents.
Participate in member grievance resolutions and escalate to senior leadership as needed
Assist in resolving provider service complaints by; researching problems and negotiating with internal/external partners/customers to resolve escalated issues.
Prepare, analyze, review, and project financial impact of provider contracts and alternate contract terms
Review network in order to determine new providers for expansion opportunities
Assist providers with claim inquires and mitigate provider concerns
Establish, maintain, and amend agreements as needed
Responsible for accurate and timely contract loading, configuration, and interface with matrix partners for network implementation and maintenance
Review and analyze financial trends and present findings to leadership
Review agreements to determine opportunities for cost containment
Engaged in team development and independent work to conclude best practices
Coordinate and host skilled nursing facility operations meetings and provider formal orientations
Congressman Mario Diaz-BalartAlia Transportation United States House of Representatives MiamiWest Palm Beach, Florida 02/2023- Present
Transportation AssistantCo Ambulance not emergency ide, 09/2016 – 08/2017
Acted as a liaison with federal, state, and local agencies for the Member and Constituents
Handled casework for matters potentially requiring legislative action and make recommendation to the District Director or Chief of Staff
Acted as a community representative for the Member, specifically as to matters regarding Senior Citizens and Women in the community
Reviewed Military Academy applications in order to assist Member in narrowing field of candidates for Congressional nomination and assist in coordinating Academy Day event to provide constituents with information regarding Military Academy Application process.
Supported community outreach events and Congressional Art Competition
Staff Assistant, 01/2015 - 08/2016
•Assist Congressional Aides in day-to-day tasks
•Interact with constituents and process intake forms
•Process casework for Congressional Aides
•Contact federal, state, and local agencies for the Member and Constituents
•Supported outreach events
Ambulatory Diagnostic CenterTaller Abelardo Coral Gables, FloridaCuba 01/2020- 11/2022
Repair engines, gearboxes, transmission bar, crusette changes, radiators, starter motor, alternator and car differential. Install and change brakes, brake pads, bearing changes, suspension . Repair, power outages and ground problems. Also changed bulbs, fuses, tires, car alignment, oil change, oil filters and fuel filters.
•Accounted for and conducted daily cash deposit
•Ordered and distributed supplies
Billing Manager &Manager & Vice-President of Operations Assistant 11/2004 – 12/2013Batalla de Mal Tiempo - High School
•Supervised Billing, Collections Department, and front desk staff.
•Initiated and managed cross-functional teams and multi-disciplinary projects.
•Wrote appeals to insurance companies disputing payments and denials
•Worked directly with provider relations regarding contracting issueCruces, Cubas
Bejucalparlet.corporation Relevant Skills:
Driver forklift,04/2023-05-2024Languages: Bilingual Proficiency in English and Spanish.
Proficient in Word, Excel, Outlook & PowerPoint.
Contact this candidate