Project Management Change
Resume:
JENNIFER JINZO
**** ********** ***, ********, ** 30062 505-***-**** **************@*****.***
Professional Summary
A highly skilled leader with a solid background over 25 years in healthcare credentialing, enrollment, facility credentialing, contracting, contract negotiations, project management, team management, leadership, data conversions, implementations, building and configuring software, consulting, change management, process improvements, and strategy. Possesses strong leadership skills, and organizational leadership, including building and training teams, process improvement, establishing effective workflows, goals, benchmarking, sales, software demonstrations, and ensuring client satisfaction by establishing and maintaining quality and accuracy of projects. An adaptable and motivated leader with experience performing multiple, distinct roles without sacrificing quality. Energized by empowering teams to solve problems, introducing innovation, and improving processes that accelerate growth.
Summary of Qualifications
● Over 25 years of experience and knowledge in Credentialing, Payer Enrollment, Medical Staff Management, MCO Credentialing, Management, Project Management and Database Administration, Database Implementations, and Database Management For large enterprise healthcare organizations across all 50 states.
● Consultation and Expert level experience in providing services in medical staff services, and credentialing services in several settings, such as Academic, GME, Hospital, Private Practice, MCO, CVO, Physicians Groups, Telehealth, Behavioral Health and other ancillary services and large healthcare organizations.
● Expert Knowledge and awareness of all credentialing regulations to include NCQA/TJC/AAAHC/CMS/DNV standards, in both MCO and HMO settings.
● Experience in people and project leadership, product development, training & development, change management, strategic planning, client onboarding & success, software implantation, data validation, training, process improvement, consulting, and building best practices within implementations processes, management/project management, webinars on industry best practices, sales, and software demonstrations for potential customers.
● Successful experience providing provider support, administrative support, meeting management, site surveys, regulatory survey preparations, data entry, auditing, credentialing, database administration and billing support for large enterprise healthcare organizations.
August 2022 - August 2024 QGenda Atlanta, GA
Director of Credentialing
Manage implantation consultant team and services team, organization and facilitate all new implementations to ensure successful completion, and collaboration with other departments to ensure all timelines are met and client expectations are met. Established process improvements to eliminate client slotting, and improve implantation kick-off turn around times from 3 months to 1 week. Established goals, process improvement, tracking and evaluation to decrease implantation time from 6 months to 3 months for mid market customers. Evaluate and define customer needs for the implementation process to address requirements, and leverage expertise to assist in organizational rollout. Cultivate project timelines, documentation, establish processes and updates to develop and manage tactical plans. Assist in providing recommendations into the development of the software, and provide continuous support and recommendations for enhancements to solve business needs, customer feedback and requirements. Collaborate closely with upper management to drive strategy through development and implementation of new processes. Navigate, support and execute on change management within the organization. Provide assistance, expertise and support to other team members to educate on credentialing terminology to help aid in sales, marketing and development process. Develop, configure and test applications for accurate alignment with project standards. Liaise between product and internal departments and other personnel to assist with client requests,enhancements and future solution development. Actively participate in supporting product demonstrations, sales discovery conversations, RFP processes, aid in participating in webinars for client best practices on how to best utilize our product, assist marketing in the creation of ebooks and webinars, assist sales team to participate in conversations with potential customers, customer consultations for best practices, customer training, provide training to other departments on best practices relating to the implantation process, participate in on-site demonstrations, as well as leading the implementations on all current credentialing enterprise customers to help establish processes, and best practices, with continuous consultations in all areas credentialing from workflow building, to training, and data management, and review customers policies to ensure they are aware of industry standards, and help consult them on their own credentialing process improvements by evaluating, and providing them educational accreditation requirements to ensure they are aware of the standards and are kept up to date with requirements, Helped many customers reduce process turnaround times by consulting them, and helping achieve best practices and process improvements in the credentialing industry. February 2018 – August 2022 MedTalent dba CredentialGenie (Was acquired by QGenda) Jacksonville, FL Director of Credentialing (Remote)
Start up company consulted in the processes of building credentialing services, and new software development, oversaw and managed a team, in all credentialing services and contracts, to include services and software customers. Completed and processed credentialing applications for participation on a Medical Staff for privileges, to include primary source verifications to necessary standards such as CMS, TJC, AAAHC, DNV, NCQA. Perform enrollment for new providers with all payers in all states including all government, and Managed Care enrollments, e.g., Medicare, Medicaid, etc. Complete applications, facilitate contracts for groups, and individual provider's. Interview new providers in the recruitment process. Oversee the daily operations, and management of the credentialing and contracting for clients. Complete contract negotiations, on behalf of the client. Maintain provider's CAQH. Maintain reappointment processes. Maintain and monitor license expirations. Facilitate new service, or business startup, to include assistance with the business license, federal taxation, state registrations, site visits, and any other service we can provide for facilities, new groups or practices. Provides issue resolution and complex trouble shooting for providers. Perform consulting for medical staff management, policies and procedures, payer enrollment, practice start up, audits, and quality reviews. Assisted in the demonstration of the software for sales, and services. Assisted in the growth and success of small business to grow and increase in customers of over 70% only after 3 months, and increased profit and revenue by 80% in one year. After 5 years it was acquired after the success and growth and development of our services and software.
JENNIFER JINZO-CHAVEZ
February 2017 – February 2018 Medical Practice Solutions Albuquerque, NM Credentialing Account Manager/Coordinator/Remote
Enroll new providers with all payers e.g., Medicare, Medicaid, Medical Staff, etc. Complete applications, and facilitate contracts for groups, or individual provider's. Interview new providers in the recruitment process. Oversee the daily operations, and management of the credentialing and contracting for clients. Complete contract negotiations, on behalf of the client. Maintain provider's CAQH. Maintain reappointment process. Maintain and monitor license expirations. Facilitate new service, or business startup, to include assistance with the business license, federal taxation, state registrations, site visits, and any other service we can provide for facilities, new groups or practices. Provides issue resolution and complex trouble shooting for providers.
October 2012-February 2017 UNM/UNM Sandoval Regional Medical Center, Inc. Rio Rancho, NM Medical Staff Program Manager
Oversee the daily operations, and management of the credentialing & privileging for 600 providers. Process incoming applications and all paperwork associated therewith, ensuring that strict (appropriate) measures are taken to protect confidential information. Obtain primary verification of all items per standard credentialing guidelines. Coordinate physician-privileging process including supervision procedures. Create and maintain all provider credential files. Coordinate, maintain, and distribute all physicians’ on-call schedules for the hospital. Coordinate, manage, and act as recording secretary for all executive meetings, including Medical Executive Committee, Credentials and all Medical Staff Bylaws Committees, and annual Medical Staff Meetings. Act as a liaison for Medical Staff. Respond to external requests for privilege verification on current and past medical staff. Process and distribute all incoming mail. Oversee all functions of the Medical Staff. Integrated new software, managed, maintained and served as the administrator for all credentialing related software, to include custom reporting, user access, new entity integration and startup. Participate in the planning, development and implementation of CVO computer related applications. Provide continuous support, for updates, modifications and upgrades to current CVO software. Perform regular system monitoring, password management, create, change and deactivations of end users. Maintain, create and manage all custom reports. Oversee all education related rotations for the facility, to include the management and scheduling of Residents, Fellows, Medical Student, Nurse Practitioner, Physician Assistant, Paramedic Students, Dream Makers programs, and other community supported learning and shadowing experiences. Orientation and onboarding of new provider’s, develop, and maintain OPPE/FPPE criteria, coordinate, maintain, and ensure all peer review activities for closed sessions. Credentialing Coordinator/Database Administrator March 2012 – October 2013 University of New Mexico Health System Senior Analyst August 2007 - October 2011
& January 21, 2002 – April 8, 2005
Program Assistant
Hospital Services Corporation Albuquerque, NM
Primary source verification of education, licensure, insurance, references, affiliations/work history, follow-up and closing of NCQA/JCAHO files. Billing of initial and closing requests, process and data entry of all incoming mail items and credentialing documents. Process and writing of all credentialing related checks; maintain an ongoing interaction with providers & credentialing personnel or office managers to complete the credentialing process. Fingerprinting in accordance with the Department of Health Standards for background checks. Handle all applications for new licensure in the state of New Mexico; maintain reappointments to ensure timeliness of completion for over 50 customers, which were over 3,000 providers in the states of New Mexico and Louisiana. Implementation of all new customers, online access setup, and customer training. Maintained and managed all contracts, including new customers. Oversee and supervision of daily operations for all Analysts & Program Assistants. Performed as a lead in new database creation and setup, to include, windows based programs, access customized database, implementations of web crawling capabilities, and other web based software. Maintain and manage all tables, organization, entity set up, and end user training.
Relevant Experience/Certifications/Education:
CPCS Certification October, 2012 - December 2022
PESC Certified
Completed fundamentals in FDA, FCC, Terms of Sales and Evaluation, PC coding, Table software coding certificates. Proficient in Google & Windows based programs, to include administrator and database management for credentialing software. Previous credentialing database experience: Cactus, Verity, EchoOne App, Midas, Sales force, AMION, Cerner, Health Insight, Taleo, UHC, Press Ganey, NPDB/HIPDB, Pecos, NPPES, NaviNet.
Q Security Clearance held from 2015 - 2022
Associates of Applied Science in Management, June 2017 Bachelors of Applied Science in Organizational Leadership, 2019-2020 JENNIFER JINZO-CHAVEZ
Professional References:
Eleana Zamora, MD, Chief of Staff, Medical Director of Quality, Chief of Staff, Medical Director of ICU
Rebecca Bair, MD, Clinical Service Chief of Medicine
Peatra Bergenthal, RN, Quality Consultant
Ivette Liard, Data Outcomes Analyst
Grant Fields, Co-Founder & CEO
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