Manager Medical
Resume:
ROBERTO
PENAFUERTE
CASE MANAGEMENT
CONSULTANT
SKILLS
- Budgeting proficiency
- Project management authority
- Effective staff coach
- Planning and development
- Analytical thinker
- Supervisory training
- Strong presentation skills
- Management Information Systems
- Knowledge of statutes and regulations
- Strategic planning capability
PROFESSIONAL SUMMARY
Innovative, customer-oriented health care administrator with background in managed, ambulatory and long-term care. Strong background in quality assurance, claims analysis and management principles and practices.
Seeking a leadership role within an integrated delivery system. Highly analytical health care management
professional combining more than number years of work in long term care with proficiency in financial
management, leadership and positive clinical outcomes. As a Workers compensation adjuster, I am skilled at communicating, organizing and solving problems to raise the stature and rankings of health care facilities. Successful health care administrator with 16 years designing and implementing regulatory compliance
systems and guidelines.
REACH ME AT:
Telephone: 214-***-****
Email: *************@*****.***
LinkedIn: @robertoprenafuerte
WORK EXPERIENCE
Medromedical Consultants
Manager/Partner 2013-present
- Managing partner and co-owner of this Administrative Business
-Performs case management functions such as coordinating and providing care to DOL clients in a safe, timely, effective, efficient, and client-centered manner.
-Handles case assignments, draft service plans, reviews case progress, determine case closures, develops effective working relations with clients and cooperate with medical teams throughout the entire client's case.
-Serves as liaison between claims examiners, medical doctors, and their staff, as well as clients who need assistance in other issues such as medical treatment, insurance issues or denials and others. Accuhealth, Incorporated
Office Manager, Medical Adjuster & Case Manager
11/1997- 02/2013
- Organized the department in accordance with administrative guidelines in order to provide specified nursing services to meet the legal, organizational and medical staff guidelines.
- Skillfully developed departmental goals, objectives, standards of performance, policies and procedures.
- Led the planning and achievement of goals and objectives consistent with the agency mission and philosophy.
-Recruited, hired, trained and coached on average of number new employees per year.
-Developed a system of staff communication that ensured proper implementation of treatment plans and comprehensive patient care.
- Educated staff on state and federal statutes, rules and regulations governing home care services.
- Oversaw private and MCR billing, payroll, AP, and AR and verified that proper procedures were followed.
- Developed and achieved financial and growth goals.
- Encouraged creative thinking, problem solving, and empowerment as part of the facility management group to improve morale and teamwork.
- Investigated and reported issues relating to patient care or conditions that might hinder patient well-being.
- Cooperated and communicated effectively with physicians to ensure client satisfaction and compliance with set standards.
- Certified that equipment and supplies were properly maintained for quality patient care and safety.
- Assigned employee areas, scheduled staff breaks and authorized overtime.
- Analyzed patient and family feedback to identify opportunities for staff recognition as well as areas for improvement.
- Created and maintained computerized record management systems to record and process data and generate reports. American Airlines/American Eagle
Fleet Service Clerk, 09/1986 to 11/1997
- Effectively worked as a fleet service person for airline ramp services by assisting and managing customer baggages and trip plans to ensure that all baggages are transported properly and timely to every destination.
ROBERTO
PENAFUERTE
CASE MANAGEMENT
CONSULTANT
REACH ME AT:
Telephone: 214-***-****
Email: *************@*****.***
LinkedIn: @robertoprenafuerte
CERTIFICATIONS:
Workers Compensation Adjusting in the State of Texas ( August 27, 1999 - completion of Authority Code 3 level)
Ethnic in Disability (July 7, 2000 - American Academy of Disability Evaluating Physicians Completion Training) AMA Guides Basic Training Course (July 7-8, 2000 - American Academy of Disability Evaluating Physicians Completion Training) Medical Review Educational Seminar for the State of Texas
(August 16, 2000)
ACADEMIC EXPERIENCE
EL CENTRO COMMUNITY COLLEGE IN DALLAS, TX
INSURANCE AND MEDICAL ADJUSTING -1999
Associate of Arts
Dallas, Texas
PATTS SCHOOL OF AERONAUTICS
AERONAUTICAL ENGINEERING/BSAMT - 1976
Bachelors of Science
Manila, Phillippines
ST. ANDREWS SCHOOL
HIGH SCHOOL DIPLOMA -1972
Manila, Phillippines
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