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Customer Service Center Specialist

Location:
El Paso, TX, 79907
Posted:
September 08, 2022

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Resume:

JESUS N. QUIROGA

**** **** ****** **.

Canutillo, TX 79835

CELL PHONE 214-***-****

E-MAIL: adsht0@r.postjobfree.com

OBJECTIVE

Offer professional support to a company or institution by presenting an effective globally directed approach in delivering services to its client/market base with superior outcomes. Additionally, deliver a level of proficiency in an executive level leadership role that is unmatched. Individually broadening my overall scope of business acumen, management poise, and operations agility; optimizing my prospective, thus ultimately maximizing my organization's advantage potential.

EDUCATION/CERTIFICATIONS/LICENSURES

Ongoing

May, 2001

March, 2022

Oct., 2021

Oct., 2011

August, 2008

June, 2010

May, 2008

August, 2008

Pursuant of Ph.D. in Psychology Keiser University Ft. Lauderdale, Fl

B. A. Psychology New Mexico Highlands University Las Vegas, NM

Licensed Chemical Dependency Counselor-Intern

Department of State Health Services, TX Control #59223

Certified as a (QMHP), Qualified Mental Health

Professional in accordance with the Texas Mental

Health Community Standards.

National Registry Licensed EMT Life Ambulance Academy

American Association of Suicidology (AAS)

Individually Certified Member

Applied Suicide Intervention Skills Training (ASIST) by Living Works

Instructor Certified

QPR-Gatekeeper by the Institute for Suicide Prevention

Instructor Certified

National Council for Community Behavioral Healthcare

Mental Health First Aid

Instructor Certified

LANGUAGES

Full Bilingual Fluency: Speak & Write in the Languages of English and Spanish

Currently Learning: Speaking and Writing the Language of Arabic

PROFESSIONAL EXPERIENCE (LISTED BY DATE)

September 2021-Present Homeward Bound Inc.

El Paso, TX

Clinical Counselor

■Assist in managing operations on certain shifts. Provision of patient care including providing group therapy to patients with mental illness and substance use disorders.

■Provide family sessions with both adults and children/adolescents to resolve family discord and inter-personal conflicts.

■Provide psycho-education, motivational interviewing, individual sessions and cognitive behavioral therapy.

February 2020-May 2021 Dallas Behavioral HealthCare Hospital (Signature HealthCare)

Dallas, TX

Director of Admissions & Care Center Operations

■Efficaciously managed an Admissions Department and a Transfer enter including Bed Control. With an average daily 22 walk-in patients (voluntary & involuntary), transfers, and police drop-offs, intakes would be facilitated for a capacity of 116 psychiatric beds.

■Directly supervised, hired, promoted, trained, and groomed 34 professionals ranging from Nurses, Licensed Counselors, Social Workers, Admissions Call Nurses, and other peripheral staff.

■Managed to reduce through-put time (door-to-floor) from an average of 5.3 hours to 2.9 in one year. This was accomplished by reducing unnecessary forms in the intake process and training staff that delay of care to the patient is detrimental.

■Worked in tandem with the marketing team to retain the vision and mission of the hospital, and its core values to increase occupancy in the hospital based on clinical appropriateness and medical necessity.

■Provided trainings throughout the community and participated as a lecturer in various national/local conferences and health fairs promoting behavioral health training, mental health first aid, psychiatric disorder awareness, crisis management, and suicide prevention-intervention techniques. Provide CIT to law enforcement departments (Dallas PD, Dallas CO. Sheriffs, DeSoto PD, Garland PD, and Irving PD.

■Recently participated, passed, and commended after a comprehensive tri-annual audit by the Joint Commission (March 2021). Accreditation was re-granted.

■Participated in a Systems Improvement Agreement (SIA) that lasted 16 months. CMS audited all areas of the hospital including intake and exemplary marks where noted.

February 2017-February 2020 Dallas Behavioral HealthCare Hospital(Signature Health)

Dallas, TX

Director of Business Development & Care Center Operations

Manage 5 community liaisons for business development, 2 mobile assessment staff, 8 care center specialists and 4 reception/PBX staff.

Developed and implemented a detailed action plan for census growth every quarter, assigning key providers in the community to each community liaison based on the staff member’s acumen and experiential expertise and assigned geographically.

After extensive market research, created 20 deep-dive market analyses for each city in the DFW-Metroplex with a population above 50,000 persons. Each market analysis includes population, demographics, home values, household income, median age, medically insured percentage, Medicare percentage, and a disability index with the number of nursing/rehab senior facilities and hospitals and schools and universities.

Increased inpatient acute census, year over year from 2016 to 2017 and to 2018:

o2016Q1: ADC: 65.53 2017Q1: ADC: 95.85 2018Q1: ADC: 102.52

o2016Q2: ADC: 79.14 2017Q2: ADC: 102.35 2018Q2: ADC: 104.00

o2016Q3: ADC: 71.29 2017Q3: ADC: 97.65 2018Q3: ADC: 101.00

Implemented procedures in the Care Center/Transfer Center/Bed Control to maximize the processing in acceptance of MOTs(facility transfers), nearly doubling the number of transfers from 2016 to 2017.

Improved customer/call engagement by training care center specialist on phone etiquette, appropriate probe questions, review of test calls, call control, converting the call to assessment, and entering information accurately.

Implemented systems in the Care Center such as the 15-minute window for accepting/denying a transfer, ensuring medical appropriateness, proper bed assignment, documentation, 4-hour shift reports, and call follow up.

Working with a search engine optimization (SEO) and an online reputation management company to ensure hospital website, hospital reviews, posts on social media, and all other online content is positive and has a maximum impact in business development.

Provide community training/presentations at conferences, symposiums, and other venues on suicide intervention/prevention and crisis management.

May 2016-November 2016 TriWest Healthcare Alliance

El Paso, TX

Director of HUB Operations

Manage all contact center and medical operations with 5 departments, utilization management, quality assurance, referral, and medical management, inbound, and outbound.

Supervise 5 department managers with 13 supervisors and 26 team leads, and 240 representatives that report up to the leadership team.

With the Veteran’s Administration (VA) as a partner and a primary customer, the HUB is responsible for appointing veterans with medical/specialist appointments in which the VA is unable to or has service gaps.

Accept complex medical referrals from the VA, contact the veteran, and secure the timeliest appointment with a provider within the network

March 2013-April 2016 EPIC IPA, LLC/Cigna-HealthSpring

El Paso, TX

Director of Network Operations

Administer and oversee an operating budget of $7.4 million

Supervise, evaluate, and motivate 8 direct reports and approximately 400 personnel in contact centers staffed with Nurses, Auditors, Provider Rep’s, Marketers, Sales Rep’s, and Coders

Manage a provider network of 31 primary care physicians, 49 specialist physicians and associated 89 clinics throughout El Paso County

Recruit and negotiate with primary care physicians and specialists and promote capitation contracts and as appropriate fee-for-service contracting

Develop service trend analyses, referral patterns, service-cost analysis, and evaluate individual physician performance in order to optimize network optimization

Consult, train, coach, and maintain physician performance in accordance with CMS guidelines, insurance plan strategies including STARS measures, Risk Score, membership retention, growth, & the enhancement of customer service

Assisted in the development, growth, and oversight as an administrator of an Independent Physicians Association (IPA) with a physician run executive board with bi-laws, a strategic plan, and the eventual advancement into an LLC

Conducted a market analysis on El Paso County for a targeted demographic population in an aim to grow patient membership for the IPA

Achieved in executing a $68 thousand marketing campaign to include television, radio, print advertisement, print magazine, merchandize, and billboards

oAssisted in the creation, message, and production in 3 commercials with differing strategic objectives broadcasted on 4 different local Spanish language networks lasting 8 months at peak viewer times.

oDesigned 4 English language billboards to be strategically placed in high visual areas of the city with highest traffic volume for the pursued demographic

oDesigned and published a professional medicine-oriented magazine showcasing the IPA’s network of physicians, specialists, their locations, services, while style placing unrelated storing of entertainment and intrigue.

March 2011 – March 2013 El Paso Behavioral Health Systems (Prev: UBH) (UHS)

El Paso, TX

Director of Admissions & Director of Outpatient (PHP/IOP)

■Successfully managed an Admissions Department and an Outpatient (PHP, IOP, OPS), program with an average daily 46 walk-in patients (voluntary & involuntary), 190 psychiatric calls and an average daily acute inpatient census of 156 patients and an average daily census of 91 patients in sub-acute outpatient

■Increased inpatient average daily census from 128 to 151 in one year and increased average daily outpatient census from 45 to 91, highest census day in outpatient was 110 patients. This occurred over the course of two years through rigorous marketing efforts and maximization of quality care

■Directly supervised, hired, promoted, trained, and groomed 39 professionals ranging from Nurse Practitioners, Nurses, Licensed Counselors, Social Workers, Admissions Call Takers, Billing Staff, Pre-Cert Staff, Court Liaison, and other peripheral staff.

■Networked, build relationships, and communicated frequently with other medical emergency room directors, physicians, and other psychiatric facilities in Texas and New Mexico, and coordinated with the Office of Emergency Management, 911 operations, 211 operations, local law enforcement agencies, and the emergency preparedness office.

■Worked in tandem with the marketing team to retain the vision and mission of the hospital, and its core values to increase occupancy in the hospital based on clinical appropriateness.

■Enhanced customer service survey rates by 12% in one year, and by 16% the following.

■Provided trainings throughout the community and participated as a lecturer in various national/local conferences and health fairs promoting behavioral health training, mental health first aid, psychiatric disorder awareness, crisis management, and suicide prevention-intervention techniques.

■Successfully maximized insurance reimbursements through resourceful pre-certing procedures, verification of benefits, and timely billing, fiscal efficacy grew from 78% to 84% of insurance reimbursement at admission

■Participated, passed, and commended after comprehensive audits by CMS, DSHS, and the Joint Commission. An exemplary outcome rating was granted by all regulatory entities within the two years of auditing.

■Reduced violent/disruptive and self-harm by 11%. Implemented a safer process at admissions to include the wanding for weapons and conducted more intensive/frequent training procedures for all staff.

■Implemented a triage process by walk-in acuity status within 15 minutes of presentation assessed by a registered nurse and as needed by a licensed counselor with improved wait time by 24%, enhanced safety, and upheld customer service to a higher standard.

oThose preliminarily assessed as more severe/acute, were categorized as urgent (psychotic/imminent danger to self) would be seen at priority and immediately by a crisis assessment counselor.

oThose who were routine, not presenting danger to self at triage would be seen after the urgent patients.

oThose categorized as emergent would be transferred by a nurse via ambulance to a medical facility due to their medical acuity such as recent overdose or compromised medical condition.

September 2007 – March 2011 Emergency Health Network (Prev: El Paso MHMR) El Paso, TX

Director—Intake & Crisis Emergency Services Dept.

■Efficaciously developed and sustained a budget of $9.1 million

■Managed and developed training modules and competencies (when none existed) for 42 professionals ranging from Nurses, Licensed Counselors, Social Workers, Crisis Assessment Specialists, Crisis Hotline Specialists, a Jail Liaison at the EP county jail, and mental health technicians.

■Proficiently lead and directed all operations of a 24/7/365 psychiatric emergency intake walk-in crisis department with a daily average of 32 walk-ins, receiving, triage, a medical assessment, and a full psychiatric assessment leading to various dispositions from acute inpatient hospital referral, sub-acute facilities, and transport to the facility to discharge and a referral to outpatient services.

■Guide and manage a mobile crisis outreach team with an average of 18 daily calls for assistance for a psychiatric assessment to an acute crisis situation. Location would include in the community and in hospital emergency rooms.

■Developed from the ground up two sub-acute facilities, a Rapid Crisis Stabilization Unit and a Crisis Residential Unit to divert, as clinically appropriate, patients from more restrictive/longer stay/more costly/ acute facilities and psychiatric hospitals.

■Secured the funds from DSHS for a mobile intake crisis unit (a 28-foot tele-medicine capable RV) that went to remote areas of El Paso County to duplicate the intake/walk-in process and assessment.

■Lead a 24/7/365 crisis hotline for El Paso County with an average daily call volume of 210 calls with suicidal, homicidal, and intoxicated callers needing help.

oSuccessfully brought a National Suicide Prevention Lifeline center to El Paso to be integrated with the El Paso MHMR crisis hotline, only two others existed in Texas, in Houston and in Dallas.

oSuccessfully expanded the National Suicide Prevention Lifeline center in El Paso to have the capacity to accept crisis calls for another 46 west Texas counties.

■Accredited the Intake/Crisis Dept. walk-in unit, mobile crisis unit, and its crisis hotline to be accredited by the American Association of Suicidology after an extensive audit. Received the highest score in Texas, 144 points of a possible 148.

■After applying and as a result of the department’s accreditation and inclusion of the National Suicide Prevention Lifeline, a grant by DSHS was granted for $850 thousand dollars for infrastructure improvements, staffing enhancement, and community awareness education.

oSelected by DSHS as the Suicide Prevention Officer for El Paso County, which included the directive to gain suicide statistics for the medical examiner’s office and promote suicide prevention awareness in the community.

oProvided trainings throughout the community and participated as a lecturer in various national/local conferences and health fairs promoting behavioral health training, mental health first aid, psychiatric disorder awareness, crisis management, and suicide prevention-intervention techniques.

oConducted training to El Paso PD and El Paso County Sheriffs Dept. for all new recruits in the manner of dealing with the mentally ill and crisis management methods that include verbal de-escalation and reality orientation.

■Acted as a consultant for other crisis departments, mobile outreach teams, and crisis hotlines around Texas and the Nation as a model of efficiency in quality service, financial proficiency, customer satisfaction rates, a regulatory/utilization management asset, a patient safety innovator, and superiority in clinical patient outcomes.

April 2006 – August 2007 El Paso MHMR---ChAMHPs (Children’s Services)

El Paso, TX

Program Administrator—Clinical Counselor

■Direct overall operation of a program team in the Children’s Unit (ChAMHPs) of El Paso MHMR, children ranging from 4y.o. to 17.o.

■Provide individual and group therapy to children and

■Successfully ensured the clinic’s fiscal, operational, and quality assurance goals with state regulators and local stakeholders by maintaining proficiency and compliance in public health rules, state contracting guidelines, audits and ultimately ensured full compliance in all areas conducted by the multiple licensing authorities.

■Maintained excellent service quality, continued proper capacity of patient programing, and preserved core principles of treatment programs.

■Met financial goals within established budgetary guidelines in regard to revenue over expenditure. Sustained and exceeded maximum revenue flow streams and profitability through the diversification of billings and new revenue streams through the services provided by medical staff, counselors, and other direct care staff.

■Effectively marketed externally and internally for continues exposure in the intention of growth and competition awareness.

REFERENCES

●Terrance O’ Reilly—CEO, Smokey Point Behavioral Healthcare Hospital, Seattle, WA 972-***-****

●David Santillan—Service Coordinator, El Paso, TX. 915-***-****

●Nathan Smith—Clinical Staff Pharmacist, Flagstaff Medical Center, Flagstaff, AZ 520-***-****

●Selene Hammon--CEO, Unity Behavioral, Dallas, TX 385-***-****



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