PROFESSIONAL SUMMARY

Trilingual Clinic Director with 16 + years of experience in health insurance managed care environment to optimize goals for patients and ensure compliance with CMS regulations and government programs. Advanced knowledge of nursing principles, practices, and systems. Excels in executive and leadership development with the capacity to measure the success, and impact of programs and strategies, including but not limited to Managed care products, market research strategies, financial goals. Skillful in partnering with cross-functional stakeholders while supporting staff members to fulfill and deliver the mission and vision of the organization.

SKILLS & COMPETENCIES

Training & Development Regulatory Compliance Electronic Medical Records

Fiscal Management Operations Management Grant Research

Staffing Management Training Facilitation Critical Thinking

Emotional Intelligence Medical Management Federal Regulations

Care Coordination Population Management Managerial Finance

Value Chain Analysis Process Improvement Physician Relations

Process Implementation Health Plan operations Practice Optimization

Onboarding Process CPC+, PCMH experience Customer Service

Strong executive communication Budget Management Health Plan operations

Managed care products Market research Product development

Government Healthcare programs

PROFESSIONAL EXPERIENCE

Penn Medicine Princeton HealthCare System, Plainsboro, NJ 06/2005 – 07/2022

Clinic Director 01/2015 – 07/2022

Implemented program planning, budgeting, managing, and evaluating business and clinical services based upon community needs and Nursefinders resources and policies by identifying trends to anticipate future and ongoing needs, meeting operational and financial objectives, including implementation, support of government programs.

Eliminated process discrepancies and implement continuous improvements for optimal performance by offering administrative leadership in planning, developing, and executing best practices.

Increased client care scope by successfully transitioning the Bristol Myers Squibb Community Health Center to a Federally Qualified Health, growing clinic patient census/treatment volume.

Facilitated efficient and effective center operations by formulating schedules for all providers to guarantee adequate patient access and coverage, slashing clinic wait times. Specific slots were created for same day visits- increase number of visits and scores on patient satisfaction surveys.

Conducted, evaluated, reviewed, and approved research studies for the Institutional Review Board for Princeton Medicine.

Overseen efficient utilization of medication, laboratory, inventory, supplies, and equipment, achieving supply cost goals following established guidelines.

Administered initial corrective actions by overseeing the day-to-day performance of 80 FTEs, including setting performance targets, employing cross-training, and optimizing performance and satisfaction rates.

Facilitated informed decision-making by crafting and analyzing clinical and financial performance reports for optimal practice management, NJDOH state survey, and VFC audits.

Overseen overall clinical services, quality assurance, and performance improvement program following applicable standards of care by liaising with leadership, improving the effectiveness of programs.

Supervised physician onboarding and integration processes, including training and mentoring to boost their proficiency and competency, delivering the best care to patients via tools from the new EMR.

Liaise with health insurance to implement new initiatives, providing guidance, review material, and report quarterly on the progress of key metrics, optimizing goals for patients, and verifying compliance with CMS regulations. Developed and implemented policies to support Medicare, Medicaid, Charity care products for government programs.

Collaborated with different companies to identify opportunities and projects for underserved populations by conducting grant research, maximizing referral potential.

Developed plans and monitored implementation, integration and optimization of ambulatory practices by overseeing integration initiatives, including managing integration projects and facilitating the development and deployment of analytics processes.

Cultivated and maintained collaborative relationships with state and federal regulators in support of different programs, including NJIIS, DSRIP, and Horizon among others.

Evaluated medical records especially on Oncology and gastroenterology specialties to coordinate with various health insurance companies, for benefits to get patients’ future testing ordered by their health provider, as aid to decision making for next treatment.

Key accomplishments:

Diminished workplace injuries and eliminate worker compensation costs by spearheading multiple renovations to clinic space to ensure patient and staff safety continuity of care.

Developed a patient-driven access program by coordinating functions and activities of clinical operation departments, delivering the highest quality care/service to the community.

With Horizon NJ Health(Medicaid product), programs were created to maintain better clinical measures to all patients and bonuses checks were received for completion of all tasks and excellent patient care, with an 80% accomplishment increased on all evaluated measures.

Transitioned to 2 different EMRs without any discrepancies or disturbance on patient care.

Successfully increased amount of vaccines received from VFC program(over $250,000), due to the excellent monitoring, cold chain and inventory of them, demonstrated on each audit.

Decreased 15% on utilization of materials, without affecting clinical outcomes for patients.

With an increased of access to care during evening and Saturdays, a 30% reduction of unnecessary urgent care visits tip emergency room was obtained, with an increase on customer satisfaction due to the expanded hours, as well as designated slots throughout the day for same day visits.

Increased compliance percentage to 100% for audits on Charity care applications performed.

More access to other specialties under Medicaid program was established for more continuation of care of our entire population.

Increased access to care during business hours to adults and children, representing on a 17% decrease of unnecessary use of the emergency room services. Excellent customer experience.

Director Outpatient Practices 01/2011 – 01/2015

Developed a same-day access program for patients seeking specialized care by relocating practice from old to a new campus and opening recent locations within the community, meeting and exceeding organization goals.

Maintained a high level of service standards while increasing employee satisfaction by creating professional growth and training opportunities to ensure clinical competence.

Leverage EMRs knowledge to coach physicians, clinical staff, and administrative staff on effective exploitation to ensure efficient and effective delivery of health services in a unit, meeting quality objectives and targets.

ADDITIONAL WORK EXPERIENCE

Administrator Private Practices 08/2008 - 01/2011

Office Coordinator/Manager 06/2005 - 08/2008

EDUCATION & CERTIFICATIONS

Colorado Technical University, Colorado Springs, CO

Master of Business Administration (MBA), Healthcare Management

Universidad del Valle del Cauca, Cali, Valle del Cauca

Pediatrics

Universidad del Valle del Cauca, Cali, Valle del Cauca

Doctor of Medicine and Surgery

Languages: English, Spanish & French

TECHNOLOGY

MS Office Suite, EMRs, Electronic Medical Records: e-MDs, EPIC, eCW. PfP, ISR, NJIIS, Tableau.

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