Experience

Pacific Partners Management Services, Inc.

• United States
• Medical Practices
• 1 - 100 Employee

• UM Compliance

  • Jan 2018 - Present

  Maintain a working relationship with all Health Plan auditors. Oversight of Appeals, Grievances, and response timelines. Participate in all Health Plan audits and logistics. Prepare and submit all supporting documents for health plan audits. Successfully created a regulatory authorization report. Manage weekly, monthly and quarterly regulatory health plan reports. Responsible for specialist termination letters to members. Utilization Management/Quality Improvement Committee preparations and minutes. Department all staff meeting preparations and minutes. Attended four ICE Conferences in San Francisco. Participant of the company Safety Team. Show less



Pacific Partners Management Services, Inc

• United States
• Medical Practices
• 1 - 100 Employee

• Authorization Representative

  • May 2016 - Jan 2018

  Oversight of Appeals, Grievances, and the timeline response. Completely overhauled the entire Medical Management incoming faxes and filing. Utilization Management/Quality Improvement Committee preparations and minutes Department all staff meeting preparations and minutes. Coordination of daily incoming authorizations, totaling approximately 125 per day. Oversight of Appeals, Grievances, and the timeline response. Completely overhauled the entire Medical Management incoming faxes and filing. Utilization Management/Quality Improvement Committee preparations and minutes Department all staff meeting preparations and minutes. Coordination of daily incoming authorizations, totaling approximately 125 per day.



Physician Focus, Inc.

• United States
• 1 - 100 Employee

• Executive Assistant

  • Jul 2012 - May 2016

  Oversight of daily work flow, including: Performing payroll calculations, Responsible for 401K and H.S.A distribution following payroll. Monitoring physicians credentialing process. Monthly reconciliation of bank accounts. Verification of shift schedules and daily patient census. Oversight of daily work flow, including: Performing payroll calculations, Responsible for 401K and H.S.A distribution following payroll. Monitoring physicians credentialing process. Monthly reconciliation of bank accounts. Verification of shift schedules and daily patient census.



Synergy Healthcare Partners, Inc.

• Project Manager

  • Dec 2010 - Jun 2012

  Collaborated with the executive teams of individual physician practice groups to form Medical Foundations in the Silicon Valley including: Coordinate and develop physician initiatives. Conducted research and present solutions on physician initiatives. Coordinate operational activities to ensure timely completion of defined milestones. Maintained accurate documentation of meeting attendance and committee logs. Developed tools and tracking systems for documents and critical activities. Coordinated executive business calendars. Prepare and coordinate committee and organizational meetings. Created an information management system scheduling regular updates to ensure current and accurate information. Assist with compliance and audit preparation. Show less

• Medical Management Administrative Assistant

  • Apr 2009 - Nov 2010

  Provided overall support to the Medical Management and Corporate Departments for a large Medical Services Organization (MSO), including: Coordinated schedules for multiple Medical Directors. Assist Quality Assurance Manager with Quality Assurance projects to meet annual standards. Synchronized multiple projects to achieve the strategic business plans and the organizational objectives. Responsible for establishing rapport and maintain communication with stakeholders both internally and externally. Collaborate with Project Management staff to manage cost, coordinate schedules and evaluate project performance. Coach, mentor and lead personnel within a team environment. Received and screened visitors and callers exercised judgment in their disposition. Assist with research report outcomes. Handle challenging individuals with professionalism. Oversee departmental operations (non-personnel) to ensure alignment with stakeholder objectives. Show less



Santa Clara Family Health Plan

• United States
• Insurance
• 100 - 200 Employee

• Network Management Administrative Assistant

  • Aug 2002 - Feb 2009

  Liaison for the Vice President of Network Management for internal and external contacts, including: Explained operational and administrative processes and procedures. Interface with Federal, State and County associates. Preparation of complex documents and proposals. Drafted correspondence, bulletins and memoranda. Managed detailed and complex files, records and reports. Maintained systems for tracking of projects. Provided administrative and organizational support for department meetings. Received and screened visitors and callers, exercised judgment in their disposition. Maintained confidential information and records. Knowledge of HIPAA requirements. Assisted in managing contracting processes and contract files. Performed credentialing functions for ancillary providers. Show less



Mitchell C. Sollod, MD Inc.

• Team Leader

  • Dec 2001 - Jul 2002

  Served as a Team Leader for a busy five- physician pediatric office, including: Coordination of doctors’ schedules. Scheduling and confirming patient appointments. Oversee print production related to patient flyers, immunizations, child safety and miscellaneous forms. Ordered and organized supplies. Process correspondence. Coordinate monthly staff meeting agendas and logistics. Performed general physician office duties. Served as a Team Leader for a busy five- physician pediatric office, including: Coordination of doctors’ schedules. Scheduling and confirming patient appointments. Oversee print production related to patient flyers, immunizations, child safety and miscellaneous forms. Ordered and organized supplies. Process correspondence. Coordinate monthly staff meeting agendas and logistics. Performed general physician office duties.



San Mateo IPA & San Francisco IPA

• Corporate Executive Assistant

  • Jul 1997 - Oct 2001

  Provided administrative assistance to Chief Executive Officer, IPA Physician Presidents, Corporate Officers and Consultants, including: Preparing presentations, proposals and tables, formatting documents from hand written drafts, and overseeing incoming correspondence. Maintained corporate files and contracts. Coordinated meetings for three Boards of Directors including compilation of agendas and materials. Coordinated annual shareholder meetings including compilation of annual reports. Managed off-site storage of corporate records. Coordinated HMO audits. Show less



San Mateo IPA & San Francisco IPA & Santa Clara County IPA

• • Feb 1995 - Jul 1997

  Provided administrative and organizational support to CEO and IPA Presidents for special projects, including:Coordinate meeting logistics and compilation of meeting materials.Managed files and corporate records.

• • Nov 1993 - Feb 1995

  Extensive contact with hospitals, physicians, Federal and State agencies in the maintenance of the Network Management physician files for the credentialing and re-credentialing process.