Experience

White Memorial Medical Center/Adventist Health

• Germany
• Hospitals and Health Care
• 1 - 100 Employee

• Manager Physician Relations

  • Apr 2017 - Present

  •Coordinate, develop, and implement the organization's strategies related to physician integration, development and practice support services. •Direct the expansion of the managed care delivery network and the access to medical services in the organization's surrounding communities. •Execute and manage all strategies to enhance relations between potential and current medical staff members. •Supervise and direct the activities of various levels of assigned personnel using both professional and supervisory discretion and independent judgment. •Build, cultivate and strengthen relationships with individual physicians, clinics, physician groups, staff and the broader community. •Analyze organization and physician related volume/activity on a regular basis. •Provide support to administration and service line directors to assist organization in meeting growth strategies as outlined in the organization's strategic plan •Coordinate implementation of a physician outreach and retention program. •Ensure ongoing identification of new physicians for recruitment or redirection from other facilities into key product lines. •Work to increase visibility of organizational referrals and increase referrals. •Coordinate ongoing physician relations activities including, but not limited to, networking meetings, luncheons, special events and seminars. •Participate in educational and self-development activities to enhance professional growth. •Perform other job-related duties as assigned. Show less



AltaMed Health Services

• United States
• Wellness and Fitness Services
• 700 & Above Employee

• Business Development Associate

  • Nov 2015 - Apr 2017

  •Identify primary care physicians to contract with AltaMed’s IPA in order to build business volume. Must enroll a company targeted % of contracted Primary Care Provider’s with AltaMed, 20 per fiscal year. Must enroll 20 Specialist per fiscal year. •Act as a liaison between the broker community, the plans and providers. •Facilitate the referral of managed care members from other organizations into AltaMed senior programs. •Investigate the industry trends and competition. •Conduct market research and analyzes data and make recommendations on sound business strategies. •Develop a situation analysis of the company including its strengths, weaknesses, opportunities and threat to assist in the development of a strategic plan for the future of the business. •Collaborate with marketing staff to build awareness of AltaMed managed care programs in the community. •Develop presentations and other materials as necessary to promote managed care programs. •Participate in health fairs and other community events to promote managed care programs. •Identify business development opportunities that will assist managed care programs achieve annual goals and objectives. •Track and reports outcomes of all business development efforts. •Work with Primary Care Providers to obtain membership transfers. •Create Financial Comparisons for negotiated Primary Care Provider agreements. •Negotiate Memorandum of Understanding for special programs, Primary Care Provider Agreements and Capitated Agreements with Specialist Providers. •Conduct Primary Care Provider orientations (includes training them on CapConnect and AltaMed Net) and conduct site reviews current and following a change of address. •Resolve Primary Care Provider’s claims inquiries, make monthly visits and develop relationships with them. •Conduct Specialist Provider Access Studies, Orientations and Site Reviews. •Organize internal and external communication to the IPA provider network. •Prepare and execute an IPA Communication Plan. Show less



PIH Health

• United States
• Hospitals and Health Care
• 700 & Above Employee

• Business Development Coordinator

  • Aug 2013 - Jun 2014

  •Safeguard and preserves the confidentiality of patient’s protected health information in accordance with State and Federal (HIPPA) regulatory requirements, Hospital and department policies. •Ensure a safe patient environment and adhere to safety practices per policy. •Utilize the approved process to resolve biophysical, psychological, educational and environmental needs of patient/significant other when administering care. •Collaborate with Business Development Consultants to support external needs, communicate issues, coordinate visits and streamline organizational physician outreach efforts. •Maintain BD sales tracking database and all other BD reporting required for the department. •Receive provider and patient calls and assist and/or refer to appropriate resource for assistance. •Assist in the development and maintenance of PIH Health Physician Directory. •Assist Business Development with various duties including meeting planning, scheduling, filling, etc. •Maintain a working knowledge of commercial, Medicare, Medi-Cal including Medicare Advantage plans and the various options for seniors. •Maintain the sales collateral inventory and coordinate reprints and updates with marketing department. •Support marketing and business development phone lines. Show less



BRIGHT HEALTH PHYSICIANS OF PIH

• Hospitals and Health Care
• 1 - 100 Employee

• Network Management Representative

  • Mar 2011 - Aug 2013

  •Schedule and attend provider office visits on a regularly established basis and/or as such needed to establish rapport and develop relationships with IPA physicians. •Communicate and resolve provider issues with operational procedures and conduct follow up within one week to close the loop and ensure provider’s issues were adequately resolved. •Compile provider feedback, surveys, suggestions and present initiatives to Network Management Director. •Prepare and distribute training and educational materials to all IPA provider offices and review materials with other office staff to ensure understanding. •Record, in database format, all office visit times, dates, personnel, issues encountered and resolution and/or other information regarding the provider discovered as a result of meeting. •Collaborate with Physician Relation staff to communicate issues, coordinate visits and streamline organizational physician outreach efforts. •Review and accurately maintain HMO/PPO directories, periodically reviewing directories for HMO/PPO accuracy. •Assist Network Management department with various contract management duties such as filling and mailing. Show less



Loma Linda University Medical Center

• United States
• Hospitals and Health Care
• 700 & Above Employee

• Administrative Assistant

  • Nov 2006 - Oct 2007

  •Answer all incoming calls and direct to appropriate department and personnel. •Schedule all patient appointments for Adult Echo, Pediatric Echo, Cardiac Lab and MRI departments. •Transcribe and type all medical reports for Adult Echo, Pediatric Echo, Cardiac Lab and MRI departments. •Review policies for completeness, accuracy and compliance with regulations to improve and develop policies and procedures. •Compile, transcribe and distribute minutes of meetings. •Prepare invoices, reports, memos, letters, financial statements and other documents using Microsoft Word, Excel, Power Point, access and outlook. •Assist other departments in the absence of personnel. Show less



Loma Linda University Health

• United States
• Hospitals and Health Care
• 700 & Above Employee

• Patient Service Representative

  • Oct 2005 - Oct 2006

  •Answer all incoming calls and direct to appropriate department and personnel. •Schedule all patient appointments for Internal Medicine and Pediatric clinics. •File and retrieve all medical records for internal and external purposes. •Open, sort and distribute incoming correspondence and faxes. •Prepare all Patient charts for daily appointments. •Verify all patient insurance information for eligibility and collect co-pays. •Monitor and control patient flow for check-in and check-out process. •Code and post all ICD-9 and CPT for billing insurance purposes. •Process all insurance authorizations. Show less



Dr. John H. Sanchez

• Front Office Specialist

  • Jan 2003 - Oct 2005

  •Monitor and control patient flow for check-in and check-out process. •Verify all patient insurance information for eligibility and collect co-pays. •Prepare all patient charts for daily appointments. •Obtain insurance authorizations and referrals. •Schedule patient appointments. •Open, sort and distribute incoming correspondence and faxes. •File and retrieve all medical records for internal and external purposes. •Answer all incoming calls and direct to appropriate department and personnel. Show less