Skills
technical proficiency in Power BI, OMNI, UNITY, ABS, Microsoft Excel, Outlook, Teams and claims systems.
Network Adequacy, Appeals & Grievances, Provider Relations, Regulatory Compliance
Detail-oriented, collaborative, adaptable, strong communication, positive team player
Commercial, Medi-Cal, Medicare, Managed Care, Timely Access Standards
Medical Terminology
Utilization Management
Prior Authorization and Benefits
Data Analytics
HIPAA Regulations
About
With over 20 years of experience in health administration, provider relations, and regulatory compliance, provider engagement, data analysis, training and education, reporting and audit readiness within managed care environments. I am well-versed in all Line of Business and Federal and State regulations.
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