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CLINICAL OPERATIONS COORDINATOR/MANAGEMENT – HEALTHCARE

Accomplished and dynamic professional, with extensive experience in clinical operations management. Highly motivated, dependable, and demonstrates professionalism in handling various organizational functions and management strategies critical to organizational success with proven ability to thrive in busy environments with positive results. Detail-oriented and strategic thinker with strong analytical skills and proficiency in clinical operations with profound capability to prioritize, coordinate and direct multiple tasks simultaneously. Innovative and reliable individual with proven ability to achieve organizational goals while displaying effective multi-tasking and time management skills. An excellent communicator coupled with strong interpersonal skills, adept at building productive relationships and building rapport with a diverse set of individuals.

Core Competencies
Organization Leadership • Operations Management • Customer Service • Client Relations Management • Case Management • Procedural Compliance • Six Sigma (Healthcare Green Belt) • Sales • Project Management

PROFESSIONAL EXPERIENCE
CVS, Greensboro • NC 4/2012 – Present
Clinical Operations Coordinator
Coordinated care to enrollees of all ages for 17 rare illnesses, including families and service providers, and provided appropriate services and resources. Answered enrollees’ questions regarding educational materials, benefits and risks of all services within the Person- Centered Plan. Responded to inquiries regarding waiting list status and assisted with requests for emergency service consideration, transition from one service to another and routed state required eligibility and clinical support documents to state evaluators for enrollment. Assessed potential enrollees for service. Performed related tasks as assigned.

GMAC, Winston-Salem • NC 4/2011 – 4/2012
Direct Sales Agent
Handled inbound sales calls and customer service calls regarding underwriting, marketing, billing, and endorsement inquiries from current and potential insurers. Provided rate quotes and presented new policies to prospect clients, performed cross selling of other products. Documented calls, conducted research, calculated billing amounts, analyzed and processed policy transactions and maintained company records. Conducted outbound calls to follow-up on sales leads or obtained additional customer information.

Aetna Health Insurance, High Point • NC 9/2010 – 3/2011
Engagement Account Manager
Engaged Federal and State employees with major illnesses within the disease, case management, wellness, and maternity programs for Aetna. Organized wellness coaching and nurse assessments for Aetna Health Insurance Technical support for portal assistance. Consulted on deal terms to ensure operational viability of the solution, determined, and executed operational plan for achieving overall program goals.

Blue Cross and Blue Shield of NC, Winston-Salem • NC 9/2005 – 12/2007
Account Executive
Presented health and ancillary insurance products to North Carolina individual clients in sales meetings for Medicare Advantage, Medicare Supplement and Dental Programs. Handled multiple projects under the Director of Sales at Blue Cross of NC. Complied with the Center for Medicare and Medicaid Services regulations and HIPAA guidelines. Sustained knowledge of interactive products, industry trends and compliance issues. Prepared weekly sales reports, activities and revenue reports. Organized meetings and developed Person-Centered Plans for eligible enrollees. Evaluated potentially eligible enrollees for services, including verification of Medicaid and Medicare eligibility and assurance. Maintained good relationships with community stakeholders including enrollees, community agencies and residential facilities.

EDUCATION AND CREDENTIALS

Masters of Science in Human Services, on going
University of Capella

Bachelor of Science in Healthcare Management, 10/2010
Associate Degree of Arts in Liberal Arts, 11/2004
University of Saint Leo

LICENCES & CERTIFICATIONS

Executive Certificate of Negotiations, 5/2011 | Health and Life Insurance License, 11/2006 | Long Term Care and Medicare Supplement License, 11/2006 | Risk Case Management, 2010 • Health Management, 2012 • Records Management Program (2012) | Records Management-Corporate Handling PHI and Other Confidential and Propriety Information, 2012 • Medicare D 2012

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