Medicare Unit Manager and Interregional Liaison

Posted on: 2006-06-21

Tracy Mora 7565 Dawn Haven Dr. Parma, OH 44130 (440) 342-7510 [email protected] Summary Strong experience with EPIC software in a clinical Healthcare setting including several billing applications. Substantial integration experience with Siemens, CMS, EPIC, and other Software. Supportive team worker and IT trainer for RN’s, MD’s, other Providers, and Management Staff. Able to prioritize and organize workload meeting deadlines and accomplishing goals, in static or changing environment. Nine years of specialized experience with disabled adults, senior citizens, End Stage Renal Disease, and Hospice patients in a non-profit organization. Relevant Experience Managerial Skills Reporting to the Finance Director, responsible for managing day-to-day operations of the Medicare Unit in Membership Administration. Track the progress and job costs of multiple projects taking place in an 8-state area. Conduct company meetings to inform staff about issues such as new employee benefits; train staff on company policy; and report on department goals. Perform the function of interregional Ambassador to facilitate change and communication for Special needs clients. Creating and maintaining departmental guidelines; including budgets, payroll, Federal and State regulations, and producing reports. Cost recovery and quality assurance for Medicare plans; liaison between Organization and Government Agencies. Customer Service Skills Acknowledging the customer’s needs and expediting requests for service; assuring quality contact with Special Needs clientele. Greeting and maintaining a friendly demeanor with internal/external clients. Able to manage difficult clients and situations with calmness and professionalism. Taking the time answer a question or find someone who will. Office Skills/IT Skills Use of multi-functional phones and ACD line technology. Advanced Computer Skills; Word, Excel, Access, PowerPoint, Epic, WordPerfect, Lotus, McCoy, DB2, CMS, SIEMENS. Business end-user and trainer specializing in data-mapping, conversion, and migration of systems; Membership, Claims, and Patient Accounting. Employment History 1996-Present Kaiser Permanente of Ohio Held positions of increased responsibility for this Non-Profit HMO with clients throughout The United States. Interregional Liaison between Ohio and other Kaiser Medicare and Membership units. Medicare Unit Manager-Responsible for the daily operations of the Medicare Membership administration of staff, policy and procedure, and compliance of multiple Medicare and Medicaid plans. Created audits with the Medicare Unit to ensure quality and compliance with Federal and State guidelines. Interregional Project Manager-Data mapping of membership information from old Kaiser Claims and Patient Accounting systems to new Claims and Patient Accounting EPIC systems. Recruitment, hiring and firing, training, goal setting, and performance reviews of staff, including interregional teams. Successfully led the migration and conversion of Membership services from the Ohio office to Fort Worth TX, while meeting all Federal and State audit requirements and deadlines. 1995-1996 Future’s Unlimited, Parma Ohio Temporary Staffing Held several Office Manager Positions including; Port Authority of Cleveland, Physician’s Office in Rocky River Ohio, and Kaiser Permanente (was hired permanently in 1995 by Kaiser). 1989-1994 Artistic Advancements Imaging Consultant using Computer Imaging Software. Manager of client communications, sales and collections. Education Baldwin Wallace Berea, OH Business Administration Dean’s List Degree Expected June 2007 Awards December 2004 Manager of the Year-Healthcare Administration March 2003 Service Award for Excellence June 2002 Service Award for Excellence October 2001 Customer Service Award-Manager of the Month Volunteer 2001-2006 Children’s Book Fair-Learn to Read campaign. 1995-2005 Harvest for Hunger Campaign; Raising Funds through monthly Breakfast Drives, Bake Sales. 1997-2005 Coats for Kids Volunteer 2006 PTA-Pleasantview Elementary, Book Fair June 2006-Volunteer Award, Pleasantview Elementary