Amythist Rodriguez Email & Phone Number

Honolulu, Hi

➤ Served as primary liaison between healthcare providers and the health plan for the entire West region of Oahu.➤ Supported open enrollment process, quality initiatives, NCQA accreditation, MQD readiness, and HSAG audits.➤ Produced timely, accurate reports including fulfillment of state contractual requirements and organizational needs.➤ Coordinated, developed, and executed communications such as surveys, directory, manual, website, and newsletters.➤ Researched and shared industry information on current issues in the health industry and communities served.➤ Represented the company at external provider events including exhibit booths, conferences, and meetings.➤ Developed and implemented strategic activities focused on provider retention and recruitment to improve profitability.➤ Coordinated and participated in provider contract negotiations as well as proactively met with providers and staff.➤ Provided materials and conducted provider training on policies, procedures, and available in-network services.➤ Monitored provider credentialing activities and contacted providers to obtain/document any missing information.➤ Maintained up-to-date knowledge of all current applicable federal, state, and local laws regarding healthcare.➤ Coordinated with providers to resolve issues regarding claims, fee schedules, policies, and prior authorizations.➤ Provided ongoing provider-facing services as well as researched and resolved provider appeals and grievances.➤ Recorded provider interactions and ensured performance metrics, objectives, and goals were met in a timely manner.

Kapolei, Hi

Waipahu, Hi

➤ Managed day-to-day operations to ensure adherence to the DD/ID Medicaid Waiver Provider Standard manual.➤ Oversaw programs including business, contracting, product development, healthcare delivery system, and compliance.➤ Collaborated with the Outreach Supervisor and Adult Day Health Supervisor to implement individual support plans.➤ Developed behavior management plans and techniques, training, and support for individuals served by the program.➤ Facilitated meetings with Service Supervisors, Case Managers, and family members to help coordinate plan of care. ➤ Monitored and evaluated the effectiveness of client's individual program and monitored Medicaid-approved budgets.➤ Provided monthly reports or supporting documentation required for any changes and concerns to the administrator.➤ Performed internal audits to ensure all reports and documentation were accurate and submitted in a timely manner.➤ Prepared and compiled required information and documents for State of Hawaii Department of Health annual audit.➤ Monitored employees and independent contractors credentialing activities and collected/filed missing information.➤ Facilitated oral and written communication between employees, case managers, guardians, and other agencies.➤ Ensured Standards of Conduct were maintained and maintained electronic filing system and hard copy files.

Temecula, Ca

➤ Assisted patients with exercise and stretching routines and led patients through their rehabilitation process.➤ Represented the department in the interdisciplinary team at assigned meetings and contributed to rehab meetings.➤ Monitored rehab equipment and supply needs and oversaw provision of various interdisciplinary education programs.➤ Provided direct patient treatment and maintained relationships with physical therapists, physicians, and other staff.➤ Ensured the highest standard of rehabilitation services were delivered efficiently with the best possible patient outcomes.➤ Contributed to a team of therapists and assistants to provide direct patient care and document medical services provided.➤ Monitored the standard of clinical services delivered to ensure adherence to evidence-based care delivery standards.➤ Ensured management of the rehab department including oversight for care planning and quality improvement initiatives.➤ Provided status reports and developed and implemented programs appropriate for the patient population served.➤ Educated patients by demonstrating proper use of equipment and exercise routines and answered questions and requests.➤ Maintained patient confidentiality and supported patients with mobility impairments through ambulation and transfer.

Lawton, Ok

➤ Assisted therapists with patient ambulation, transfer, and treatments as well as tracked patient vital statistics.➤ Supported patients with prescribed exercises and strengthening techniques under the supervision of licensed therapists.➤ Managed patient admission and discharge process as well as retrieved, organized, filed, and maintained patient records.➤ Ensured all documents were completed and filed properly and conducted internal audit to ensure quality of care.➤ Managed daily office operations such as answering the telephone, scheduling appointments, and controlling inventory.

Temecula, Ca

➤ Operated switchboard to relay incoming and outgoing calls and assisted guests in booking resort reservations.➤ Provided information and handled questions or requests for hotel, golf, show, restaurant, spa, and other activities.➤ Collaborated with other departments and vendors to integrate sales and bookings and increase company revenue.➤ Assisted customers in resolving any challenges regarding reservations, billing, and general hospitality issues.➤ Processed group reservations, online bookings, and package reservations with in-house outlets and outside vendors.➤ Performed clerical/administrative duties such as screening incoming calls, faxing, scanning, and copying documents.

Murrieta, Ca

Master'S Degree, Health Administration

Bachelor'S Degree, Kinesiology

Associates In Arts, Liberal Arts Studies

Associate In Science, Mathematics And Science

Associate In Arts, Social/Behavioral Science

Associates In Arts, Liberal Arts Studies