Andre G. Email & Phone Number

San Diego, Ca, Us

San Diego, Ca, Us

Holistic Project Engagement: Lead the charge in all project phases, from requirements gathering to testing, training, and stabilization.Policy and Procedure Mastery: Gather and document UC policies, collective bargaining agreements, and procedures, laying the groundwork for insightful requirement sessions.Process Optimization: Define current and future business processes. Effective Documentation: Document functional issues, risks, and configuration decisions collaboratively with vendor consultants, ensuring clarity and consistency.Technical Collaboration: Collaborate with technical teams to articulate integration requirements and specifications, fostering system cohesion.Custom Solution Design: Develop detailed functional specifications for custom report generation, enabling comprehensive data-driven insights.Stakeholder Consultation: Advise stakeholders on options, risks, and cross-functional impacts, ensuring informed decision-making.Transparent Reporting: Provide concise project status updates to management, promptly highlighting priorities, issues, and risks.Supportive Role: Assist the project team with administrative and reporting tasks as required, contributing to seamless project execution.

Oakland, California, Us

Focuses on case resolution with emphasis of coverage issues to ensure no discrepancies exist among systems, with our members’ complaints.Supports daily Business Case Development through timely analysis and resolution of member complaints by performing research and review through multiple systems.

San Diego, California, Us

• Conducted hundreds of interviews with confirmed infectious disease cases, demonstrating adept data extraction skills to gather crucial information vital for an in-depth analysis of disease spread patterns within the community.• Utilized San Diego County's advanced infectious disease software to methodically curate and manage complex datasets, encompassing lab reports and referrals directed to key entities, including the Center for Disease Control and Prevention, California Department of Public Health, Border Patrol, and Division of Global Migration and Quarantine. Leveraging financial modeling software, I ensured the meticulous organization of data for comprehensive analysis and financial reporting. • Orchestrated a meticulous documentation process for infectious disease cases, covering the entire span from the initiation of the exposure period to the conclusion of the communicable phase. These meticulously captured insights laid a robust foundation for data collection and served as valuable inputs for subsequent research endeavors aimed at unraveling clinical intricacies.• Collaborated closely with multifaceted teams, including contact tracers, case managers, CDC officials, and esteemed public health professionals. Together, we designed and executed a systematic approach that incorporated Testing, Tracing, and Treatment. My utilization of data software in data analysis allowed us to effectively stem the spread of infections across diverse settings, including households, workplaces, and the broader community.

Oakland, California, Us

•Execute data maintenance and collection strategies for Kaiser Permanente's insurance beneficiaries: HMO, POS, Medicaid & Medicare beneficiaries, adhering to stringent standards and protocols. •Monitor, track, and oversee file transmissions between regions, ensuring the timely and secure delivery of sensitive data to our print vendor, while meticulously mitigating any potential breaches of protected health information (PHI). •Manage and maintain a comprehensive record of insurance card inventory, collaborating closely with vendors to ensure consistent availability and appropriate stock levels. •Serve as the primary point of contact for incoming insurance card inquiries and requests, delivering prompt, accurate, and professional responses while upholding the highest standards of customer service.•Develop and generate monthly and weekly financial reports, meticulously detailing costs nuances to assist with proper budgeting. These reports were instrumental in informing data-driven decision-making processes.

San Diego, Ca, Us

•Solely responsible for a comprehensive financial analysis in order to secure funding for over 30 in-house patients during a week-long period for both uninsured and underinsured patients, evaluating eligibility for diverse funding sources, including governmental, commercial, and private options. My role was centered on leveraging individual patient financial data to guide strategic decision making on a case-by-case basis, ensuring seamless access to essential healthcare services. •Collaborate synergistically with a multidisciplinary team encompassing social workers, case managers, and physicians to orchestrate seamless discharge planning and coordinate patient care, optimizing resource allocation and enhance patient outcomes. •Leverage my data-driven process to educate patients on the intricacies of their health insurance benefits, empowering them to make informed decisions in relation to any healthcare services allotted in their benefits. Also provide as a liaison between health insurance agencies, both public and private, and patients to mitigate patients misunderstanding their benefits and cost share responsibilities.•Demonstrate data proficiency by providing self-pay patients with meticulously calculated estimates, utilizing DRG, CPT, and ICD-10 codes for both inpatient and outpatient procedures and provide all details for patients to make a clear conscious financial decision. This approach not only facilitated transparency, but also streamlined the financial aspect of their healthcare journey. •Slashed patient procedure estimates costs by over 30% by negotiating financial aid with funding sources by highlighting patient financial data and responsibilities, while ensuring the continuation and enhancement of services.

San Diego, Ca, Us

Obtains and processes patient demographics, visit, and financial information in order to facilitate maximum financial reimbursement and promote premier customer service. Verify insurance eligibility, perform in depth benefits analysis, and assist with obtaining pre-authorization. Provide patients with financial obligations. Pre-billing: objectifying correct plan codes to correctly identify payor for claims processing.

San Diego, Ca, Us

Perform in depth financial analysis of individual's financial status for the purpose of evaluating the individual's eligibility for public funding. Assist the underinsured and uninsured patients in securing governmental, commercial and or private funding to cover healthcare costs. Works in collaboration with physicians, social workers, and case managers with discharge planning needs. Educate patients on healthcare options and resources.

Assist the Program Director with the management of the program operations Conduct individual, group, and milieu therapy sessions with clients Assist with management of program staff, including training, scheduling, and participating in hiring process Assist with program development, discharge planning, quality assurance, chart review, improvement processes, and clinical oversight and implementation

Mentor and Tutor high school students at Berkeley High School. Academic and social mentorship was provided. Students were chosen from a selective application process from a pool of low-income college bound students in grades 9th-12th. Academic tutoring ranged in all school subjects; I mainly focused on math: algebra 1, algebra 2, pre-calculus, calculus and discrete mathematics, and science: biology, chemistry, and earth science.

Obtains client information by answering telephone calls; interviewing clients; verifying information.Determines eligibility by comparing client information to requirements.Establishes policies by entering client information; confirming pricing.Informs clients by explaining procedures; answering questions; providing information.Maintains communication equipment by reporting problems.Maintains and improves quality results by adhering to standards and guidelines; recommending improved procedures.Updates job knowledge by studying new product descriptions; participating in educational opportunities.Accomplishes sales and organization mission by completing related results as needed.