Anthony C. Email & Phone Number

United States

Grossmont

The Lead Patient Experience Navigator provides support for the implementation of programs and process designed to build patient and customer relationships for the whole hospital. The role is responsible for leading a team of Patient Experience Navigators who support operations for service and engagement trainings, interpretations of data and research, patient satisfaction improvement initiatives, and reward and recognition initiatives. The Lead Patient Experience Navigator works collaboratively with executives, managers, physician leaders and all staff to assure effective implementing of tactics and strategies around patient experience.Manages projects to improve the patient experience.

Works closely with the QI department and with all other departments necessary to ensure that the processes, programs and services are accomplished in a timely and efficient manner in accordance with CHG policies and procedures and in compliance with applicable state and federal regulations including Centers for Medicare and Medicaid Services (CMS) and/or Medicare Part D, Department of Managed Health Care (DMHC) and Department of Health Care Services (DHCS). Responsible for ensuring that the grievance and appeals system and QI system is clearly understood and followed by all applicable staff. Addresses and resolves all non-quality of care grievances within specified time lines and procedures. Coordinates with the QI department to ensure all Potential Quality Improvement (PQI) issues are addressed within specified timelines and procedures. Ensures appropriate remedial action to members' grievances by working closely with appropriate staff to ensure that all member grievances, appeals and PQIs are processed in accordance with regulatory requirements and internal policies and procedures. Works closely with Community Services staff when internal or external operational issues identified during the resolution of any given grievance or appeal. Educates primary care providers by providing orientation and training on CHGs complaint and grievance system. Assists in the gathering of reports/documents related to DHCS, DMHC, NCQA and CMS program audits, including review of records with auditing team. On a quarterly basis develops a grievance and appeals report and present the findings and/or trends during the SQIC and Public Policy committee meeting. Uses Innovare software to capture all needed data and run all required internal and regulatory reports. Prepare monthly written report to the Operations committee meeting as needed. Develops quarterly grievance and appeals reports (and other related reports) for regulatory agencies: DMHC, CMS, and DHCS.

Greater San Diego Area

Provides direct supervision to Ambassadors and Experience Liaisons Functions as an advisor to the department in providing exceptional service to all patient facing departments Analyzes and resolves problems, interprets policies (e.g., fiscal management, HR, contracts and grants, resource management in defined areas) and demonstrates subject matter knowledge Supervises staff to assure accountability and stewardship of department resources (operational, financial, and human) in compliance with departmental goals and objectives Supervises patient relations professionals by monitoring performance and service to patients/families Addresses and investigates patient/family complaints and grievances Responsible for assigned staff training, goal setting, and performance evaluations Oversees daily operations of Patient and Guest Services ensuring the department meets standards of performance and service Assists with problem solving, patient feedback escalations and crisis intervention, as necessary Distributes assignments, interprets and administers policies as they affect subordinate staff Helps draft and/or interprets/analyzes changes in policies, procedures, and regulations Acts as a subject matter expert in complaint and grievance related matters to internal departments and agencies Serves as the liaison between patient and families, and seeks to achieve satisfactory solution and/or reasonable alternative options in response to complaints, concerns and grievances Functions in a consultative manner with Health System departments to build and sustain a patient/customer focused culture Provides education and training to all levels of staff in matters related to Patient Rights and Responsibilities Evaluates subordinate staff and participates in decision making on hiring, salary actions, terminations, performance ratings, and other HR matters Promotes a climate of teamwork, open communication and collaboration Communicate regularly with management on operational and HR issues

Greater San Diego Area

Part-Time Associate Faculty-Ashford University 2012-Present• Organize, prepare and revise online Child and Adolescent Development course material• Facilitate online discussions with students and engage in classroom discussion boards, grade assignments and respond to student inquiries in a timely manner.• Collaborate within the University community to ensure a positive overall experience for students.

Greater San Diego Area

Assist students in following through with referrals for treatment orders outside the Student Health Services clinic and/or Counseling and Psychological Services operations, help students to utilize their insurance in order to receive medical services and aid students identified as experiencing an economic crises access community programs in order to receive medical or mental health services. Educate individual students on specific health education topics such as family planning, HIV/AIDS, STIs, sexual assault, wellness and health behaviors, & violence prevention.

San Diego

Bilingual Match Support Specialist Lead-Big Brothers Big Sisters of San Diego County 2008-Present • Supervise and manage the daily activity and goals of three Match Support Specialists. Responsible for monitoring their overall effectiveness within the organization’s strategic plan. • Assist with organization and implementation of Sports Bigs program quarterly sports clinics in the community.• Manage, counsel, and supervise a caseload of 100-120 matches, providing support to culturally diverse volunteers, parents and youth including physically, sexually and emotionally abused children. • Provide on-going support, training, motivation, problem-solving and resource networking to volunteers, children and low-income families through regularly scheduled contact.• Furnish reliable assessments of adults and youth by extracting accurate information, using past relationship development experience, and background/reference checks.• Effectively assess and execute the following relational support skills: guiding, supporting, counseling, confronting, and advising. Bilingual High School Bigs Specialist-Big Brothers Big Sisters of San Diego County 2007-2008 • Recruited, interviewed, assessed and supervised high school and elementary school aged youth at four local schools for participation in High School Bigs program.• Provided case management to 160 students through regularly scheduled contact.• Assisted students with college related inquiries and vocational needs and provided educational resources as needed.• Created and sustained relationships with school liaisons (teachers, after-school counselors, principals) and discussed child development and proposed plans of action.

Greater San Diego Area

• Administered consistent standards of behavior and discipline in order to ensure the safety and well-being of students.• Taught, advised and supervised students 4-12 years of age with mental and physical disabilities including Asperger’s.• Provided diverse and engaging activities geared towards children including science, cooking, art, music and sports.

Greater San Diego Area

• Organized Kid’s Club soccer clinics, which allowed participants to improve their tactics and learn lifelong skills. • Responsible for marketing Kid’s Club program and team, through public speaking and other promotional opportunities.• Organized and managed monthly budgets and travel logistics for staff and 26 players.

Ma, Human Behavior

Activities and Societies: Graduated with Honors- Straight A'sThe degree exposes the student to a wide array of behavioral topics covering.

Bachelor Of Arts (B.A.), Sociology: Children, Youth And Family

Sociology is the study of human societies; of the institutions, organizations, and groups that compose them; and of the way individuals.

Master Of Arts - Ma, Human Behavior