Carlo Rabino Email & Phone Number

Mckinley

Reviews medical cases and authorizations in preparation for a peer to peer discussionVerifies that the attending/ordering doctor or other licensed health care professional is making the requestProvides extensive benefit details of each member to ensure that a peer to peer discussion is necessaryEnsures all clinical documentations are organized and available for medical directorsChecks applicable softwares to find which medical director rendered the adverse determinationEnsures that the appropriate medical director is alerted to the peer to peer request and schedule appointment for the discussionProcessing requests to accommodate the attending/treating/orderingphysician's schedule within normal business hours for that physician's time zone.

Mckinley

Manage administrative intake of members or the admission/discharge information post notification Work with hospitals, clinics, facilities and the clinical team to manage request for services from members and/or providers Manage the referrals process, processing incoming and outgoing referrals, and prior authorizations, including intake, notification and census roles Receive care coordination notification cases for non-clinical assessment/intervention and provide appropriate triage. Review requests for adverse determination, approval notification and processing notification requirements Assist the clinical staff with setting up documents/triage cases for Clinical Coverage Review Handle resolution/inquiries from members and/or providers that may include: Benefit and Eligibility information Billing and Payment issues Customer material requests Physician assignments Authorization for treatment Explanation of Benefits (EOB) Verifying appropriate ICD-9 and CPT coding usage

Training, scheduling, and coaching Customer Service RepresentativesPrepare reports on call and sales activesProvide in-depth one on one coaching, training and follow-up to optimize sales and customer serviceCommunicate changes in products, promotions, pricing, campaigns and proceduresMonitor sales and service calls through real time observationsHelp improve deficiencies and build on the strengths of individual performersAssist in developing sales scripts, training and workflowsUnderstand marketing campaigns and bundling options for productsReceive and resolve complex or sensitive customer complaints and appealsDesign, lead and coordinate sales incentives and activities to maximize sales

Maintain post-sale contact with clients in order to facilitate a positive and productive long-term relationship. Communicate with customers with regard to any account problems. Discuss customer concerns and suggestions. Focus efforts on product feedback, enhancement, upgrades, and development. Handle add-on sales for clients.Achieves customer service objectives by contributing customer service information and recommendations to strategic plans and reviews; preparing and completing action plans; implementing production, productivity, quality, and customer-service standards; resolving problems; completing audits; identifying customer service trends; determining system improvements; implementing change.Meets customer service financial objectives by forecasting requirements; preparing an annual budget; scheduling expenditures; analyzing variances; initiating corrective actions.Updates job knowledge by participating in educational opportunities; reading professional publications; maintaining personal networks; participating in professional organizations.Accomplishes information systems and organization mission by completing related results as needed.

Provide team leadership and coachingAssure that the team members have the necessary education and training to effectively participate on the teamCoach and help develop team members; help resolve dysfunctional behaviorFamiliarize the team with the customer needs, specifications, design targets, the development process, design standards, techniques and tools to support task performanceInitiate sub-groups or sub-teams as appropriate to resolve issues and perform tasks in parallelAssure that the team addresses all relevant issues within the specifications and various standardsFacilitate problem solving and collaborationFocus the team on the tasks at hand or the internal and external customer requirementsCoordinate team logisticsWork with functional managers and the team sponsor to obtain necessary resources to support the team's requirementsCoordinate the review, presentation and release of design layouts, drawings, analysis and other documentationCommunicate team status, task accomplishment, and directionProvide status reporting of team activities against the program plan or scheduleServe as a focal point to communicate and resolve interface and integration issues with other teams

Identifying training and development needs within an organization through job analysis, appraisal schemes and regular consultation with business managers and human resources departments;Designing and expanding training and development programs based on the needs of the organization and the individual;Working in a team to produce programs that are satisfactory to all relevant parties in an organization, such as line managers, accountants and senior managers at board level;Devising individual learning plans;Managing the delivery of training and development programs and, in a more senior role, devising a training strategy for the organization;Monitoring and reviewing the progress of trainees through questionnaires and discussions with managers;Ensuring that statutory training requirements are met;Evaluating training and development programs;Amending and revising programs as necessary, in order to adapt to changes occurring in the work environment;Helping line managers and trainers solve specific training problems, either on a one-to-one basis or in groups;Keeping up to date with developments in training by reading relevant journals, going to meetings and attending relevant courses;Having an understanding of e-learning techniques, and where relevant, being involved in the creation and/or delivery of e-learning packages;

To deliver friendly, efficient customer service and to create a warm and welcoming atmosphere for all of our customers, with the key aim of retaining and attracting new customers.Deliver excellent customer service, at all timesServe and present hot non-alcoholic beverages quickly and efficiently, meeting our standardsMake customers aware of offers on our great food and drink rangeSpeak to customers to ensure that they are satisfied with their mealsMaintain personal knowledge by completing in-house training and workbooksAlways adhere to all company policies and procedures and licensing lawsBe involved and contribute at team meetings