Daniel Cueto Email & Phone Number

Miami, Florida, United States

- Manage relationships with key Full Risk IPAs in Florida Market on behalf of WellCare Health Plans, Sunshine Health and Ambetter Health- Execute strategy for membership growth and retention in collaboration with Sales and Marketing- Influence IPA processes to drive improvements in quality, provider and member satisfaction, optimizing member outcomes and maximizing shared savings- Analyze, interpret and communicate financial, quality and performance reports to IPA partners - including publicly traded entities with national contracts

Miami, Fl

- Negotiated and contracted with primary care and specialty physicians and ancillary providers for all product lines- Identified network gaps - Managed physician network by developing and maintaining relationships to drive business results throughout Miami-Dade and Monroe- Conducted site visits to service providers, resolve issues, educate staff/providers on policies, collected credentialing information, and reviewed contractual obligations. - Supported regional Network Improvement Plan targets by providing utilization reports, pharmacy profiles, ER contingencies, Frequent Flier Reports and other analytics available to improve/maintain regions. - Managed incoming provider inquiries, identified potential claims trends, and followed up with providers and internal departments to resolve network and provider issues

Miami, Fl

Florida Health License: 240- Negotiated contracts with provider offices, diagnostic facilities, urgent care centers, etc. for all lines of business (Medicare, Medicaid, Commercial) and follow-up credentialing on behalf of the HMO.- Integral team member for the initiation and production of Medicare and Medicaid Risk Contracts for trusted providers with large patient volumes.- Assisted in network development for Managed Medical Assistance under program-specific and state-regulated requirements. - Worked closely with administration and various department directors (pharmacy, medical affairs, authorizations, member services, etc) to identify new, low-utilizing providers for contracting based on network needs for HMO members while agreeing to appropriate rates for all specialties.- Drafted and executed Letters of Agreement for non-contracted providers.- Produced marketing materials, drafted and edited company newsletters.- Coordinated educational events for network providers and hosted presentations on behalf of the Provider Relations department. - Participated in editorial meetings for implementation of marketing and public relations strategies, including social media outreach.

Miami, Fl

Florida Health License: 240- Negotiated contracts and follow-up credentialing with HMO’s on behalf of medical providers.- Provided Medicare Risk Adjustment (MRA) and HEDIS coder/audit support staff.- Implemented and/or integrated Electronic Medical Records (EMR) system for doctor’s offices.- Offered “Access” services to Medicaid providers who require in-house applications for potential Medicaid patients.- Prospected providers in Medically Underserved Areas (MUAs) with high Medicaid patient volumes.- Prepared Federally Qualified Health Center (FQHC) and grant applications for candidate practices. - Sold and maintained employee benefits for small and large groups including health, dental, disability, 401K, etc.- Conducted informational seminars in English and Spanish to educate groups of prospective clients interested in obtaining insurance coverage.- Provided on-call service for English and Spanish-speaking clients to respond to any questions and concerns regarding their services.

Miami, Fl

www.vimeo.com/dannycueto- Handled both in-house package research/writing/editing and on-location editing and production of area collegiate and professional sporting events. - Shot video footage of various professional and collegiate games.- Edited VO’s, SOT’s, and packages. - Logged games both from the live truck and the CBS4 station.- Worked as associate producer for the Sunday Sports Wrap (30-minute show) and reported live from the station’s studio for a newscast produced by CBS4’s interns.- During Super Bowl XLIV in Miami, assisted in editing and production of CBS4’s coverage of the event.

Miami, Fl

www.vimeo.com/dannycueto- Collaborated with professional reporters, covering breaking stories and setting up/conducting interviews to obtain newscast sound bites. - Wrote, edited, and produced VO/SOT’s for weekend newscasts.- Prepared and performed stand-ups.- Translated interviews from Spanish to English.

Miami, Fl

www.vimeo.com/dannycuetoDeveloped and produced a mini-documentary on two homeless families in Miami. Conducted all interviews with family members; researched background information on the plight of the homeless in the area; and personally shot and edited the footage to produce the final product.

Bachelor Of Science In Communications, Communication, Journalism, And Related Programs With A Concentration In Spanish Langauge

Education record