Dina M. Email and Phone Number
Accomplished and result-oriented professional with a solid history in developing and implementing corporate health management as well as community health education and promotion programs. A creative and innovative thinker experienced in health management strategies for diverse populations extensive experience cultivating relationships, managing collaborations and engaging with business and community organizations. Overall professional goal is to improve work productivity, assist with chronic disease management, motivate the adoption of healthier lifestyles along with educating the public on healthcare access and navigation.Professional experience working in a fast-paced environment in a healthcare setting clinical and non-clinical. I also have strong organizational, technical and interpersonal skills with the ability to fluently speak Spanish. I am detail oriented and resourceful in completing projects and able to multitask effectively. Expertise on Medicaid, Medicare, Marketplace, California Children Services, Children Health Insurance Programs, Temporary assistant programs for needy families, Women Infants and Children Supplemental Nutrition Programs Proficient in Q-NXT- Molina, Word-process, Excel, Spreadsheet, Microsoft, Apple software, PowerPoint, Access, Outlook, Epic, SharePoint, Scribe right, Centricity, Mosaic, Flow cast, HBOC-Star, CUBS, Ameritech, NEXT-Gen, CACTUS, Salesforce, Triwest Systems and general computer skills. Open to challenge, change or leadership positions. Innovative ideas and solutions. Strong project management skills, and excellent influencing and negotiating skills. Highly dependable, goal oriented, punctual, and efficient. Performing complex analyses to identify opportunities.
Dignity Health Management Services Organization
View- Employees:
- 15
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Sr. Contracting SpecialistDignity Health Management Services Organization May 2022 - PresentResponsible for preparing, entering and maintaining provider contract information in all appropriate information systems and hardcopy files, ensuring that information is readly available for reference by DHMSO sta byallappropriate means,including hardcopy orelectronically. Act as aresource for internal departments as well as external organizations. Attend meetings as necessary, including responsible for agenda, minutes andhandouts.Secureonecaseagreementswith non-contracted providers as requested. Provider support yo designated managementsta asassigned.Assistwithspecialprojects as assigned. Performs anccompletesgeneral o cework,includinggeneralo ce workandcomposingcorrespondence,contracts andotherrelated documents. First point of contact between contracting and providers in our network.
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Independent Insurance BrokerJar Insurance Services Apr 2021 - PresentCalifornia, United StatesResponsible for Identifying sales opportunities for Insurance plans for the Medicare line of business and over seeing clients portfolio. Identifying risk management strategies, handling policy renewals and tracking claims. -
Network Development |Hospital ContractingArc Healthcare Sep 2019 - May 2020United StatesIn this role I was responsible for recruitment and contracting of provider network in new and prospective markets, and existing market expansions. Supporting new business launch in diverse markets by considering individual market circumstances, provider community, budgeting constraints and available resources Performing complex analyses to identify opportunities. Develop strategies to reach financial goals and execute contracting strategies to meet goals and objectives. Monitoring performance, develop, and implement business solutions to address process and quality gaps, and communicate network strategy and planning. Ensures accuracy and completeness of provider demographic information by working off the lead list to gather provider and contact information via web or phone. If a lead list is not provided, work with management to create a leads list. Coordinates the appropriate steps of communication to introduce the plan. Send out the cover letter to providers introducing the plan and the steps to send in the information to request a contract. (Pending plan approval for this step. Sends out contracts / applications to prospective providers upon requests of management. Utilizes ACR’s system to track and follow up with providers who have not responded to phone calls, contracts and / or applications sent as directed by management. Receives calls from prospective providers and answers questions as directed by management. Forwards requested information / documentation to prospective providers in a timely manner. Maintains database of all contracts and specific applications sent to prospective new providers.
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Senior Community Relations RepresentativeAnthem, Inc. Dec 2017 - Sep 2019Sacramento County, California, United StatesResponsible for coordinating and supervising the implementation of strategies related to specific business programs, products, territory or expansion. Primary duties include but are not limited to: Develop and maintain a positive working relationship with the member population for the primary purpose of increasing enrollment and decreasing unenrollment. Ensures consistent compliance with state, federal, and company specific requirements. Develops a standard process for assessing the feasibility and development of sponsored event programs. Conduct marketing activities, events, exhibits, education, and presentations to gain members and maintain and/or establish relationships with providers, community, and faith-based organizations. Identify and enlist the cooperation of individuals, groups, social service agencies and other community organizations in educational and outreach activities. Identifies cultural issues regarding current and potential members; communicate those issues and concerns to management immediately. -
Senior Provider Relations RepresentativeMolina Healthcare Nov 2016 - Jul 2017Sacramento County, California, United StatesPrimary functions were to train other Provider Services Representatives. Engaged with high volume, high visibility providers to ensure Provider Satisfaction. Under general supervision/direction, responsible for supporting various provider services functions with an emphasis on working externally with Plan's Providers to educate, advocate and engage as valuable partners. Also responsible for resolving Provider issues that may cross departmental lines and involve senior leadership. Have knowledge of healthcare information terminology and understanding of medical billing, and claims processing systems. Extensive software skills and competencies, as well as Internet research abilities and strong communication skills. Maintain confidentiality and comply with Health Insurance Portability and Accountability Act (HIPAA). -
Senior Advocate Community EngagementMolina Healthcare Apr 2015 - Nov 2016Sacramento County, California, United StatesResponsible for carrying out enrollment events and accountable for achieving assigned membership growth targets, through a combination of direct and indirect marketing activities. In this position I was held accountable to achieve all established goals with the primary responsibility of improving the plans overall “choice” rate. In addition, I have worked with several departments to increase Medicaid and CHIP assignments. Within this position I have worked with Managers and other Advocates, Community Engagement Team and members to develop/maintain/deepen the relationship with key business leaders, community based organizations and providers, faith based and Law Enforcement Agencies while ensuring that all efforts are directed towards building Medicaid, CHIP and Marketplace membership. I also have provided training, development, coaching mentoring and being a positive role model.
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Financial Counselor /Patient LiasionProvidence Health & Services Jul 2012 - Nov 2014Portland, Oregon Metropolitan AreaPart of a team who handles the direct interaction with patients and their families during difficult times, providing financial, insurance, and payment information to assist them in resolving patient account balances. In addition, educate patients on various sponsorship programs available. Be the Regional Business Office liaison to the assigned hospital. I also worked as an Advocate with the Outpatient Behavioral Health Clinics and the Spanish speaking population to ensure patients receive adequate care. I was a Community Partner with Cover Oregon and the federal health exchange along with processing financial assistance applications for five different states and different regions in our service area. -
Clinical Data Reviewer -Epic SystemsProvidence Health & Services Oct 2010 - Jul 2012Portland, Oregon Metropolitan AreaDelivering clinical support, reviewing and analyzing content of current medical records to ensure accurate patient information, abstracts essential health care information, determine accurate ICD9 and CPT codes, monitors and updates medical charts and perform Quality Assurance.
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Registrar/Hospital OperatorProvidence Health & Services Nov 2010 - Oct 2011Portland, Oregon Metropolitan AreaAssist with all aspects of administrative management, directory maintenance, logistics, equipment inventory and storage, developed innovative programs to hire and retain a diverse workforce, managing inventory of assets and supplies, submit all invoices, coordinate between departments and operating units in resolving day-to-day administrative and operational problems, scheduling and coordinating meetings, interviews, events and other activities, providing customer services and relations, managing multi-phone lines and hospital paging system.
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Case Manager AssistantKern Family Health Care Sep 2007 - Sep 2009Bakersfield, California, United StatesDepartment technical support, patient screening, insurance authorization, completing complex documentation, filing, assisting community members and provider liaison to the Kern Health System, gathering and accurately coding, preparing complex authorizations documents for approval. Coordinators for questions or clarifications on criteria, interpretation of benefits, or whenever they need my clinical expertise and/or guidance also handled gathering all information to transfer patients to facilities as needed.
Dina M. Education Details
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Licensed Practical/Vocational Nurse Training
Frequently Asked Questions about Dina M.
What company does Dina M. work for?
Dina M. works for Dignity Health Management Services Organization
What is Dina M.'s role at the current company?
Dina M.'s current role is Independent Broker at JAR Insurance Services.
What schools did Dina M. attend?
Dina M. attended Sumner College.
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