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Dulce T. is listed as Healthcare Process Optimization | Performance Insights & Strategy at Oscar Health, a company with 1215 employees, based in Chicago, Illinois, United States. AeroLeads shows a matched LinkedIn profile for Dulce T..
Dulce T. previously worked as Senior Manager, Process Optimization at Oscar Health and Manager of Provider Performance Optimization at Centene Corporation. Dulce T. holds Master Of Arts - Ma, Community Counseling, 4.0 Gpa from Northern Arizona University.
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Performance improvement leader with 10 years of experience leading teams in the healthcare payor setting, generating performance insights via data analytics and collaborating cross functionally to develop, execute on, and measure success of improvement strategy. Targeted outcomes have included improving operational health (reducing avoidable inventory, shortening cycle times, decreasing workflow variation, and developing analytics tools for ongoing production monitoring), and optimizing physician member facing processes for stronger CAHPS scores, reduced grievance volume, increased adherence to treatment plan, and stronger HEDIS gap closure rates.Lean Six Sigma Green Belt and certified Project Management Professional (PMP).
Listed skills include Leadership, Team Building, Procedure Development, Lean Process Improvement, and 32 others.
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A career timeline built from the work history available for this profile.
Developed teams responsible for process optimization of grievance, appeals and utilization management workflows. Accomplishments include the below.- Created monthly data insights reporting on grievance and appeal drivers. Trend analysis on member pain points contributing to grievances and (overturned) appeals was used to develop initiatives for improved.
Chicago, Illinois, United States
Promoted internally during Centene's acquisition of WellCare. Stood up a team of 5 project managers responsible for optimization of provider Quality (CMS Star) performance. - Analyzed monthly market KPI performance to identify quick win HEDIS measures, providers with highest impact potential, at risk performance areas and predict year end outcomes..
Project Manager responsible for initiatives intended to improve CMS Quality scores, with primary focus on HEDIS gap closure. - Responsible for identifying providers and measures of highest impact potential and developing recommendations for performance improvement strategy accordingly. Priority providers and measures identified based on analysis of several.
Chicago, Illinois, United States
Promoted internally to lead a team of Clinical Care Managers responsible for connecting at risk members to the appropriate providers, community supports, and educational resources to improve member health outcomes proactively, reducing utilization of emergency services and inpatient readmissions.
Chicago, Illinois, United States
Supported medical and behavioral health care coordination needs for Medicare, Medicaid and MMP members, conducting health risk assessments followed by development and maintenance of member centered care plans in alignment with individual need, risk and engagement
Des Plaines, Illinois, United States
Phoenix, Arizona, United States
Other employees you can reach at hioscar.com. View company contacts for 1215 employees →
Daniel Louzeiro
Colleague at Oscar Health
Bloomfield, New Jersey, United States, United States
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CK
Chandler King
Colleague at Oscar Health
Brooklyn, New York, United States, United States
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RJ
Rains Jordan
Colleague at Oscar Health
New York City Metropolitan Area, United States, United States
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JM
Johnny Mathiah
Colleague at Oscar Health
Strongsville, Ohio, United States, United States
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JD
Jade Debarros
Colleague at Oscar Health
Duluth, Georgia, United States, United States
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RJ
Rakhi J
Colleague at Oscar Health
Louisville, Kentucky, United States, United States
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AJ
Ashley Jeffery
Colleague at Oscar Health
Dallas, Texas, United States, United States
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KA
Katrina Avery
Colleague at Oscar Health
Cypress, Texas, United States, United States
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AY
Angela Young
Colleague at Oscar Health
Greater Sacramento, United States
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GQ
George Quievryn
Colleague at Oscar Health
Stow, Massachusetts, United States, United States
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Quick answers generated from the profile data available on this page.
Dulce T. works for Oscar Health.
Dulce T. is listed as Healthcare Process Optimization | Performance Insights & Strategy at Oscar Health.
Dulce T. is based in Chicago, Illinois, United States while working with Oscar Health.
Dulce T. has worked for Oscar Health, Centene Corporation, Wellcare Health Plans, Aetna, A Cvs Health Company, and Thresholds.
Dulce T.'s colleagues at Oscar Health include Daniel Louzeiro, Chandler King, Rains Jordan, Johnny Mathiah, and Jade Debarros.
You can use AeroLeads to view verified contact signals for Dulce T. at Oscar Health, including work email, phone, and LinkedIn data when available.
Dulce T. holds Master Of Arts - Ma, Community Counseling, 4.0 Gpa from Northern Arizona University.
Dulce T. is listed with skills including Leadership, Team Building, Procedure Development, Lean Process Improvement, Cahps, Employee Engagement, People Management, and Powerpivot.
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