Edwin Rojas Email & Phone Number

Lead and oversee multiple specialty departments, including Pediatrics, Behavioral Health, and Ambulatory Outpatient Care, managing teams that provide care to over 5,000 patients across Riverside County. Utilize Lean methodologies to streamline workflows, achieve patient-centered goals, and meet state-mandated metrics, ensuring continuous improvement in care delivery. Leverage data analytics and interpretation to inform decision-making and assist in achieving program goals, optimizing operational efficiency, and improving patient outcomes. Provide supervision, technical assistance, and consultation to program staff while interpreting and implementing complex state and federal mandates. Collaborate with Managed Care Plan agencies to enhance care coordination, improve patient outcomes, and expand access to vital services. Represent the organization at local, state, and federal meetings, preparing comprehensive reports and fostering community partnerships to promote program objectives. Serve as a subject matter expert in Enhanced Care Management, driving innovation and operational excellence in healthcare programs.

Assist physicians and other healthcare providers by coordinating care to ensure patients receive optimal care; interact with Primary Care Providers, Specialty Providers, and other healthcare staff to coordinate patient care. Maintain technical documentation and procedures for using and navigating software and application systems like EPIC, Care Director, and Manifest Medex. Assist with patient referrals to appropriate community resources, including public welfare programs; may provide patient education. Daily management of referrals includes inputting data into the managed care system, verifying member eligibility and provider participation, and tracking pending referrals. Reviews IEHP monthly program reports and recommends corrective action as needed to ensure that metrics are being met per state requirements provided by the Supervisor. Develop and recommend the implementation of new and the revision of existing programs, policies, procedures, standards of care and practice, and goals and objectives of ambulatory care Implement root cause analyzes in error reporting in the Epic EHR, be a liaison for ECM Team in IT meetings to address team concerns for multiple clinics and teams across Riverside County. Assist Health Coaches Volunteers developing outreach methods for their workload and training in Epic. Reach out to IEHP as necessary to address any questions or challenges that might be occurring and devise a workable solution for the team. Liaison between healthcare staff and patients regarding maintenance of care and treatment; work closely with Providers to ensure continuity of care and treatment; facilitate communication among patients and healthcare staff regarding their care, including making appointments, treatment authorizations, and resource needs. Ensure that all Health Care compliance and regulations are followed by new staff and that new methods meet each standard.

Riverside County, California, United States

Conduct interviews with clients who receive Mental Health services and who cannot apply and obtain Medi-CAL and or Social Security benefits on their own. Maintain up-to-date knowledge with Social Security and Medi-CAL regulation and eligibility, for proper follow up for the client. Maintain technical documentation and procedures for using and navigating software and application systems. Conduct trainings in the operation and use of software and application systems to staff. Created a SharePoint page to assist with tracking referrals. Troubleshoot SharePoint Website and provide any maintenance as needed. Created a Microsoft Office Power Automate flow chain to created automatic E-Mail response, through SharePoint and Forms. Provided proper guidance to the right agencies that will assist on getting the client what they need to receive services. Gather evidence, and maintain constant monitoring throughout the application process. Act as a liaison for the client throughout the process on getting an approval or denial for either program. Obtain personal, family, and financial data required to determine eligibility for one or more public social service aids and/or basic information required authorizing social service. As well as assisting with reporting any changes, that could be different with the client’s current case, such as income, address, family household size, ect.

Moreno Valley, California, United States

Conducts pre-screening and other interviews with applicants and clients using standardized forms to obtain personal, family, and financial data required to determine eligibility for one or more public social service aids and/or basic information required to authorize social service plans. Gives applicants standard forms and requests that routine verifications be returned with completed forms; reviews forms for completeness when returned by the applicant; may assist clients with completing application forms for financial assistance. Records verifications of birth, income, property, and other required information according to standard procedures. Brings discrepancies to the attention of the eligibility or social worker responsible for the case; files required forms and verification in an established filing order. Completes notices of action and other required forms following eligibility determination; accepts late income reports from clients reviewing them for completion and accuracy. Clears routine case controls using computer printouts; responds to routine telephone calls or lobby visits from applicants and clients reporting changes in their circumstances or requesting information on the status of their applications or case.

Rancho Cucamonga, California, United States

I was part of the launching team for this clinic. In this position my duties were from Front Office/Back Office and assisting the Physician Assistant and the Office Manager. I’ve done paper charting/Electronic Medical Records, answer phones, make appointments and give out directions. I would also check if there needs to any reminder calls out to the patients. Check how many Appointments we have for the day. Run inventory twice a day to match the count from closing the other night. We ran an all cash clinic so money had to be counted and put in a safe location. Spreadsheets had to be made in Excel to keep track of sales per counselor to tack their performance in the sales part of the clinic. Spreadsheets were made for Daily, Weekly, Monthly and setting up for yearly sales. I also had to prepare the patients for the evaluation that the PA was going to perform, had to identify if the patient was there for Premature Ejaculation, Erectile Dysfunction or Low Testosterone. Had to educate the patient on how the medication we have in the office and educate them more about the penis. Once the PA was done with his evaluation I would get the chart and make up a dose that the doctor has ordered and compound the medication. Once I was done mixing 2-4 medications together I would perform a Corpus Cavernous Injection (the shaft of the Penis). After the medication was given I would come back and evaluate the patient’s erection on firmness and how erect it was. If a patient was a Low Testosterone I would draw blood from the patient and run a “Fast Pact” to get the Testosterone reading. Once the test is done I would hand it over to the PA and he would instruct me on how much Testosterone to give the patient. Once the medication was drawn up I would administer the medication in the Gluteal.

Riverside County, California, United States

In this position I was working on my Externship hours as a Medical Assistant. In the Front Office I would check in patients, start a new chart if they are a new patient to the clinic or I would pull the chart for recurring patient. The clinic offered Family Pact Insurance for the HIV/Aids and STD screening. But also accepted Medi-Cal and most PPOs and TriCare. If the patient had their own Insurance I had to run an eligibility check through Phone or Internet to check if any Co-Payment had to be mad or can receive treatment at the time. I would answer phone calls and questions that the caller had and set up appointments. I would so pull out charts for the appointments that were made for the following day and do reminder calls both English and Spanish. In the back office I would draw blood and prepare it for pick up for the Lab. I would set up a Pap Smear for each room since 80% of our patients were females. I would educate the patient to practice safe sex and the different methods of birth controls that were available. Performing Vitals of the patient had to be done as the patient is walking to the room that they are going to be assigned to.

Riverside County, California, United States

This job was at a warehouse for Ross. Here I would receive clothes that needed to be counted to match what was order from Ross. I had to match it with a Purchased Order on the computer and match Color, Size, Style and Brand to make sure that it was the product that was being counted for. Counting was a big factor here and time; I had to count at least 2-20 thousand items a day to meet the demand of the stores. Since this job was at a warehouse I had to maintain a clear and clean work area at all times per safety guidelines for my safety and others around.

Master'S Degree, Health/Health Care Administration/Management

Bachelor Of Science - Bs, Public Health

Associate Of Arts - Aa, Social And Behavioral Studies

Certification Of Completion: Ccna Cisco Networking, System, Networking, And Lan/Wan Management/Manager

Medical Assistanct, Medical/Clinical Assistant