Gabrielle Torres Email & Phone Number

Oakland, California, Us

Oakland, California, Us

Support the ongoing operations of state-wide initiatives in California including the Align. Measure. Perform (AMP) Program. Responsible for the overall success of an assigned portfolio of clients including client onboarding, client support, account management, business process reviews, and training. Also, responsible for guiding and coaching clients in their implementation of data exchange with IHA’s data partners, and evaluating the business requirements to execute on delivery and implementation plans.

San Francisco, Ca, Us

• Identified gaps in service to improve patient experience and quality of care by tracking, trending, and analyzing grievance data • Advised department leaders and key stakeholders on improvement opportunities based on grievance trends • Collaborated with cross-functional partners to lead improvement initiatives related to patient experience or regulatory compliance• Owned the migration of grievance reporting in excel to a Tableau dashboard, from concept to launch, to streamline quarterly reports and metrics • Designed and spearheaded process and policy improvements by collaborating with cross-departmental teams to ensure smooth implementation and compliance with regulatory requirement • Managed, planned, and prioritized projects to completion and within scope • Directed and managed the day-to-day operations of the grievance process to ensure cross- functional teams adhered to policies and procedures • Architected and implemented optimizations to the grievance process and reporting that ensured compliance, created efficiency, and improved data quality for reporting • Partnered with management to set performance goals and audit strategy for the grievance team • Managed grievance and appeal audit duties for state, delegate, and internal audits• Implemented updates to grievance policies and procedures • Drafted monthly, quarterly, and annual reports to monitor and assess grievance performance metrics and ensure compliance to regulatory requirements• Served as grievance and appeal Subject Matter Expert (SME) when collaborating with other departments and/or external stakeholders

San Francisco, Ca, Us

• Advocated for patients while investigating their care concerns to resolution by collaborating with cross functional stakeholders • Ensured that deliverables and deadlines were executed for grievances and assigned projects • Devised a new report to capture provider data related to response turnaround time and quality and modified the grievance management platform to ensure appropriate data capture • Collaborated with front-line employees to revamp the grievance intake form to allow better evaluation of a complaint’s urgency and improve member experience when filing a grievance• Created and implemented process improvement for grievances involving carved out services • Identified and implemented reporting enhancements to improve data collection and quality • Prepared internal and state grievance reports on a monthly, quarterly, and annual basis • Contributed in state audits by presenting grievance policies and procedures and collecting audit files • Assembled grievance committees by calendaring, securing meeting room, taking minutes, preparing meeting materials

San Francisco, Ca, Us

• Provided superior customer service to members and providers while investigating grievances regarding member care • Processed grievances in the required timeframes and accurately documented investigation results according to policies and procedures • Wrote grievance resolution letters to members summarizing investigation results using concise and easy to understand language • Presented grievance investigation summaries and proposed grievance resolution to a cross- functional committee and Chief Medical Officer to ensure grievances were resolved appropriately • Organized monthly mailings of 100+ letters to notify new members in need of an Initial Health Assessment (IHA) • Performed data entry with high accuracy for 6 member intervention programs distributing a total of $99,270 in direct incentives to around 3,500 SFHP members

Vancouver, Wa, Us

• Liaison between Veterinarians and pet owners as well as provided technical support for licensed Veterinarians • Interviewed clients, either over the phone or in person, to collect accurate patient history• Reviewed medical recommendations and financial costs of the Veterinarian’s treatment plan for each patient with the pet owners • Communicated wellness plan options and detail cost efficient services that pet owners may need to maintain great health for their animals• Performed case maintenance by updating hospital records using the Petware system• Transcribed and documented a chronicle of patient's medical history and care• Scheduled vaccines, rechecks, comprehensive exams, and surgery appointments• Obtained accurate information and history from clients, which resulted in 100% completed medical notes• Accurately calculate premedication dosages for vaccines and anesthetics

• Negotiated with Alumni and parents to secure donations for the Annual Fund, which provides additional financial support for student resources on the UC Davis campus. • Raised $10,000 in donations.• Educated UC Davis Alumni regarding services and resources still available to them on campus. • Gained effective communication skills, specifically over the phone.

Diemen, Noord-Holland, Nl

• Performed data entry as requested with high accuracy.• Identified and tagged different elements of online books. • Indentified critical problems with images, and categorized for fixes. • Provided feedback and suggestions for improving application tools.• Formatted books for online use of electronic books, kindle, and E-Reader• Proofread and edited online books.

Bachelor Of Arts (B.A.), Sociology And Chicano Studies

Education record