Jose M. Rodriguez Email & Phone Number

Oldsmar, Fl, Us

Austin, Texas, Us

Everly Health Solutions is a virtual care provider that uses advanced diagnostics and telehealth to improve early detection and prevention of disease. Our solutions provide the clinical, legal, and technological framework to facilitate population-scale testing across key healthcare markets in all 50 states, Puerto Rico, the U.S. Virgin Islands, and Canada.We believe that empowering people with convenient access to clinically actionable testing has the power to change lives, improve outcomes, and create a healthier world.

Provide consulting services in operational development and project management with primary focus on health care. • Guided Client’s Project Implementation team deploying AI medical coding platform - delivered $14 million in annual cost savings• Responsible for account management and client services team• Spearheaded clients’ admission into one of the country’s premier technology incubators

Ramsey, Nj, Us

National leader in pediatric in-school health services and technology. CareDox connects K-12 public schools with the health ecosystem to deliver a tech enabled, no-cost solution to families and schools.Reported to the COO. Responsible for delivery of in-school health services leading a team of 6 direct reports with matrix responsibility for over 500 professionals and $10 million budget.• Led the re-engineering of the parent consent process projected to save over $1 million annually in shipping, scanning and labor cost• 45% boost in workforce productivity by applying workforce recruitment and management best practices• Piloted cost reduction initiative saving $450,000 in cost of clinical materials, transportation and print costs

Provider of prospective and retrospective risk assessments services on the behalf of Medicare Advantage health plans and medical service providers throughout the United States.Reported to the CEO. Accountable for delivery of Medicare in-home health risk assessments and retrospective medical record retrieval and coding in 8 states. Managed 5 direct reports and responsible for over 300 in staff and $12 million budget• Increased labor utilization efficiency by 38%, with improved front-end medical record collection workflows and data processing enhancements• Headed the organization to ramp up capacity to support an 18% growth in demand fueled by new sales, improved medical coding quality and data delivery performance• Developed and managed a medical coder internship and training program that supplied 25 new in-house HCC medical coders in a one-year period

Tampa, Florida, Us

Peak’s management team is comprised of highly skilled and experienced project managers and health information management experts that understand how the coding process affects the revenue cycle.

San Juan, Puerto Rico, Pr

Health insurance provider in Puerto Rico with products including Medicare Advantage and Commercial Health InsuranceReported to the SVP Health Plan Operations. Accountable for Claims team processing Medicare and Commercial claims in Puerto Rico. Managed 4 direct reports and responsible for over 150 in staff.• Processed 12 million claims annually while reducing claims center expenses by more than $1.8 million, an 8% reduction.• Led the re-engineering of claims workflows, integrating automation to drive improvements in claims throughput between 30% and 35%.• Seamlessly executed the concept of Operational Excellence and reported KPI's weekly.

Scottsdale, Az, Us

Largest provider of prospective risk assessments services on the behalf of Medicare Advantage health plans and medical service providers throughout the United States.Reported to the COO. Accountable for delivery of Medicare in-home health risk assessments in 23 states. Managed 8 direct reports and responsible for over 1,000 in staff and $18 million budget.• Part of team that grew the company from 200 to 700 employees with 19 Medicare Advantage clients and annual revenue exceeding $50 million. • Direct responsibility for the coaching, mentoring and direction of 8 direct reports to ensure their continued professional growth and development.• Increased labor utilization efficiency by 31%, with improved back-office workflows and technology enhancements.

London, Gb

Selected and promoted by Senior Management to optimize all aspects of the member acquisition process including database modeling and database management, print production, e-commerce, lead generation, contact center operations, CMS compliance and sales analytics. Established and executed annual review of print work with outside sources.Collaborate with marketing and advertising to enhance overall member acquisition processes in a cost effective way.

Universal is a health insurance provider based in St. Petersburg, Florida, providing managed care services including Medicare Advantage plans with 190,000 members in 19 states, Medicaid and Long-Term Care Nursing Home Diversion.Provided strategic and tactical guidance to ensure key operational performance indicators are met or exceeded. Managed the redesign and implementation of operational processes to enhance member experience and process improvements driving to full compliance with CMS requirements. Developed a customer experience program leading to18% increased member retention and satisfaction. Responsible for various aspects of the member acquisition process including lead generation, enrollment/disenrollment, contact center operations and broker services.

MarCom is a leading contact center services provider operating multiple locations domestic and foreign responsible for direct consumer operations, affinity sales and insurance sales including Life & Health, Property & Casualty and Medicare Advantage products.Leverage health care, insurance and contact center operations experience and comprehensive knowledge to analyze, plan, and implement a 3 year business expansion plan to grow from one contact center and $5 million in revenue to fifteen locations and revenues in excess of $100 million. Provide leadership and direction in overseeing the performance of multiple locations and 1,800 employees across diverse functional areas including sales, back office fulfillment, production control, human talent, training & employee development, quality assurance, account management, payroll and compliance.

Humana is a health insurance provider based in Louisville, KY - products and services include group and individual health insurance, Medicare Advantage and Medicare Part D programs with more than 12 million members in 50 states.Directed Inbound & Outbound Telemarketing, Customer Service, Data Entry, Direct Mail Campaigns and new member acquisition programs. Motivated and supervised a staff of up to 150+ licensed insurance agents and customer service agents. Developed systems, training programs, call scripting, and performance/accountability metrics to facilitate in efficient sales operations and providing world-class customer service.