Responsible for leading the strategic planning and execution of complex healthcare and social services programs, overseeing teams, and ensuring efficient service delivery. Collaborating with state agencies and managed care organizations to forge robust partnerships, enhancing program coordination, and maximizing impact. Developing and tracking performance metrics, utilizing data-driven insights to inform decision-making, optimize processes, and drive continuous improvement. Successfully managing budgets, allocating resources effectively to maintain program sustainability while adhering to fiscal responsibility. Providing visionary leadership to diverse teams, fostering professional growth, and promoting a culture of innovation and collaboration. Ensuring strict compliance with federal and state regulations, managing internal controls, and reporting to meet evolving program requirements. Championing diversity, equity, and inclusion initiatives, promoting a workplace culture that values and celebrates differences. Effectively overseeing project management aspects, from planning and resource allocation to execution and timely delivery. Presenting comprehensive reports and presentations to executive leadership, policymakers, and external stakeholders, effectively communicating program accomplishments and challenges.

Responsible for leading the strategic planning and execution of complex healthcare and social services programs, overseeing teams, and ensuring efficient service delivery. Collaborating with state agencies and managed care organizations to forge robust partnerships, enhancing program coordination, and maximizing impact. Developing and tracking performance metrics, utilizing data-driven insights to inform decision-making, optimize processes, and drive continuous improvement. Successfully managing budgets, allocating resources effectively to maintain program sustainability while adhering to fiscal responsibility. Providing visionary leadership to diverse teams, fostering professional growth, and promoting a culture of innovation and collaboration. Ensuring strict compliance with federal and state regulations, managing internal controls, and reporting to meet evolving program requirements. Championing diversity, equity, and inclusion initiatives, promoting a workplace culture that values and celebrates differences. Effectively overseeing project management aspects, from planning and resource allocation to execution and timely delivery. Presenting comprehensive reports and presentations to executive leadership, policymakers, and external stakeholders, effectively communicating program accomplishments and challenges.

In my role as a Network Operations Specialist, I collaborated closely with healthcare providers, insurance carriers, and regulatory agencies to streamline network operations for the timely and effective delivery of healthcare services to Medicaid beneficiaries. This involved coordinating provider enrollment, monitoring network performance, and ensuring compliance with regulations. I played a central role in negotiating provider contracts and managing performance metrics, while also serving as a point of contact for issue resolution and preparing comprehensive reports for stakeholders. Additionally, I provided crucial support in the negotiation and management of provider contracts, fee schedules, and performance metrics, optimizing network value, improving service delivery, and enhancing the overall beneficiary experience. My ability to navigate the regulatory landscape by staying current with Medicaid program guidelines, policies, and regulations ensured full compliance and timely adaptation to industry standards. Lastly, I also acted as a point of contact for escalated issues, effectively resolving concerns from providers, beneficiaries, or internal stakeholders related to network operations, claims, and authorizations. Additionally, I prepared comprehensive reports and presentations detailing network performance, compliance, and improvement initiatives for senior management, regulatory agencies, and other external stakeholders.

As an Enrollment Broker, I served as a subject matter expert, providing staff with unbiased presentations of enrollment options to assist customers in enrolling into Medicaid Managed Care or CHIP plans. I educated customers about the benefits of Texas Health Steps and guided them through the enrollment process, ensuring they had a clear understanding of their healthcare coverage choices. I adeptly facilitated the transfer or referral of callers to other Call Center units as needed, ensuring seamless assistance and optimal customer service. Moreover, I was responsible for handling customer grievances with sensitivity and professionalism, I escalated unresolved concerns to designated departments for thorough investigation. My dedication to ensuring customer satisfaction was unwavering, and I consistently sought to address their needs promptly and effectively. I also leveraged my strong communication skills to convey complex information in an understandable manner, empowering customers to make well-informed healthcare decisions. Through collaboration with colleagues and stakeholders, I upheld ethical standards and ensured accurate information was provided to customers.

As a Production Manager, I was responsible for overseeing the end-to-end manufacturing process to ensure the efficient, high-quality, and timely production of goods. Leveraging my strong leadership skills, I led and coordinate diverse teams, including production supervisors, technicians, and operators, to achieve production targets and meet customer demands. By implementing and optimizing production schedules, I ensured optimal resource allocation and utilization, minimizing downtime and maximizing output. I closely monitored production metrics and quality standards, implementing continuous improvement initiatives to enhance operational efficiency and product quality. Additionally, my role involved collaborating with cross-functional departments, such as procurement, quality control, and maintenance, to streamline processes and resolve any production-related issues. Through effective project management, strategic planning, and a commitment to safety protocols, I contributed to the overall success of the organization by delivering exceptional products that meet or exceeded customer expectations.