Patsy Martinez Email and Phone Number

Responsible for daily performance of dedicated plan sponsors. Successfully and consistently forecast daily volumes for staff needs to ensure customer satisfaction. Consistently predict monthly rates successfully at 85% accuracy. Agent performance monitoring, identifying issues and concerns, shift scheduling and continuous monitoring of business and system issues.• Forecast, analyze & provide recommendations related to staffing, scheduling for customer service agents• Monitor agent adherence, provide feedback & additional training as needed• Create agent schedules on a monthly basis• Facilitate weekly manager & supervisor meetings for updates, changes & concerns• Process all new hires and terminations• Manage RTA to determine agent availability on queues• CMS agent changes moving from different queues based on need, hold times, tsf, & acw• Interval analysis on multiple work-types • Conduct training for all new hired agents, include schedule all TBT, culture trainings, 1:1 & performance meetings• Develop & monitor performance reports, observe overall trends for multiple service areas for overall line of business satisfaction

Monitored new hires and senior agents to ensure accurate and precise processing of precertification guidelines for procedures, medications and injectables. Continuous case audit achievements at 99% accuracy and efficiency. Distribution of all daily work assignments to case managers and care management associates. • Capable of retrieving, reviewing clinical data from the ORHS system for nurse processing• Produce Quarterly Disability reports, Frequent ER reports & Pulse reports• Handle distribution of all work to case managers & registered nurses to insure timely, equal distribution• Process inpatient and outpatient pre-certification admissions via email, telephone queues & fax requests• Responsible for handling pre-determination & retrospective reviews• Handle multiple excel reports to include Pre-Admission/Post Discharge Reports• Resolve all retro claims & incorrect filing of claims• Preceptor & mentor for new hires of CMA’s within department, provide one on one feedback for new hires to ensure success within their individual departments• Create & maintain all training manuals• Create monthly team building exercises for all CMA’s & registered nurses• Travel within the city during open enrollment to educate AETNA members of new benefit changes for the new year

Dispensed and packaged prescriptions for client deliverables. Recognized for the ability to efficiently dispense all medications with 100% accuracy while providing excellent customer service.• Receive & review prescriptions including verification of all patient information• Maintain proper storage & security for prescription drugs • Answer all inquiries from patients & doctors• Applied systematic approach to avoid prescription shortages