Sue L. Argüello Email & Phone Number

• Establish interface between PBM and clients to ensure compliance with regulatory and legal standards.
• Resolve client questions or concerns regarding changes in health care regulations and policies.

Remote

Rochester, New York

• Conducted risk analysis for annual audit work plan.
• Performed audits to ensure that the managed care plan operated within the policies, procedures and regulations.
• Researched state and federal health care and privacy laws, including Medicare/Medicaid and HIPAA.
• Interacted with internal business units and external vendors to identify process improvement opportunities and program enhancements.

Pittsford, NY

• Managed quality assurance and compliance programs for multiple projects.
• Implemented ISO 9001 quality management systems for existing and start-up projects for government service contracts.
• Identified, developed and documented policies and procedures to ensure contractual, regulatory and client requirements were met.
• Supervised a team of internal auditors and quality control analysts to measure performance quality and ensure improvements opportunities are identified and tracked.

• Planned and executed internal audits in accordance with the annual audit schedule.
• Oversaw the implementation and maintenance of the corrective/preventive action program.
• Led investigations of and research into quality findings or incidents.
• Managed internal clients' expectations, and effectively communicated corporate quality standards.
• Evaluated the effectiveness of all areas of functional operations and reported issues to management

Jd

Activities and Societies: Latino Law Student Association, Research Assistant for law professor, Legal Writing Teaching Assistant

Bachelor Of Business Administration (B.B.A.), Finance And International Business

Education record