Sue L. Argüello Email & Phone Number

Rochester, Ny, Us

• 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