CarePlus Health Plan
Address: 350 W 31st St, New York, NY 10001 Phone: (212) 947-9182: Place name: Category: Website: : : : Hours: : : Category: Insurance agency Suggest an editUnable to add this file. Please check that it is a valid photo. Unable to add this file. Please check that it is a valid photo. · Own this business?Add missing informationAdd business hours Unable to add this file. Please check that it is a valid photo. Add website Unable to add this file. Please check that it is a valid photo. Questions & answers Ask a questionBe the first to ask a question Add a photoThanks for sharing!Your photo will be posted publicly on Google.Contribute MoreDoneUpload public photos of Careplus Health Plan Posting publicly on the Web Write a review Reviews Be the first to review
CarePlus Health Plan List of Employees There's an exhaustive list of past and present employees! Get comprehensive information on the number of employees at CarePlus Health Plan. You can filter them based on skills, years of employment, job, education, department, and prior employment.
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CarePlus Health Plan Employees
Humana September 2015 - Present
Miami-Dade County April 2014 - Present
CarePlus Health Plan November 2014 - Present
All Family Care Centers August 2009 - Present
Community Outreach Resource Centers Inc. March 2004 - Present
WellCare February 2011 - Present
Skills
Public Speaking, Strategic Planning, Wellness, Team Building, Healthcare, Customer Service, Marketing Strategy, New Business Development, Fitness, Marketing, Nutrition, Social Media, Nonprofits, Entrepreneurship, Sales Management, Event Planning, Small Business, Sales, Public Relations, Healthcare Management, HIPAA, Managed Care, Medicare, Medicaid, Healthcare Consulting, Management, Health Insurance, Insurance, Leadership, Healthcare Industry, Negotiation, Medicine, Process Improvement, Training, EMR, Social Media Marketing, Microsoft Excel, Executive Management, Physicians, Physician Relations, Account Management, Employee Benefits, Business Development, Contract Negotiation, EHR, Provider Relations
Education
Universidad Central del Este
GuideWell June 2015 - Present
Florida Blue February 2011 - June 2015
Corporate Caterers October 2010 - February 2011
AXA Advisors August 2008 - October 2010
OneTen Group March 2005 - July 2008
CarePlus Health Plan January 2002 - November 2005
Skills
Sales, Management, Insurance, Health Insurance, Team Building, Strategic Planning, Salesforce.com, Marketing, Change Management, Business Process..., Strategy, Sales Management, Leadership, Retail, Team Leadership, Budgets, Customer Service, Business Strategy, Customer Satisfaction
Education
Nova Southeastern University 2012 — 2014
Master of Business Administration (M.B.A.), Sales Management
Florida International University 1998 — 2003
Bachelor of Business Administration (B.B.A.), Management Information Systems, General
Cigna February 2015 - Present
Cigna September 2013 - Present
Cigna July 2010 - September 2013
AvMed Health Plans September 2009 - July 2010
AvMed June 2008 - October 2009
HealthSun Health Plans, Inc July 2005 - June 2008
CarePlus Health Plan February 2004 - July 2005
CarePlus Health Plan January 2003 - February 2004
CarePlus Health Plan December 2001 - January 2003
Beacon Health Plans/HIP December 2000 - December 2001
Skills
Provider Relations, Provider Contracting, Utilization Management, Service Provider..., Physician Network..., Business Planning, PPO, Hospitals, Contract Negotiation, Contract Recruitment, Medicare, Network Development, Credentialing, Policy, Health Insurance, Medical Terminology, Medicaid Managed Care, Disease Management, ICD-9, Medical Billing, Medicare/Medicaid..., Healthcare Industry, NCQA, Pharmacy Benefit..., HMO, Medicaid, Medical Coding, Physician Relations, Claim, HIPAA, EMR, Healthcare Management, Budgets, Medicare Part D, Analysis, Managed Care, Revenue Cycle, Pay for Performance, Health Policy, Healthcare, Healthcare Information..., Healthcare Reimbursement, CPT, HCPCS, Quality Improvement, Physicians, Healthcare Consulting, EHR, Accountable Care
Education
Florida International University
Bachelor's degree, Health Services Administration
Miami Dade College
Associate of Arts
CityView Realty August 2012 - Present
CarePlus Health Plan May 2006 - Present
Skills
Medicare, HIPAA, Health Insurance, Provider Relations, Medicaid, Data Entry, Home Care, Healthcare Management, Invoicing, Medical Coding, Medical Records, Medical Terminology
Education
Kaplan University-Davenport Campus 2015 — 2016
Bachelor's degree, Criminal Justice
Everest University-Tampa 2006 — 2008
Associate of Science (AS), Criminal Justice
United Healthcare May 2006 - Present
CarePlus Health Plan October 2003 - June 2006
Neighborhood Health Partnership/Perot Systems February 1997 - October 2003
Fidelity Investments 1994 - 1996
Skills
National HEDIS Project..., HEDIS, Medicaid, Health Policy, Medicare, Disease Management, HIPAA, Managed Care, Healthcare Information..., Healthcare, Health Insurance, Healthcare Management
Education
Texas Tech University 1989 — 2003
Bachelor of Business Administration (BBA), Business Administration and Management, General
Alvord High School 1984 — 1988
CarePlus Health Plan December 2014 - Present
Physicians United Plan November 2012 - October 2013
Martial Arts World of Metro West October 2011 - November 2012
Little Big Steps Therapy Services January 1995 - November 2012
OBDS January 2011 - October 2011
Internal Medicine April 2009 - December 2010
metrohealth of metrowest September 2008 - December 2010
Associated Healthcare Management November 2008 - April 2009
Florida Primary Medicine June 2008 - November 2008
Family Practice Specialist February 2005 - June 2008
Skills
EMT, Medical Coding, Auditing, Medical Billing, Medical Records
Education
Valencia College 1998 — 2006
Billing and coding, Medical Insurance Coding Specialist/Coder
Seminole State College of Florida
Medical Coding, Medical Office Assistant Degree
Lake Howell High School 1995 — 1997
General Education, High School/Secondary Diplomas and Certificates
Lake Howell High School
High School Diploma
reNewJerseyStronger March 2014 - Present
Abbott Point of Care October 2013 - March 2014
reNewJerseyStronger June 2013 - August 2013
Manhattan Professional Group October 2012 - May 2013
Falcon Engineering July 2010 - April 2012
Criticom Monitoring Services; Protection One August 2007 - July 2010
Fedders Addison June 2005 - August 2007
Dail A Mattress May 2004 - June 2005
Fidelis Care New York July 2003 - May 2004
CarePlus Health Plan October 2001 - June 2003
Skills
Customer Service, Word, Microsoft Office, PowerPoint, Excel, Problem Solving, Budgeting, Scheduling, Outlook, Hiring, Contract Negotiation, Negotiation, Purchasing, Team Leadership, Supervisory Skills, Coaching, Public Speaking, Research, Customer Relations, Team Building, Administration, Real Estate, Event Management, Marketing Strategy, Social Media, Accounting, Accounts Receivable, Marketing, Sales, Management, Microsoft Excel, Budgets
Education
Strayer University 2007 — 2011
BBA, Management
CarePlus Health Plan 2008 - Present
Skills
Healthcare, Healthcare Management, Outlook, Microsoft Word, Microsoft Excel, Healthcare Information..., Medicare, Leadership, Strategic Planning, Public Speaking
Education
University of Phoenix
Master of Business Administration (MBA)
University of Phoenix
Bachelor's degree, Business, Management, Marketing, and Related Support Services
CarePlus Health Plan January 2007 - Present
Education
Barry University 2002 — 2004
BSN, NUSRSING SCIENCE, 3.89
CarePlus Health Plan April 2010 - Present
Humana October 2008 - April 2010
WellCare March 2002 - September 2008
Skills
Medicare, Managed Care, Health Insurance, HMO, Medicaid, Provider Relations, Network Development, Medicare Part D, Healthcare, Long-term Care, Healthcare Consulting, Healthcare Management, PPO, HIPAA, EHR, Employee Benefits, Healthcare Industry, Insurance, Life Insurance, Health Policy, Disability Insurance, Hospitals, Claim, Revenue Cycle, EMR, Healthcare Information..., Term Life Insurance, Health Savings Accounts, Disease Management, Credentialing, Utilization Management, Home Care, Medical Terminology, Physician Relations, Medicare/Medicaid..., Medical Billing, Medical Coding, Medicaid Managed Care, Health Care Reform, Team Building, Strategic Planning
Education
Santa Fe College
CAC-Florida Medical Centers October 2010 - Present
CarePlus Health Plan August 2007 - August 2009
Skills
Medicare, Healthcare Management, Medicaid, Credentialing, HIPAA, Practice Management, Problem Solving, EHR, EMR, Healthcare Consulting, Hospitals, Physician Relations, Revenue Cycle, Clinical Research, Physicians, Team Building
Education
Grantham University 2014 — 2015
Master of Healthcare Administration, Health/Health Care Administration/Management
Nova Southeastern University
Bachelors, Management
Nova Southeastern University
MBA, Business Administration
CarePlus Health Plan March 2014 - January 2015
Fossil Watches June 2013 - December 2013
Arrow Merchandising, Inc. November 2012 - February 2013
PATLive April 2011 - April 2012
PATLive October 2010 - April 2012
Skills
Fluent in written &..., Fluent in spoken Spanish, College-level writing, Online Research, Oral & Written..., Customer Service, Invoicing, Environmental Science, Data Entry, Sales, Access, Coaching, Teamwork, Time Management, Retail, Facebook, Communication
Education
Florida State University 2008 — 2010
Bachelor of Science (BS), Environmental Studies
Miami Dade College 2006 — 2008
Associate of Arts (AA), Environmental Studies
CarePlus Health Plan January 2012 - June 2015
Tenet Healthcare 2006 - 2012
Hospital without walls June 2011 - December 2011
Memorial regional hospital March 2005 - March 2006
Skills
Hospitals, Healthcare, Healthcare Management, Home Care, Nursing, Clinical Research, Inpatient, Medicare, Medical Records, Acute Care, Utilization Management, Managed Care, Physician Relations, Medication..., EMR, Cerner, Case Management, Health Promotion
Education
South University 2013 — 2015
Master of Science (M.S.), Family Practice Nurse/Nursing
Barry University 2003 — 2004
Bachelor of Science (BS), Registered Nursing/Registered Nurse
Palm Beach Community College 2000 — 2002
Associate of Arts (AA), A. A.
The Bridges-The Home Association June 2005 - Present
CarePlus Health Plan May 2001 - October 2004
DynCorp International July 1992 - February 1997
Skills
Microsoft Word, Health, Nursing, Quality Assurance, Customer Service, Research, Typing, Underwriting, Home Care, Data Entry, Healthcare, Medical Terminology
Education
University of Phoenix
Bachelor of Business Administration (B.B.A.)
Leary Technical Center
Certification, Nursing Assistant
Corban OneSource August 2010 - Present
CarePlus Health Plan 1997 - 2009
Dun and Bradstreet / Health Plan Services 1993 - 1997
Dun & Bradstreet Health Plan Services 1989 - 1993
Skills
ADP Payroll, Payroll Taxes, Payroll Services, Multi-state Payroll..., Payroll Conversions, PowerPoint, Microsoft Office, Account Reconciliation, Project Management, Customer Service, Microsoft Excel, Graphic Design, Microsoft Word, Small Business, Web Design, Publishing
Education
Southern New Hampshire University 2014 — 2019
Bachelor’s Degree, Forensic Accounting, 4.0
Hillsborough High School 1974 — 1977
High School, 4.0
American Payroll Association - San Antonio, TX
CPP, Certifield Payroll Professional
Rio de Dios, Iglesia de Dios January 2014 - Present
Safeguard Properties July 2012 - Present
City of Refuge & Worship October 2010 - September 2012
Ignite Life Center October 2009 - October 2010
Baygulf Imports January 2009 - October 2009
Prestige Auto Sales August 2008 - November 2008
CarePlus Health Plan October 2004 - October 2008
Careplus Health Plans Inc October 2004 - September 2007
Uniform City January 2003 - August 2004
USA PARKING March 2002 - October 2002
Skills
Real Estate, Property Management, Customer Service, Outlook, Microsoft Office, Microsoft Excel, Microsoft Word, Data Entry, Property, Team Building, PowerPoint, Office Management, Public Speaking, Leadership, Training, System Administration, Time Management, Event Planning
Education
Ultimate Medical Academy 2012 — 2013
MCLA, Medical/Clinical Assistant, A
Southwest Florida College 2008 — 2009
Associate's degree, Computer/Information Technology Administration and Management, A
Ignite School of Ministry 2007 — 2008
Certification, Youth Ministry, B
Best Doctors December 2011 - February 2014
J and B Importers April 2010 - December 2011
CarePlus Health Plan January 2009 - September 2010
Skills
Event Planning, Strategic Planning, Microsoft Office, Event Management, Administrative..., Medical Records, Receptionist Duties, Healthcare, Outlook, Customer Service, Data Entry, Microsoft Word
Education
Florida International University 2014 — 2016
Miami International University of Art and Design 2013 — 2014
Bachelor of Architecture (BArch), Architecture
Florida International University 2010 — 2013
Bachelor of Architecture (BArch), Architecture
CarePlus Health Plan August 2014 - Present
Physician Partner Alliance, LLC - a division of Bayshore Holdings 2009 - April 2013
AvMed Health Plans 2006 - 2008
Mount Sinai Medical Center Miami Beach 2004 - 2007
Skills
Healthcare, Managed Care, Healthcare Consulting, Medicare
Education
Tulane University 1989 — 1992
CarePlus Health Plan May 2015 - Present
Hotel Connections, Ltd February 2014 - January 2015
Comptex systems May 2007 - February 2014
Skills
Computer Hardware, Servers, Windows Server, Active Directory, Hardware, Troubleshooting, VMware, Windows 7, Operating Systems, Linux, XP, Virtualization, Technical Support, Windows, Network Administration, Windows 8, Visual C#, ASP.NET, Java, HTML 5, SQL, Microsoft Exchange, System Administration, Computer Repair, Visual Basic, Databases, Unix, Microsoft SQL Server, Visio, Laptops, Cloud Computing, Information Technology, IT Management, Antivirus, MySQL, Workstations, OS X, Remote Desktop, Printers, HP, Dell Computers, IT Service Management, System Deployment, Windows XP, Microsoft Excel, Management, Networking, Leadership, Software Installation, Project Management
Education
Florida International University 2013 — 2015
Master's degree, Management Information Systems, General
Florida International University 2010 — 2013
Bachelor's in Science, Information Technology
Miami Dade College 2007 — 2009
Associate of Arts (A.A.), Business
CarePlus Health Plan February 2014 - Present
Maxim Healthcare Services April 2013 - February 2014
Skills
Nursing, Training, Time Management, Healthcare, Nursing Education, Customer Service, Medicaid, Home Care, Healthcare Industry, HIPAA, Hospitals, Healthcare Management, Patient Education, Managed Care, Medicare
Education
University of Maryland Baltimore
BSN
CarePlus Health Plan July 2014 - Present
Indepent October 2013 - July 2014
AT&T Mobility August 2012 - October 2013
Banco Santander November 2010 - June 2011
Skills
Bilingual, Call Centers, Customer Satisfaction, Customer Retention, Customer Service, Customer Experience, Data Entry, Telephone Skills, Outlook, Time Management, Microsoft Office, Team Leadership, Access, Sales, Retail Sales, Face to Face Sales, Face to Face..., Result Oriented, Mobile Technology, Health Insurance, Medicare Advantage, Microsoft Excel, Leadership
Education
Universidad del Sagrado Corazón 2008 — 2010
Bachelor's degree, Criminal Justice/Police Science
CarePlus Health Plan 2014 - Present
Advanced Medical Support 2010 - 2013
Kentwood Preparatory School 2002 - 2010
Skills
Microsoft Office, Microsoft Excel, Microsoft Word, Customer Service, PowerPoint, English, Windows, Research, Outlook, Teaching, Photoshop, Public Speaking, HTML, Strategic Planning, Budgets, Negotiation, Editing, C++, C, Java
Education
Strayer University-Florida 2010 — 2012
Master's Degree, Education
Florida State University 1996 — 2001
Social Science, Social Sciences
CarePlus Health Plan March 2002 - Present
Rafael Barrial,MD,PA January 2000 - Present
Skills
Healthcare, Medicine, Internal Medicine, Healthcare Management, Health Policy, Physicians, Hospitals
Education
Columbia University College of Physicians and Surgeons 1993 — 1997
Doctor of Medicine (MD), Medicine
CarePlus Health Plan October 2010 - Present
CarePlus Health Plan April 2010 - October 2010
CarePlus Health Plan January 2007 - April 2010
Blue Cross Blue Shield of Florida January 2002 - January 2007
PanAmerican CAC Medical Centers April 2001 - December 2001
CAC-United Health Care Medical Centers March 1995 - April 2001
Publix August 1994 - February 1995
Skills
Pharmacy, Pharmacy Automation, Utilization Management, Medicare, Managed Care, Medicaid
Education
Florida A&M University
PharmD, Pharmacy
Sarah Davis Jewelry December 2013 - Present
CarePlus Health Plan December 2012 - Present
CarePlus Health Plan December 2011 - December 2012
CarePlus Health Plan May 2010 - December 2012
CarePlus Health Plan February 2011 - December 2011
CarePlus Health Plan March 2006 - May 2008
Bank of America November 2004 - March 2006
Capital One October 2000 - November 2004
Skills
Microsoft Office, Microsoft Excel, Microsoft Word, Customer Service, English, Research, Outlook, Insurance, Policy
Education
St Petersburg College
St. Petersburg College
HealthSouth Rehabilitation Hospital of Altamonte Springs March 2015 - Present
Medicomp. Inc September 2013 - Present
Gentiva Health Services May 2012 - June 2013
Preferred Marketing Consultants September 2011 - May 2012
CarePlus Health Plan April 2010 - September 2011
Preferred Marketing Consultants 2010 - 2010
Humana 2008 - 2010
Gateway Hospice December 2006 - March 2007
Skills
Medicare Advantage..., Licensed Pracitcal Nurse, Medicare, Healthcare, Long-term Care, Nursing, Insurance, Hospitals, Team Building, Health Insurance, Budgets, Marketing, Home Care, Strategic Planning, Healthcare Consulting, Health Policy, Managed Care, Public Speaking, Employee Benefits, Sales, HIPAA, Healthcare Management, Physicians, Healthcare Industry, Case Management, Disease Management, Physician Relations, Clinical Research, Cardiology
Education
Hamilton Fulton Montgomery BOCES-Practical Nursing Program 1985 — 1987
Licensed Practical Nurse, Nursing Practice
Wilbur H Lynch High/ Amsterdam High School 1973 — 1976
High School Diploma, Regents College
CarePlus Health Plan March 2015 - Present
Physicians United Plan July 2013 - June 2014
Orlando Health Medical Center November 2009 - July 2013
University Physicians, Inc. October 2005 - September 2009
Skills
Medical Coding, Cardiology, Internal Medicine, Critical Care, Infectious Diseases, Pediatrics, General Surgery, Software Documentation, Vascular, Healthcare, HIPAA, Healthcare Information..., EHR, EMR, Healthcare Management, Informatics, Medical Records, Medicare, Medicare Advantage, Microsoft Excel, Revenue Cycle
Education
Eastern Illinois University 1979 — 1983
Bachelor's Degree, Computational Mathematics
Eastern Illinois University 1979 — 1983
Bachelor's degree, Mathematics and Computer Science
Liebler, Gonzalez & Portuondo January 2015 - May 2015
United States District Court for the Southern District of Florida August 2014 - November 2014
United States Attorney's Office June 2014 - August 2014
US Securities and Exchange Commission January 2014 - April 2014
US Securities and Exchange Commission September 2013 - December 2013
Miami-Dade State Attorney's Office May 2013 - August 2013
Pearl Media LLC. February 2011 - September 2012
R/S Capital Corp. October 2009 - February 2011
CarePlus Health Plan May 2007 - October 2009
Skills
Westlaw, Legal Writing, Legal Research, Commercial Real Estate, Outdoor Advertising, Securities Regulation, Real Estate Transactions, Corporate Law, Lexis, Legal Compliance, Criminal Law, Policy Analysis, Legal Issues, Social Media, Civil Litigation, Public Speaking, Microsoft Office, LexisNexis, Bankruptcy, Litigation, Public Policy, Licensing
Education
American University Washington College of Law 2012 — 2015
Juris Doctor (J.D.)
Florida International University 2009 — 2011
Bachelor of Arts (B.A.), Economics
Miami Dade College 2007 — 2009
Associate's degree
Christopher Columbus High School 2003 — 2007
High School
Tara2Assist 2012 - Present
CarePlus Health Plan July 2005 - April 2012
CarePlus Health Plan July 2001 - July 2005
Physicians Healthcare Plans Inc December 2000 - May 2001
Physicians Healthcare Plans Inc June 1998 - December 2000
Physicians Healthcare Plans Inc May 1997 - June 1998
Physicians Healthcare Plans Inc May 1996 - May 1997
Sallie Mae June 1992 - April 1996
Skills
Data Entry, Microsoft Excel, PowerPoint, Data Analysis, Medical Terminology, Auditing, Microsoft Word, QuickBooks, Medicare Reimbursement, Contract Management, Pivot Tables, Formulas, Microsoft Access, Database Design, Query Writing, Project Management, Appointment Scheduling, Letter Writing, Proofreading, Policy Writing, Policy Review
Education
University of Phoenix 2007 — 2013
Bachelor of Applied Science (BASc), Health/Health Care Administration/Management, 3.85
Southeast Community College 1990 — 1991
Associate of Arts and Sciences (AAS), Business Administration/Accounting
New York Presbyterian Hospital December 2013 - Present
New York Presbyterian Hospital September 2009 - December 2013
New York Presbyterian Hospital August 2007 - September 2009
New York City Campaign Finance Board February 2005 - August 2007
CarePlus Health Plan January 2004 - February 2005
Congressman Anthony Weiner November 1999 - December 2003
Skills
Auditing, Compliance, Healthcare, Hospitals, Government, Regulatory Affairs, Public Policy, Revenue Cycle, Data Analysis, Financial Analysis, Legislative Analysis, IT Audit, Internal Audit, Certified Internal..., Compliance Audits, Audit, Government Compliance, Healthcare Industry, Healthcare Management, Campaign Finance, Health Care Compliance, Health Care Regulation, Business Process..., Healthcare Information..., Medicaid, Managed Care, Medicare, Policy, Health Policy, Risk Assessment, Process Improvement
Education
Baruch College 1998 — 2001
Master of Public Administration (MPA), Public Administration
SUNY at Buffalo 1993 — 1997
Bachelor of Arts (BA), Political Science and Government
Hand in Hand Together Home Care June 2015 - Present
A Boutique Concerto August 2013 - Present
J&M Jewelry 2012 - Present
FutureCare Health Services September 2014 - May 2015
Bestcare Inc June 2014 - August 2014
Universe Garment LTD 2010 - 2012
JS Trading INC 2006 - 2009
New York Asian Women's Center 2003 - 2006
Dayspring Ministries International 2003 - 2006
CarePlus Health Plan 2002 - 2002
Skills
Management, Community Outreach, New Business Development, Small Business, Startup Development, Relationship Marketing, Relationship Building, Non-profit..., Non-profit Volunteering, Non-profit Leadership, Business Management, Conflict Resolution, Team Building, Pastoral Counseling, Local Government, Government Relations, Healthcare Management, Program Development, Healthcare, Medicaid, Public Speaking, Hospitals, Nonprofits, Case Management, Managed Care, Social Services, Strategic Planning, Leadership
Education
Glion Institute of Higher Education
Western Governors University 2006 — 2010
Hardin-Simmons University 2000 — 2001
CarePlus Health Plan September 2011 - Present
Americatel Corporation March 2001 - February 2008
Skills
Microsoft Office, Microsoft Excel, Microsoft Word, Customer Service, PowerPoint, English, Windows, Research, Outlook, Teaching, Photoshop, Public Speaking
Education
Miami Dade College
Pureza de Maria
Prestige Health Choice July 2014 - Present
Coral Reef Nursing and Rehabilitation Center June 2013 - August 2013
CarePlus Health Plan September 2011 - May 2013
CarePlus Health Plan July 2010 - June 2011
Skills
Healthcare, Medicare, Medicaid, Inpatient, Customer Service, Healthcare Management, Public Speaking, Team Building, Health Insurance, Time Management, Microsoft Word, Data Entry, Clinical Support, Bilingual-English/Spanis..., Windows & Mac operating..., Eager to learn new..., Adaptable to Changes, Managed Care, Process Improvement, Utilization Management, Caring
Education
Miami Dade College 2003 — 2006
Associate in Science, Computer Engineering Technology/Technician
Airborne Data Imaging Group July 2015 - Present
My Personal Doc October 2010 - Present
Northeast Business Group on Health October 2009 - May 2013
Agile Health Partners March 2010 - October 2010
My Expert Solution February 2010 - September 2010
CMO The Care Management Company January 2006 - November 2009
Touchstone Health Partnership, Inc. October 2002 - August 2005
Presbyterian Community Health Plan October 2001 - October 2002
CarePlus Health Plan July 2000 - October 2001
Beth Israel Medical Center December 1999 - June 2000
Skills
Prevention, Wellness, Lipidology, Disease Management, Care Management, Utilization Management, Quality Management, Urgent Care, Managed Care, Medicare, Healthcare, Hospitals, Healthcare Information..., EMR, Medicine, Clinical Research, Healthcare Management, Process Improvement, Informatics, Physicians, Health Policy, Treatment, Practice Management, Healthcare Consulting, Ambulatory, Health Education, Medical Coding, Program Development, HIPAA, Provider Relations, Inpatient, EHR, Quality Improvement, Internal Medicine, Home Care, Medicaid, Credentialing, Board Certified, Physician Relations, Patient Safety, Diabetes, Healthcare Industry, Public Health, Medical Education, Cardiology, Health Information..., Proactive self-starter, Primary Care
Education
Good Samaritan Hospital/Johns Hopkins University 1989 — 1990
Senior Resident
University of Maryland/ Baltimore VA 1987 — 1989
Intern and Junior Resident
Temple University School of Medicine 1983 — 1987
MD
University of Pittsburgh 1982 — 1983
Haverford College 1977 — 1981
Bachelor of Science
The Madison Square Garden Company October 2014 - Present
The Madison Square Garden Company October 2014 - March 2015
ADP August 2014 - October 2014
TRAC Intermodal June 2011 - November 2013
Integra LifeSciences Corp August 2005 - July 2011
CarePlus Health Plan August 1999 - July 2005
Donna Karan International June 1999 - June 2000
Andin International INC January 1996 - June 1999
Wiggby Precision Machine Corp March 1990 - December 1995
Skills
Strategic Planning, Management Consulting, Due Diligence, Succession Planning, IT Operations Management, Team, Facilities Management, Proposal Writing, Benchmarking, Leadership, Cross-functional Team..., IT Management, IT Strategy, Process Improvement, Integration, Change Management, Project Management, Vendor Management, Data Center, Business Intelligence, Strategy, Disaster Recovery, Team Building, Management, ITIL, Enterprise Software, Security, Telecommunications, IT Operations, Virtualization, Information Technology, System Administration, Networking, Infrastructure, Servers, Program Management, System Deployment, Cloud Computing, Business Analysis, VoIP, Team Leadership, Storage, Technical Support, Troubleshooting, SDLC
Education
Touro College 1993 — 1995
LAN and Data Communications
National Technical University of Ukraine 'Kyiv Polytechnic Institute' 1982 — 1988
Masters, Information Systems
Industrial College of Ukraine 1978 — 1982
B.S, Electrical Engineering
Coventry Health Care, an Aetna Company September 2012 - Present
CarePlus Health Plan September 2012 - Present
Humana September 2012 - Present
American Care Inc March 2012 - Present
American Care Inc March 2012 - Present
Wellcare Health Plans April 2005 - Present
Applied Materials 2001 - 2004
Etec Systems 1998 - 2003
Skills
Disability Insurance, Customer Service, Employee Benefits, Health Insurance, Health Policy, Insurance, Leadership, Managed Care, Management, Medicaid, Medicare, Recruiting, Sales, Strategic Planning, Training, Process Improvement
Education
Phoenix College 1997 — 2001
BSBM, Business Management
University of Phoenix
Solera Health and One Health Networks October 2011 - Present
Jackson Health System July 2011 - September 2011
CarePlus Health Plan October 2008 - January 2011
CarePlus Health Plan January 2006 - October 2008
Skills
Customer Service, Medicaid, Medicare, Team Building, HIPAA, Call Centers, Data Entry, Outlook, Leadership, Customer Satisfaction, Sales, Healthcare, Marketing, Microsoft Excel, Medical Education, Team Leadership, Medical Terminology, Managed Care, Medicare Advantage, Pharmacy, Hospitality, Time Management, Management, Teamwork, Customer Retention, Documentation, Social Services, Telephone Skills, Event Planning, Insurance, Healthcare Management, Health Insurance, Training, EMR, Healthcare Industry, PowerPoint, Data Analysis, Access, Microsoft Word, Physician Relations, Medical Billing, EHR, Coaching, Hospitals
Education
Miami Dade College 2002 — 2005
Associate's degree, RN Program
Florida National University 1993 — 1995
X-ray technician, X-ray Tech, Diploma
G. Holmes Braddock Sr. High 1990 — 1992
High School Diploma, High School Diploma
CarePlus Health Plan May 2014 - Present
TMG Health January 2012 - May 2014
TMG Health April 2010 - January 2012
TMG Health March 2010 - April 2010
TMG Health June 2009 - March 2010
TMG Health March 2009 - June 2009
TMG Health December 2008 - March 2009
Skills
HIPAA, Microsoft Excel, Customer Service, Invoicing, Finance, Account Management, Profit
Education
Temple University 2004 — 2008
Bachelor of Business Administration (BBA), Accounting and Finance
Milian & Associates, Inc. February 2013 - Present
UnitedHealthcare February 2012 - December 2012
Medica Health Plans, Inc. June 2009 - February 2012
Angones McClure & Garcia P.A. December 2007 - January 2009
Humana March 2007 - December 2007
CarePlus Health Plan December 2006 - March 2007
CAC Florida Medical Centers June 2006 - December 2006
Skills
Medicare, Insurance, Medicaid, New Hire Orientations, Claim, Health Insurance, Employee Benefits, Healthcare Information..., Long-term Care, Managed Care, Management, Strategic Planning, Customer Service, Healthcare Consulting, Hospitals
Education
Nova Southeastern University 2008 — 2010
Bachelor of Applied Science (B.A.Sc.), Legal Studies, General
Florida National College-Main Campus 2006 — 2008
Associate of Science (A.S.), Legal Assistant/Paralegal
CarePlus Health Plan December 2014 - Present
JPMorgan Chase August 2013 - January 2014
Bank of America March 2012 - January 2013
Freedom Health August 2011 - January 2012
Albertelli Law January 2010 - August 2011
Firefly Legal, Inc. December 2008 - January 2010
Majik Touch Dry Cleaners January 2001 - July 2007
Skills
Healthcare, Insurance, Medicare, Financial Analysis, Health Insurance, Process Improvement, Access, Management, Medicaid, HMO, PPO, HIPAA, SQL, CMS, Managed Care, Visio, Microsoft Excel, Data Analysis, Workflow Management, PowerPoint, SharePoint
Education
Florida International University - College of Business Administration 2013 — 2014
Master of Business Administration (MBA), Health/Health Care Administration/Management
University of South Florida 2000 — 2005
Bachelor of Arts (B.A.), English
Database Training Academy
CarePlus Health Plan January 2013 - Present
Floridian home health agency December 2011 - February 2012
Skills
Healthcare, Nursing, Home Care, Healthcare Management, Vital Signs, Hospitals, Patient Safety, Patient Education, Wound Care, BLS, Medical/Surgical, Acute Care, Medication..., IV, ACLS, Case Management, Case Managment, Emergency Room, Mental Health, Treatment, Medical-Surgical, Medicare, HIPAA, Health Insurance, HMO, Customer Service, Collaboration Solutions, Spanish, Utilization Management, Managed Care, PowerPoint, Microsoft Excel
Education
Florida International University 2011 — 2012
Bachelor's degree, Registered Nursing/Registered Nurse
CarePlus Health Plan July 2011 - Present
Costa Farms January 2010 - July 2011
Skills
Photography, Marketing, Customer Service, Public Relations, Web 2.0, Social Networking, Microsoft Word, Blogging, Marketing Strategy, Marketing Communications, Social Media, Research, Social Media Marketing, Advertising, Facebook, PowerPoint, Sales, Email Marketing, Online Advertising
Education
Florida International University - College of Business Administration 2005 — 2010
Marketing
CarePlus Health Plan August 2013 - Present
CarePlus Health Plans (Humana) January 2012 - Present
Humana September 2011 - December 2011
Skills
Managed Care, Health Insurance, HMO
Education
Florida International University 2010 — 2011
MBA, Healthcare
Florida International University 2000 — 2004
BA, Marketing
CVS Caremark Corporation December 2011 - March 2015
CarePlus Health Plan 2008 - 2010
Humana November 2006 - December 2008
Watson Pharmaceuticals 2003 - 2004
Pfizer 2001 - 2004
Skills
Pharmacy Benefit..., Managed Care, Pharmacy, Pharmacists, Medicaid Managed Care, Medicare Advantage, Pharmacy Automation, Medicare Part D, Healthcare Management, Clinical Pharmacy, Pharmacoeconomics, Medicaid, Disease Management, Utilization Management, Clinical Research, Medicare, Healthcare
Education
Nova Southeastern University 1996 — 2000
PharmD, Pharmacy
Humana/CarePlus Health Plans January 2015 - Present
RN February 2014 - Present
North Broward Hospital District June 2013 - February 2014
CAREPLUS HEALTH PLAN March 2011 - June 2013
MEMORIAL REGIONAL HOSPITAL SOUTH 2006 - 2010
MEMORIAL REGIONAL HOSPITAL 2004 - 2006
TUCSON HEART HOSPITAL 2002 - 2004
TUCSON HEART HOSPITAL 1998 - 2002
THE REGIONAL MEDICAL CENTER AT MEMPHIS (The Med) 1991 - 1998
Skills
Nursing, Healthcare, Hospitals, Inpatient, Medicine, Medicare, Team Building, Leadership Development, Cardiology, Medical Records, Healthcare Management, Leadership, Emergency Medicine, Critical Care, Healthcare Information..., Emergency Room, Physician Relations, Acute Care, HIPAA, Patient Safety, ACLS, EMR, BLS, Managed Care, JCAHO, Medical Billing, Medical Compliance, Performance Improvement, PALS, Medical Terminology, Quality Improvement, Software Documentation, Community Outreach
Education
Methodist Hospital School of Nursing 1900 — 2017
Diploma, Nursing
The University of Memphis 1968 — 1972
Bachelor of Science, Microbiology
Simply Healthcare Plans September 2013 - Present
CarePlus Health Plan April 1999 - September 2013
FPA Medical Management January 1995 - March 1999
Grove Med Plus, Inc January 1992 - March 1998
Skills
Hospitals, Medicaid, Healthcare Information..., Revenue Cycle, Nursing, Provider Relations, Healthcare Consulting, Team Building, Data Analysis, Healthcare Industry, Credentialing, Medical Records, Medical Coding, Physician Relations, HMO, Practice Management
Education
Strayer University-Florida 2008 — 2013
Bachlors In Science, Computer Security & Forensics
Florida Risk Management 2003 — 2003
Case Management Specialist, Certification
VA Healthcare System October 2010 - Present
CarePlus Health Plan March 2009 - October 2010
Humana June 1989 - March 2009
VA Medical Center June 1986 - June 1989
Skills
Healthcare, Healthcare Management, Hospitals, Nursing, Quality Assurance, Critical Care, EHR, Process Improvement, Data Analysis, BLS, Medicare, Acute Care, Managed Care, Medicine, Team Building, Program Management
Education
Florida International University 2002 — 2005
MSN, Nursing Administration
College of Nursing & Health Sciences at Florida International University 1984 — 1986
Registered Nursing/Registered Nurse
J&L Healthcare Consulting Group LLC January 2015 - Present
Florida Healthcare Plus, Inc July 2012 - Present
WellCare Health Plans February 2007 - September 2010
CarePlus Health Plan April 2001 - January 2005
Skills
Management, Health Insurance, Customer Service, Microsoft Office, Claim, Strategic Planning, Leadership, Employee Benefits, Healthcare, Healthcare Industry, Healthcare Information..., Insurance, HIPAA, Medicare, Medicaid, Managed Care, Process Improvement
Education
Concorde Career Institute-Tampa 2010 — 2011
Certified Coder, Health/Health Care Administration
CarePlus Health Plan September 2014 - Present
CIGNA July 2011 - September 2014
CCS Medical October 2009 - July 2011
CCS Medical December 2008 - October 2009
CCS Medical April 2008 - December 2008
Konica Minolta Business Solutions U.S.A., Inc. February 2007 - December 2007
First American Title November 2005 - February 2007
Education
Penn State University 1997 — 2000
Bachelor of Science (BS), Finance, General
CarePlus Health Plan June 2014 - Present
Humana August 2012 - June 2014
Humana August 2009 - August 2012
Penske Truck Leasing September 2005 - December 2008
Carnival Cruise Lines August 2004 - August 2005
Interval International September 2001 - August 2004
Skills
Sales, Customer Service, Account Management, Sales Management, Direct Sales, Training, Customer Satisfaction, Cold Calling, Team Building, Marketing, Outlook, Coaching
Education
Nova Southeastern University 2012 — 2015
Master of Business Administration (MBA), Business Administration and Management, General
Florida International University 2005 — 2010
BS, Criminal Justice
Wellcare Health Plans August 2015 - Present
CarePlus Health Plan January 2007 - Present
Skills
Management, Microsoft Excel, Microsoft Word, Research, PowerPoint, Sales, Leadership, Training, Photoshop, English, Process Improvement, Outlook, Windows, Recruiting, Microsoft Office, Interviews, Healthcare, Health Insurance, Managed Care, Customer Service, Team Building, Insurance, Medicare
Education
Nassau Community College 1998 — 2000
Liberals Arts, Hotel Management, Liberal Arts and Sciences, Hotel Administration Management
Baroma Health Partners September 2014 - Present
Simply Healthcare Plans April 2012 - August 2012
CarePlus Health Plan August 2011 - February 2012
Skills
Healthcare, HIPAA, Managed Care, Medicare, Outlook, Data Entry, Customer Service, Medicaid, Health Insurance, Process Improvement, Healthcare Industry, Microsoft Excel, Provider Relations, PowerPoint, Public Speaking
Education
Florida International University 2007 — 2014
Bachelor's Degree, Health Services Administration
CarePlus Health Plan May 2012 - August 2015
Humana October 2007 - May 2012
Skills
Healthcare, Medicare, Sales, Customer Service, Employee Benefits, Account Management, Leadership, Health Insurance, Marketing Strategy, Sales Management, New Business Development, Team Building, Medicaid Managed Care, Medicare Supplements, Supplemental Health, Budgeting, Budget Forecasts
Education
University of South Florida
BS in Business Management
University of South Florida
Business Administration and Management, General
Major League Baseball March 2005 - Present
Dutchess County Haz-Mat Team January 1994 - May 2008
Rombout Fire Company January 1989 - May 2008
CarePlus Health Plan March 2004 - March 2005
DHL -Danzas October 2000 - October 2003
Dow Jones Local Media Group, Inc June 1998 - October 2000
KLM Royal Dutch Airlines 1989 - 1998
Skills
Microsoft Office, Business Analysis, Sports Marketing, Strategic Planning, Sports Management, Management, Leadership, HAZWOPER, Event Management, Coaching, Budgets
Education
Syracuse University 1985 — 1988
Molina Healthcare March 2015 - Present
CarePlus Health Plan January 2013 - March 2015
Alorica March 2010 - November 2011
Bayview Center for Mental Health, Inc. October 2009 - March 2010
Jackson Health System May 2009 - June 2009
Skills
HIPAA, Training, EMR, Microsoft Excel, PowerPoint, Cerner, Word Processors, MediConnect, HEDIS, Time Management, Pivot Tables, Prioritize Workload, Managed Care, HMO, Healthcare Information..., QNXT, HIM
Education
Florida Agricultural and Mechanical University 2004 — 2009
Bachelor of Science (B.S.), Health Informatics and Information Management
CarePlus Health Plan April 2002 - Present
Tenet Healthcare 1997 - 2001
MedPartners HIM 1995 - 1997
Skills
Managed Care, Medicare, Medicaid, Utilization Management, Healthcare Management, Home Care, ICD-9-CM, Discharge Planning, Document Review, Auditing, Healthcare, Health Insurance, Hospitals
Education
Sheridan Technical Center 1982 — 1982
LPN, CHCQM-CM, NURSING & CASE MANAGMENT
AMERICAN BOARD QUALITY ASSURANCE & UTILIZATION REVIEW PROFESSIONALS
CHCQM-CM, QUALITY ASSURANCE & CASE MANAGEMENT CERTIFICATIONS
Florida Career College
LPN-RN TRANSITION PROGRAM
Humana January 2015 - Present
Humana December 2013 - January 2015
CarePlus Health Plan March 2012 - December 2013
First Coast Service Options May 2010 - March 2012
Grays Enterprises December 2007 - April 2010
Sclafani Williams August 2007 - December 2007
Wood Properties, Inc May 2006 - July 2007
Liberty Tax Service November 2005 - April 2006
United States Marine Corps June 2001 - June 2005
Skills
Accounting, Auditing, SAS, Lean Six Sigma, Python, Financial Analysis, Process Improvement, Access, Tax, Microsoft Excel, Ruby, Compliance, Excel, Financial Reporting, Management, Budgets, GAAP, Internal Controls, Financial Accounting, Income Tax, Analysis, Account Reconciliation, Finance, Tax Preparation
Education
University of Tampa - John H. Sykes College of Business 2009 — 2011
Masters of Science, Accounting
University of South Florida 2006 — 2009
Bachelors, Accounting
Pine View School for the Gifted 1988 — 2000
High School Diploma, High School/Secondary Diplomas and Certificates
Keller Williams Realty January 2015 - Present
CarePlus Health Plan January 2012 - March 2014
Humana March 1996 - February 2000
Skills
Buyers Representation, New Home Sales, Listings, Foreclosures, Short Sales, REO, Selling, Investment Properties, Marketing, Sales, Budgets, Strategic Planning, Management, Public Speaking, Customer Service, Marketing Strategy, Leadership, Team Building, Negotiation, Fundraising
Education
University of Louisville 1990 — 1994
Bachelor's - Finance
CarePlus Health Plan April 2015 - Present
CarePlus Health Plan April 2014 - Present
CarePlus Health Plan October 2012 - Present
CarePlus Health Plan January 2012 - October 2012
Anthem-BlueCross BlueShield of GA October 2008 - July 2011
John B. Amos Cancer Center 2008 - 2008
Kelly Services September 2007 - 2008
Aflac October 2005 - 2006
West Central Georgia Regional Hospital October 2004 - September 2005
Skills
Team-oriented, Motivated self-starter, Microsoft Office, Medical Terminology, Medical Billing, Medical Coding, Medical Records, Oncology, Mental Health, Learning Quickly, Metrics, Performance Metrics, Healthcare Industry, Managed Care, Multitasking Skills, Multi-disciplinary Teams, Front Office, Back Office, Claims Resolution, Customer Service, Insurance, Healthcare, Medicare, Team Building, Process Improvement, Leadership, Health Insurance
Education
Kaplan University-Des Moines Campus 2009 — 2012
Bachelor of Science (B.S.), Health/Health Care Administration/Management, 3.63 GPA
Colorado Technical University 2007 — 2008
Associate of Science (A.S.), Medical Billing and Coding, 3.8
CarePlus Health Plan October 2013 - Present
Holy Cross Hospital November 2011 - October 2013
Skills
ACLS, HIPAA, Healthcare, Healthcare Management, Hospitals, Inpatient, Medical Terminology, Nursing, Patient Safety, BLS
Education
Southwest Texas Junior College 1991 — 1993
Education/Teaching of Individuals in Secondary Special Education Programs
2020 Companies October 2009 - March 2011
CarePlus Health Plan May 1997 - September 2009
Reade/ Rock Bottom Discount Store January 1997 - January 1999
Chelsea Baking and Ice Company January 1995 - January 1997
New York Department of Motor Vehicles January 1993 - January 1995
Skills
Cold Calling, Sales, Customer Service, Account Management, Team Building, Healthcare, Managed Care, Marketing, Team Leadership, Sales Management, Health Insurance, Microsoft Office, Strategic Planning, IT Solutions, Computer Repair, Computer Hardware, Computer Security, IT Service Management, Programming Languages, Microsoft..., Microsoft Server...
Education
Itt technical Institute-Maryland 2012 — 2014
Associate's Degree, Information Technology, A's & B's
Dutchess Community College 1991 — 1993
Associate of Arts and Sciences (A.A.S.), Business Administration and Management, General, 4.0
CarePlus Health Plans January 2015 - Present
CarePlus Health Plan December 2013 - Present
CarePlus Health Plan May 2006 - Present
Miami Dade Ambulance July 2010 - August 2011
Continuecare June 2005 - May 2006
Skills
Proficient on Microsoft..., Certified in emergency..., Certified for..., 10 plus years..., Organizational Learning..., 10 plus years working..., HIPAA trained, Versed in medical..., Well versed in Medicare..., Customer and client..., Bilingual-English/Spanis..., Office Administration, Claims Resolution, Grievances, Appeals, Financial Reporting, Medicare, HIPAA, Software Documentation, Healthcare, Medicaid, Insurance, Healthcare Management, Healthcare Information..., Healthcare Industry, Healthcare Consulting, Employee Benefits, Customer Service, Health Insurance
Education
Florida International University 2010 — 2014
Bachelor of Arts (BA), Liberal Arts and Sciences/Liberal Studies
Miami Dade College 1998 — 2000
Associate of Arts (AA), Liberal Arts and Sciences/Liberal Studies
York College (The City University of New York) August 2009 - July 2011
Rebel Monkey August 2008 - July 2009
York College (The City University of New York) January 2008 - September 2008
Cryptic Studios September 2005 - October 2005
Monolith Productions December 2004 - March 2005
CarePlus Health Plan 2004 - 2005
Diamondback Wireless January 2001 - December 2003
Sony Online Entertainment May 2003 - June 2003
Montrose Capital Management December 1998 - April 2001
Barington Capital Group November 1997 - October 1998
Skills
CSS, ActionScript, JavaScript, HTML, Video Games, C++
Education
Queens College 2010 — 2011
M.A., Computer Science
City University of New York-York College 2006 — 2009
Bachelor of Science, Computer Science
Molina Healthcare May 2015 - Present
Sunshine State January 2014 - December 2014
CarePlus Health Plan May 2012 - January 2014
Little Havana Activities and Nutrition Centers February 2010 - January 2012
Progressive Insurance January 2008 - February 2010
Miami Children's Hospital October 2004 - January 2008
Miami Children's Hospital March 2004 - October 2004
Miami Children's Hospital December 2002 - March 2004
Skills
Healthcare, Nursing, Case Management, Medical Records, Hospitals, Event Planning, Healthcare Management, Microsoft Excel, Microsoft Word, Case Managment, Medicare, Public Speaking, Outlook, CPR Certified, HIPAA, Employee Relations, Medical Billing, Healthcare Information..., Time Management, Non-profits, PowerPoint, Software Documentation, Nonprofits, Training, Employee Training, Medicare Advantage, HEDIS, NCQA, Regulatory Compliance, CMS, Training Facilitation, Facilitation
Education
Florida International University
Bachelors, Psychology
Miami Dade College
Associate, Emergency Medicine
Miami Dade College
Associates, Psychology
Humana December 2013 - Present
CarePlus Health Plan October 2012 - December 2013
CarePlus Health Plan June 2009 - October 2012
HSBC April 2008 - June 2009
HSBC April 2004 - April 2008
Skills
Active Directory, ITIL, Call Centers, System Administration, Disaster Recovery, Technical Support, IT Management, Data Center, SharePoint
Education
Erie Community College 2000 — 2002
CarePlus Health Plan July 2010 - May 2012
Humana November 2007 - June 2010
Skills
Network Development, Provider Relations, Medicare, HMO, Healthcare, Managed Care, Medicaid, HEDIS, Utilization Management, Healthcare Industry
Education
Nova Southeastern University—Shepard Broad Law Center 2009 — 2011
MS, Health Law
Nova Southeastern University 1999 — 2001
BS, Management
AXA Assistance USA, Inc. June 2006 - Present
CarePlus Health Plan 2002 - 2006
Santa Fe College December 1999 - December 2001
Skills
Insurance, Healthcare, Privacy Law, HIPAA, Corporate Governance, Privacy Policies, Federal Government, TPA, Producer Licensing, Analysis, Auditing, Health Insurance
Education
HCCA Compliance Academy
Certified in Healthcare Compliance (CHC), Certified in Healthcare Privacy Compliance (CHPC)
Florida International University - College of Business Administration 2003 — 2005
Bachelor of Business Administration (BBA), International Business and Management
Santa Fe College 2000 — 2001
Associate of Arts (A.A.), Business Administration
Visiting Nurse Service of New York May 2012 - Present
Visiting Nurse Service of New York October 2010 - April 2012
Visiting Nurse Service of New York October 2006 - September 2010
CarePlus Health Plan 2001 - 2005
Skills
Budgets, Finance, Medicare, Healthcare Management, Managed Care, Healthcare, Medicaid, Financial Analysis, Healthcare Information..., Hospitals, PeopleSoft, Process Improvement, Health Insurance, Financial Reporting, Data Analysis, Access, Revenue Cycle, Strategic Planning, Healthcare Industry, Healthcare Consulting
Education
SUNY Oswego 1996 — 2000
Business Administration
SunTrust 2014 - 2014
Coca-Cola Refreshments 2006 - May 2013
CarePlus Health Plan September 2005 - June 2006
US Army - 2nd Armored Calvary Regiment June 1986 - June 1989
Skills
Troubleshooting, Switches, System Deployment, Enterprise Software, Storage, Process Improvement, SharePoint, Cross-functional Team..., Windows 2000/XP/7, AirMagnet, Active Directory, Avaya Site Administrator, LANDesk, Bomgar, Lenovo IUB, MS DaRT, NetFlow, RSA Authentication..., Remedy Ticketing System, ServiceNow, Network Administration, Windows, Help Desk Support, Information Technology, Hardware, Service-Now, Quality Assurance, Windows 7, Lotus Notes, Computer Hardware, Definity, Software Documentation, Blackberry Enterprise..., Software Installation, VPN, Cisco Technologies, XP, Technical Support, Vendor Management, Printers, Visio, Security, Netflow, Windows XP
Education
Chatahoochee Technical College 2013 — 2015
Networking Specialist, Information Technology
Community College of Rhode Island
Computer Programming
Independent Consultant June 2015 - Present
The Museum of Modern Art March 2004 - June 2015
CarePlus Health Plan September 2002 - April 2006
None September 2001 - September 2002
Graham-Field Health Products January 1999 - September 2001
Mount Sinai Medical Center 1987 - 1999
Skills
Data Center, IBM iSeries, Integration, Troubleshooting, Microsoft SQL Server, Management, High Availability, Testing, IBM AS/400, IT Management, Disaster Recovery, Storage Area Networks, Cloud Computing, SDLC, Technical Support, Project Management, Databases, System Administration, IT Strategy, IT Operations
Education
Polytechnic University of New York 1971 — 1973
MS, Bio-Medical Engineering
Ecole nationale supérieure de l'Electronique et de ses Applications 1967 — 1971
Ingenieur d'Etat (MS EE), Electronic Engineering
Careplus Health Plan October 2004 - Present
Bank of America 2006 - 2006
JSA Healthcare March 2004 - August 2004
Bank of America 2004 - 2004
StarMed Staffing - Tampa 2002 - 2003
StarMed Staffing - Tampa 2002 - 2003
New Tampa Internal Medicine 2001 - 2002
JLG Medical 2000 - 2001
Hospital Inpatient Management Systems 1997 - 2000
Tampa General HealthPlan - Health Ease February 1995 - May 1997
Skills
Medicaid, Medicare, Provider Relations, Managed Care, Physician Relations, Healthcare Industry, Credentialing, HMO, Healthcare Consulting, HIPAA, PPO, Healthcare Management, Healthcare, Network Development, Revenue Cycle, Utilization Management, Practice Management, Customer Service, Health Insurance, Healthcare Information..., Disease Management, Health Policy, Hospitals, Contract Negotiation, Nursing, Physicians, Long-term Care, Claim, EHR, Insurance, Medical Terminology, Medical Records, Medical Compliance, Strategic Partnerships, Quality Improvement, Data Entry, CPT, HEDIS, Medical Billing, Medical Coding, Elder Care, EMR, Healthcare Reimbursement, Medicare Part D, Strongly self-motivated, Medicare/Medicaid..., Revenue Cycle Management, ICD-9, Claims, Skilled Nursing Facility
Education
The University of Tennessee at Chattanooga 1982 — 1986
BS, Clinical Psychology
Dalton Jr College 1979 — 1981
Transferred, Clinical Psychology
Northwest Whitfield High School 1974 — 1979
Diploma, AP College Bound
Pleasant Grove Elementary
Health First / Neighborhood Health Providers August 2011 - July 2013
Amerigroup Corporation January 2004 - February 2009
Amerigroup Corporation January 2001 - February 2009
CarePlus Health Plan 2001 - January 2004
Empire Club 1999 - January 2001
Skills
Strategic Planning, Team Building, Health Insurance, Medicaid, Leadership, Insurance, Marketing, Healthcare Industry, Public Relations, Management, Long-term Care, Customer Service, Process Improvement, HIPAA, Executive Management, Public Speaking, Microsoft Word, Health Policy, Network Development, Business Development, Sales Presentations, Training, Sales, Nonprofits, Account Management, Marketing Communications, Healthcare Consulting, Recruiting, Provider Relations, Coaching, Sales Management, Customer Retention, Budgets, Employee Relations, Program Development, Data Analysis, Supervisory Skills, Leadership Development, Applicant Tracking...
Education
Universidad Autónoma de Santo Domingo 1981 — 1984
Economics, Economics
Social Security Administration September 2014 - Present
CarePlus Health Plan September 2010 - February 2013
Skills
Claim, Provider Relations, Insurance, Accounting, Financial Accounting, Healthcare, Claims Management, Medical Billing, CPT, ICD-9, Medical Terminology, Long-term Care, Medical Records, Call Centers
Education
Saint Leo University 2014 — 2015
Master of Business Administration (M.B.A.), Concentration in Accounting
Saint Leo University 2011 — 2014
BA, Accounting
Hillsborough Community College 2009 — 2011
AA, Business Administration
CarePlus Health Plan March 2015 - Present
First Student January 2014 - April 2014
UnitedHealth Group December 2011 - September 2013
HCA-PAS April 2007 - February 2009
Lowe's Home Improvement September 2003 - April 2007
Skills
Account Reconciliation, Accounts Receivable, Accounts Payable, Payroll, Invoicing, Accounting, Budgets, Journal Entries, Spreadsheets, Customer Service, Software Documentation, Financial Statements, Microsoft Office, Human Resources, Sales, Lotus Notes, Telephone Skills, Credit, Tax, Insurance
Education
Rasmussen College 2013 — 2014
Bachelor's Degree, Accounting and Finance, 3.94
Rasmussen College 2007 — 2009
Degree: Associate Degree, Accounting; Finance
Lincoln-Cittone Institute 2001 — 2002
Diploma, Computer programming and Web design
UnitedHealthcare 2011 - Present
Amerigroup 2008 - 2011
AIG Consultants 2007 - 2008
CarePlus Health Plan 2002 - 2006
Kings Park Psychiatric Center 1981 - 1994
Skills
Healthcare Management, Managed Care, Healthcare Consulting, Medicaid, Healthcare Industry, Medicare, Healthcare
Education
Adelphi University
MBA, Healthcare Administration
New York Institute of Technology
BS, Business Administration
CarePlus Health Plan January 2012 - Present
CAC Florida Medical Centers December 2010 - January 2012
HS1Medical Management, Inc June 2002 - October 2010
Skills
Healthcare Management, Quality Improvement, Strategic Planning, Data Analytics, Performance Management, Accreditation
Education
University of South Carolina-Columbia 1989 — 1991
Master's Degree, Public Health / Epidemiology
Universidad del Valle (CO) 1979 — 1987
Doctor of Medicine (M.D.), Medicine
Physicians United Plan September 2012 - Present
CarePlus Health Plan October 2010 - June 2012
UnitedHealth Group July 2009 - May 2010
UnitedHealth Group June 2005 - July 2009
AT&T August 1994 - March 1997
Acer May 1993 - December 1993
Education
Florida International University - College of Business 1990 — 1993
M.B.A., Management and Finance
St. Thomas University 1984 — 1988
B.A., Computer Applications and Mathematics
CarePlus Health Plan Booking ManagerCloset EditorsMarch 2013 - Present
Skills
Account Management, Customer Service, Managed Care, Marketing, Medicare, Microsoft Excel, Outlook, Public Relations, Team Building, Team Leadership, Healthcare, Strategic Planning, Contract Negotiation, Leadership, Sales, Public Speaking
Education
Bennett College for Women
Bachelor of Business Administration (B.B.A.), Marketing
DII Enterprises LLC July 2015 - Present
Central Synagogue May 2012 - Present
The Harlem School of the Arts March 2011 - Present
Stratton Sound Company May 2006 - Present
Kings Collegiate Charter School September 2011 - July 2015
The Madison Square Garden Company September 2010 - September 2012
CarePlus Health Plan June 2004 - August 2005
Skills
Microsoft Office, Microsoft Excel, Microsoft Word, PowerPoint, Microsoft Exchange, Proofreading, Project Management, Project Planning, Pro Tools, Reason 5, Interpersonal Skill, Communication Skills, Garageband, ePortfolio, Social Media Marketing, Video, Performing Arts, Band
Education
Laguardia Community College 2012 — 2013
Associate of Arts and Sciences (AAS), Music, 14
Borough of Manhattan Community College 2011 — 2012
Associate of Arts (AA), Musical Theatre, 13
Fresenius Medical Care October 2012 - Present
Fresenius Medical Care November 2009 - October 2012
MHM Services, Inc. June 2007 - November 2009
CarePlus Health Plan 2005 - 2007
Skills
Nursing, Hospitals, Healthcare, Case Managment, Clinical Research, Medicare, Inpatient, Mental Health, Treatment, Medicine, Medical Records, Dialysis, Nursing Education, Critical Care, Acute Care
Education
Florida Atlantic University 2012 — 2014
Master's degree, Administration and Financial Leadership
University of Phoenix 2001 — 2003
BSN, Nursing
Broward Community College 1997 — 2000
Associate, Nursing
CarePlus Health Plan November 2011 - Present
Capital Corporation 1985 - 2011
Skills
Accounts Receivable, Accounting, Financial Reporting, Account Reconciliation, Payroll, Accounts Payable, Office Administration, Administrative..., Benefits Administration, Calendaring, Office Management, Data Entry, Expenses, Administration, Spreadsheets, Access, Administrative...
Education
Miami Dade College
Associate of Arts (A.A.), Administrative Assistant and Secretarial Science, General
CarePlus Health Plan December 2013 - Present
ProCirc March 2006 - June 2013
ProCirc December 1998 - February 2006
What a Concept! October 1997 - October 1998
Tonda & Associates March 1996 - September 1997
Skills
Highly detail oriented, Problem Solving, Merge/purge, Direct Mail, Print Production, Proofreading, Audience Development, Direct Marketing, Email Marketing, Integrated Marketing, Database Marketing, Publishing, Marketing Communications, Magazines, Customer Acquisition, Copywriting, Multi-channel Marketing, Digital Marketing, Marketing, Online Advertising, Marketing Strategy, Digital Media, Social Media Marketing, Newsletters, Publications, Campaign Management, Advertising
Education
Florida International University 1991 — 1995
Bachelors, Communications
VacationOwnership.com LLC 2011 - Present
CarePlus Health Plan 2010 - 2012
Enterprise Rent-A-Car 2000 - 2010
Skills
Life Insurance, Account Management, Operations Management, Long Term Care Insurance, Fixed Annuities, Insurance, Sales, Health Insurance, Long-term Care, Marketing, Direct Sales, Whole Life, Sales Presentations, Customer Retention, Employee Benefits, Sales Process, Sales Management, Team Building
Education
Florida Atlantic University
BA, Criminal Justice
CarePlus Health Plan April 2011 - Present
Skills
HIPAA, Medicare, Healthcare, Hospitals, Healthcare Management, Data Analysis, Analysis, Access, Process Improvement, Radiology, Business Analysis, EHR, Cerner, Epic Systems, Claim, Microsoft Excel, SharePoint, Healthcare Information..., Microsoft Office, Health Insurance
Education
Ain Shams University 1980 — 1986
Bachelor of Science, Electrical Engineer
CarePlus Health Plan October 2011 - Present
Insphere Insurance Solutions December 2010 - September 2011
Broward County Schools July 2003 - August 2011
Education
Florida Atlantic University 2002 — 2003
University of Florida 1998 — 2002
Home Health Associates September 2011 - Present
Delray Medical Center March 2010 - Present
CarePlus Health Plan 2012 - 2013
Education
South University 2006 — 2009
Bachelor of Science, Nursing
Florida International University 2001 — 2007
Bachelor of Science, Health Science
HSBC July 2003 - April 2009
CarePlus Health Plan February 2003 - July 2003
Skills
Banking, Retail Banking, Credit, Loans, Commercial Banking, Cross Selling, Consumer Lending, Relationship Management, Branch Banking, AML, Deposits, Financial Advisory, KYC
Education
St. Joseph's College 2015 — 2017
Master’s Degree, Health/Health Care Administration/Management
University of Phoenix 2009 — 2011
Bachelor of Science (BS), Business Administration and Management, General
University of Phoenix 2007 — 2009
Associate of Arts (A.A.), Business
Sunshine State Health Plan, (subsidiary of Centene) March 2013 - Present
Sunshine State Health Plan March 2009 - Present
Amerigroup Corporation March 2007 - March 2009
CarePlus Health Plan April 2004 - February 2007
Amerigroup Corporation March 2003 - March 2004
Skills
Medicare, Managed Care, Medicaid Managed Care, HMO, People Skills, Microsoft Office, Contract Negotiation, Social Networking, Credentialing, Long-term Care
Education
Palm Beach Atlantic University
Bachelor's degree, Human Resources Management and Services
Michel Properties And Investments March 2013 - Present
Corpes Tax January 2007 - Present
WF Realty Corp March 2004 - March 2013
CarePlus Health Plan January 2007 - January 2012
Westgate Resorts January 1995 - January 2002
Skills
Real Estate, Negotiation, Customer Service, Microsoft Office, Marketing, Entrepreneurship, Short Sales
Education
Strayer University 2012 — 2013
Information Technology
Strayer University
A.A, Network / Information Systems
ITT Technical Institute
CarePlus Health Plan Professional School CounselorTenafly Middle SchoolAugust 2012 - Present
The Brearley School August 2007 - June 2009
Skills
Teaching, Public Speaking, Research, Mental Health
Education
Seton Hall University 2010 — 2012
Master's Degree, School Counseling
Harvard University Graduate School of Education 2009 — 2010
Master's Degree, Risk & Prevention
CarePlus Health Plan March 2007 - Present
Health Care District of Palm Beach County January 2005 - March 2007
Skills
Medicare, Healthcare, Hospitals, Healthcare Management, Health Insurance, Managed Care, HIPAA, Medicaid, Healthcare Industry, Healthcare Information..., Physician Relations, Provider Relations, Healthcare Consulting, Revenue Cycle, Disease Management
Education
Palm Beach Atlantic University-West Palm Beach 2002 — 2005
Bachelor's degree, Organizational Leadership
CarePlus Health Plan August 2013 - Present
Skills
Healthcare Consulting, EMR, Hospitals, Clinical Research, Healthcare, Medicine, Healthcare Management, Managed Care, Healthcare Information..., Medicare, Medical Education, EHR
Education
State University of New York Downstate Medical Center College of Medicine 1975 — 1979
Doctor of Medicine (MD)
Washington and Lee University 1971 — 1975
Bachelor of Science (BS), Mathmatics and Natural Sciences
UnitedHealthcare April 2010 - Present
Magellan Behavioral Health October 1992 - December 2012
CarePlus Health Plan June 2003 - February 2010
Skills
Healthcare, Medicare, Managed Care, Provider Relations, Physician Network...
Education
Georgetown University 1978 — 1981
Master of Arts (MA), Latin American Studies
Saint Peter's University 1974 — 1978
Bachelor of Arts (BA), Sociology and Spanish
Department of Veterans Affairs October 2013 - Present
CarePlus Health Plan May 2013 - August 2013
Health Business Solutions December 2009 - April 2013
Skills
Analysis, Federal Government, Microsoft Office, Microsoft Excel, Community Outreach, Research, Customer Service, Access, Administration, Data Entry, Healthcare, Leadership, Outlook, PowerPoint, Supervisory Skills, Team Building, Training, Healthcare Management, HIPAA, Healthcare Information..., Process Improvement, Medicare, Hospitals, Management
Education
University of Central Florida 1993 — 1997
B.S., Health Services Administration
Pierce College at Fort Steilacoom 1987 — 1990
A.T., Dental Assisting/Assistant
Shell November 2007 - Present
CarePlus Health Plan April 2007 - September 2007
USDA - Office of Inspector General August 2002 - November 2006
Skills
Risk Management, Business Analysis, Sarbanes-Oxley Act, Business Process..., Analysis, Stakeholder Management, Process Improvement, Change Management, Financial Risk, Risk Assessment, Internal Controls, VBA
Education
James Madison University 1998 — 2002
Bachelor of Business Administration (BBA), Computer Information Systems
Leon Medical Centers Health Plans April 2014 - Present
Grievance and Appeals/Member Orientation Manager October 2006 - January 2013
CarePlus Health Plan April 2005 - October 2006
Skills
Customer Service, Microsoft Excel, Management, Strategic Planning, Leadership, Healthcare, Project Management, Public Speaking, Microsoft Word, Research, Outlook, Managed Care, Medicare, Healthcare Information..., HIPAA, Hospitals, Healthcare Management, Health Insurance
Education
South Miami Senior High School 1989 — 1993
High School Diploma
Florida National University
Associate of Science (A.S.), Medical Assisting Technology