Community First Health Plans
Industry: Commercial company
DescriptionFounded: 1995 Subsidiary: Community First Group Hospital Service Corp., Inc.FeedbackDisclaimer Claim this knowledge panel Knowledge ResultSee photos Moved, closed, or was never hereReportCommunity First Health PlansWebsiteDirections Saved (0) Saved Save 11 Google reviews Call center in San Antonio, Texas Address: 12238 Silicon Dr #100, San Antonio, TX 78249 Hours: Closed ⋅ Opens 8:30AM Wednesday8:30AM–5PMThursday8:30AM–5PMFriday8:30AM–5PMSaturdayClosedSundayClosedMonday8:30AM–5PMTuesday8:30AM–5PMSuggest an edit Unable to add this file. Please check that it is a valid photo. Phone: (210) 227-2347Place name: : : : : : : Category: Website: Website: http://www.cfhp.com/ Category: Call center 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. Questions & answers Ask a question See all questions (6)
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Community First Health Plans Employees
Community First Health Plans February 2015 - Present
Braverman Terry Oei October 2010 - Present
Braverman Terry Oei Eye Associates October 2010 - January 2015
HEB April 2007 - October 2010
Education
Our Lady of the Lake University 2013 — 2015
Master of Business Administration, Business
The University of Texas at San Antonio 2007 — 2010
Bachelor of Fine Arts (B.F.A.), Political Science
Aetna July 2014 - Present
Aetna December 2012 - Present
Coventry Health Care January 2012 - December 2012
Community First Health Plans August 2011 - January 2012
Visiting Physicians Association December 2008 - July 2011
AQTS Home Health and Outpatient Therapy March 2003 - November 2008
Skills
Provider Relations, Patient Education, Physicians, Medicare, Healthcare Information..., Utilization Management, Certified Case Manager, Critical Care, HEDIS, Health Insurance, Home Care, Medicaid, Elder Care, Managed Care, Physician Relations, Wellness, Clinical Research, Patient Advocacy, Disease Management, Hospitals, HIPAA, Healthcare Management, Strategic Planning, EMR, Patient Safety, Case Managment, Nursing, Healthcare, Health Education, HMO, Healthcare Consulting, Workers Compensation, Acute Care, JCAHO, Utilization Review, Healthcare Industry, Wound Care, Meditech, Quality Improvement, Case Management
Education
Unversity of Texas Health Science Center San Antonio 1989 — 1991
BSN, Nursing
The University of Texas at San Antonio 1985 — 1989
Bachelor's degree, Biology, General
Community First Health Plans February 2014 - Present
Nautilus Healthcare Management Group, LLC June 2006 - January 2014
CyberTrader September 2005 - May 2006
LaSalle Bank April 2004 - September 2005
Harriman Jones Medical Group January 2000 - April 2004
Skills
Data Analysis, Microsoft SQL Server, Healthcare Information..., Data Warehousing, NextGen, HEDIS, Clinical Quality, SSIS, Process Improvement, Data Governance, Medical Economics, P4P, Team Management, Requirements Analysis, Requirements Gathering, Information Delivery, Reporting & Analysis, Data Integrity, Stakeholder Management, CDPS Risk Adjustment, HCC-RAF, CMS Star, Performance Reporting, Agile Project Management, Technical Translation, Performance Metrics, Workflow Management, Clinical Data, DBMS, SSRS, Application Support, Business Analysis, Healthcare, Management, Informatics, EHR, HIPAA, Analysis, Analytics
Education
California State University-Long Beach
Master of Business Administration (MBA)
Loyola Marymount University
Bachelor of Business Administration (BBA)
Corizon Health January 2015 - Present
The Rezult Group/Cogent Healthcare July 2014 - Present
House Manager August 2005 - June 2014
Intergrated Care Management Services October 2004 - August 2005
Concentra Network Services August 2002 - July 2004
Nob Hill Apartments July 2002 - August 2002
SpectraCare Inc. April 2000 - October 2000
Gowdy Consultants December 1999 - February 2000
Community First Health Plans November 1998 - October 1999
Community First Health Plans December 1995 - November 1998
Skills
Medical Terminology, Bill Payment, Customer Service, Troubleshooting, ICD-9-CM, CPT, Data Entry, Organization Skills, Employee Training, Production Environment, Workers Compensation, Insurance, HMO, Medicaid, Health Insurance, Claim, Medical Billing, Provider Relations, Invoicing, Medicare, Revenue Cycle, Training
Education
Excelsior College 2011 — 2012
Certification, Administrative Medical Specialist with Medical Billing and Coding, 98.6
Ohio University 1984 — 1985
Business Administration and Management, General
University of Cincinnati 1982 — 1983
Business Administration and Management, General
Community First Health Plans August 2015 - Present
Office of Communications and Marketing at Texas Tech January 2015 - May 2015
RaiderComm August 2014 - May 2015
Texas Tech University 2011 - May 2015
Sammis & Ochoa: A Public Relations Agency May 2014 - August 2014
Cornerstone Church September 2010 - August 2014
Communities In Schools of The South Plains January 2014 - May 2014
Independence Hill Retirement Home April 2011 - August 2011
Skills
Social Media, Microsoft Office, PowerPoint, Public Relations, Public Speaking, Microsoft Word, Facebook, Event Planning, Research, Photoshop, Editing, Social Networking, Teamwork
Education
Texas Tech University 2011 — 2015
Bachelor’s Degree, Public Relations
Ronald Reagan High School 2008 — 2011
High School
Quintiles April 2013 - Present
Brookdale Senior Living January 2012 - March 2013
New Braunfels Regional Rehabilitation Hospital September 2011 - March 2012
The TriZetto Group July 2010 - August 2011
Molina Healthcare of Texas May 2009 - July 2010
Molina Healthcare October 2007 - May 2009
Community First Health Plans July 2006 - August 2007
Skills
Creative Problem Solving, Healthcare, Educational Leadership, Case Managment, Medicaid, Health Insurance, Leadership, Training, Clinical Research, Public Speaking, Managed Care, Conflict Resolution, Software Documentation, Healthcare Information..., Hospitals, Program Development, Leadership Development, Strategic Planning, Non-profits, Policy, Coaching, Management, Inpatient, Case Management
Education
East Carolina University 2002 — 2004
Master of Science, Occupational Therapy
University of Toronto 1992 — 1994
Bachelor of Science, Nursing
George Brown College 1987 — 1990
Diploma, Nursing
Dental Select 2004 - Present
Community First Health Plans 2002 - 2004
PacifiCare 1998 - 2001
Skills
Customer Service, Insurance, Strategic Planning, Health Insurance, Employee Benefits, Public Speaking, New Business Development, Disability Insurance, Life Insurance, Property & Casualty..., Healthcare, Dentistry, Health Savings Accounts, Brokers, Team Building, Sales, Data Entry, Account Management
Education
Southwest Texas State University
Bachelor of Science (BS), Fashion Merchandising
OptumRx March 2014 - Present
Catamaran September 2009 - Present
Academy of Managed Care Pharmacy April 2013 - March 2014
Academy of Managed Care Pharmacy 2007 - 2010
Boehringer Ingelheim June 2008 - September 2009
Community First Health Plans August 2005 - June 2008
Health Alliance Plan August 2004 - July 2005
FSU/MSU/BCN/IBA Health Plans/Pfizer July 2003 - June 2004
Skills
Formulary development..., Clinical Operations, Managed Care Pharmacy, Clinical Pharmacy, Product Development, Healthcare, Clinical Research, Pharmaceutical Industry, Commercial, Medicaid..., Pharmacy Benefit Man, PBM Claims Processing..., Pharmacy, Registered Pharmacist, Pharmacy Benefit..., Clinical Pharmacology, Health Policy, Leadership, Managed Care, Management, Medicaid, Medicare Part D, Medicine, Pharmacists, Process Improvement, Program Management, Utilization Management
Education
Ferris State University 2001 — 2003
Doctorate, Pharmacy
Ferris State University 1996 — 2001
Bachelors, Pharmacy
WellCare Health Plans August 2014 - Present
WellCare March 2013 - Present
WellMed Medical Management January 2012 - February 2013
Community First Health Plans February 2011 - January 2012
Health First October 2010 - February 2011
Health First January 2010 - October 2010
Health First August 2009 - January 2010
Lakeland Funeral Home June 2006 - May 2008
Skills
Healthcare IT, Process Improvement, Data Integrity, Quality Assurance, Documentation, Project Management, Project Coordination, Microsoft SQL Server, XML Scripting, Healthcare Information..., Software Documentation, Business Intelligence, SQL, Management, EMR, Hospitals, Visio, Medicaid, Managed Care, Vendor Management, Health Information..., Strategic Planning, Microsoft Office, Team Building, System Administration, Health Insurance, Integration, Software Project..., Software Development, Data Analysis, Change Management, Healthcare Consulting, Project Planning, Analysis, Business Analysis, Healthcare, HIPAA, Training, Access, SDLC, Business Requirements, SharePoint, Business Process..., Revenue Cycle, Medicare, EHR, Healthcare Management, HL7, Informatics, MS Project
Education
University of Phoenix 2012 — 2014
Master of Business Administration (MBA), Project Management, 3.7
University of Phoenix 2009 — 2011
Bachelor of Science, Healthcare Information Systems
University of Phoenix 2007 — 2009
Associates of Arts, Healthcare Administration
Polk Community College 2002 — 2004
NA, Nursing
Centene Corporation August 2014 - Present
Preferred Homecare October 2013 - May 2014
Global Rehab of San Antonio August 2010 - August 2013
Methodist Stone Oak Hospital April 2010 - August 2010
Community First Health Plans August 2006 - February 2010
Crossroads Hospice June 2004 - May 2006
Family Health Physicians of Overland Park April 2000 - April 2003
Charter Hospital of Overland Park July 1985 - January 2000
Skills
Clinical Research, Healthcare, Medicaid, Medicare, Treatment, Acute Care, Patient Advocacy, Patient Education, Hospitals, Physician Relations
Education
Sanford-Brown College 2001 — 2001
Associate's degree, Registered Nursing/Registered Nurse, 3.67 out 4.0
Beloit School of Practical Nursing 1982 — 1983
Licensed Practical Nurse, Licensed Practical/Vocational Nurse Training
Delta Dental of Colorado October 2010 - Present
Community First Health Plans May 2007 - September 2010
Westlake Board Of Education January 2000 - May 2007
Cole Managed Vision 2000 - 2005
Cleveland Clinic 1998 - 2000
Kaiser Permanente 1976 - 1996
Skills
Insurance, Medicare, Health Insurance, Managed Care, Finance, Employee Benefits, Team Building, Process Improvement, Leadership, Strategic Planning, Medicaid, HIPAA, Underwriting, Budgets, Executive Management, Healthcare Consulting, Healthcare
Education
Cleveland State University 1967 — 1972
Bachelor of Business Administration (BBA), Finance
Community First Health Plans February 2013 - Present
Community First Health Plans April 2009 - January 2013
Skills
Corporate Communications, Healthcare Management, Public Relations, Marketing Strategy, Social Media Marketing, Community Engagement, RFP Generation, Health Insurance..., Executive Management, Internal Communications, Media Relations, Proposal Writing
Education
The University of Texas Health Science Center at Houston
Public Health
The University of Texas at San Antonio
Bachelor of Business Administration (BBA), Marketing
Molina Healthcare of Texas, Inc. August 2014 - Present
Molina Healthcare Inc. March 2012 - August 2014
Community First Health Plans March 1998 - March 2012
Health Net Federal Services January 1996 - March 1998
Aetna Health Plans August 1986 - January 1996
Skills
Managed Care, Medicaid, Medicare, Health Insurance, Utilization Management, Healthcare, HIPAA, Healthcare Information..., HMO, Healthcare Management, Hospitals, Disease Management, Provider Relations, Strategic Planning, Health Policy, Pharmacy Benefit..., Insurance, Healthcare Consulting, Account Management, Network Development, Program Management, EMR, Healthcare Industry, Informatics, Revenue Cycle, Physicians, Medicaid Managed Care, Medical Billing, Medicare Part D, Credentialing, Pharmacy, Revenue Cycle Management, Home Care, Process Improvement, Employee Benefits, Nursing, Leadership, Clinical Research, EHR, Practice Management, Physician Relations, Quality Improvement, PPO
Education
Trinity University 2012 — 2014
Master's of Science, Health/Health Care Administration/Management, Summa Cum Laude
East Carolina University 1977 — 1982
BSN, Nursing and Psychology
Molina Healthcare September 2012 - Present
Community First Health Plans February 2007 - September 2012
Metropolitan Methodist Hospital August 2001 - January 2007
Skills
Utilization Management, Medicaid Managed Care, Medical Case Management, Managed Care, Medicaid, Case Managment, Home Care, Medicare, Disease Management, Healthcare, Hospitals, Nursing
Education
The University of Texas Health Science Center at San Antonio 1980 — 1983
Bachelor of Science, Nursing
Spring High School 1974 — 1978
Community First Health Plans April 2013 - Present
Community First Health Plans February 2011 - Present
Community First Health Plans November 2007 - March 2011
Community First Health Plan August 2007 - November 2007
Fisher Development, Inc. March 1999 - July 2004
CompUSA, Inc. August 1998 - March 1999
Reliant Integration Services March 1996 - August 1997
CompUSA February 1994 - February 1996
CompUSA 1992 - 1993
CompUSA April 1992 - October 1992
Skills
Software Documentation, Project Management, Access, Active Directory, Contract Management, Customer Service, Databases, Healthcare, Healthcare Information..., Human Resources, Invoicing, Leadership, Management, Marketing, Microsoft Excel, Microsoft Office, Microsoft SQL Server, Outlook, Payroll, Process Improvement, Security, System Administration, Team Building, Technical Support, Time Management, Troubleshooting, Visio, Administrative..., Analysis, Data Center, Windows Server
Education
City College of San Francisco 1990 — 1992
San Francisco State University 1988 — 1989
College of San Mateo 1987 — 1987
Western Extralite, a Division of Border States December 2013 - Present
Community First Health Plans April 2012 - August 2013
Stowers Furniture February 2010 - March 2012
Bobcat Company August 2008 - December 2009
North Dakota State University Athletics December 2007 - May 2008
Skills
Advertising, Microsoft Office, Social Media Marketing, Web Content Management, Email Campaigning, Adobe Creative Suite, Graphic Design, Marketing Research, Company Newsletters, Photo Editing, Copy Editing, Managed Print Services, HTML, Corporate Communications, Marketing Communications, Marketing
Education
North Dakota State University 2005 — 2008
Bachelor of Arts, Mass Communications
Universidad de Granada 2008 — 2008
Study Abroad, Spanish
Community First Health Plans August 2015 - Present
Cityflag Mobile Application November 2014 - Present
AVANCE, Inc June 2015 - August 2015
LATINA Style, Inc. November 2014 - May 2015
Texas Democratic Party May 2014 - November 2014
Texas Democratic Party September 2013 - May 2014
Texas House of Representatives April 2013 - August 2013
AVANCE, Inc. September 2012 - March 2013
Purple Flame Media Ltd March 2012 - May 2012
Public Broadcasting Service September 2011 - December 2011
Skills
Public Relations, Editing, Blogging, Social Media, Community Outreach, Newsletters, Spanish, Event Planning, Journalism, Video, Media Production, Final Cut Pro, Storytelling, Government, Event Management, Adobe Creative Suite, Politics, Editorial, Publishing, Producing, Ap Style, Adobe Design Programs, Political Campaigns, Political Communication, Hispanic Marketing, Strategic Communications
Education
American University 2009 — 2012
Bachelor of Arts (B.A.), Broadcast Journalism
Foundation for International Education (FIE)
Study Abroad Program, Spring 2012
Aguirre Pediatrics February 2010 - Present
Community First Health Plans February 2010 - June 2010
South Texas Center for Pediatric Care October 2008 - February 2010
Riverside Pediatrics December 2003 - September 2008
Skills
Healthcare Management, Board Certified, Healthcare, Medicine, Hospitals, Direct Patient Care, Pediatrics, EMR, Utilization Management
Education
The University of Connecticut Health Center 1986 — 1988
Fellowship in Neonatal-Perinatal Medicine, Neonatology
The University of Texas Health Science Center at San Antonio 1983 — 1986
Pediatrics Residency Program
The University of Texas Health Science Center at Houston 1978 — 1983
Doctor of Medicine (M.D.)
Rice University 1974 — 1978
Bachelor's Degree, Pre-Medicine/Pre-Medical Studies
Molina Healthcare December 2012 - Present
University of Southern Indiana August 2013 - Present
Community First Health Plans August 2012 - November 2012
Kaplan College April 2011 - June 2012
University of Southern Indiana December 2007 - May 2011
C & R Quality Living July 2010 - November 2010
Rasmussen College October 2008 - June 2010
St. John's Mercy Home Care June 2003 - August 2006
Skills
Healthcare Management, Nursing Education, Home Care, Teaching, Medicare, Medicaid, Curriculum Design, Nursing, Healthcare, Clinical Research, Medicine, Psychotherapy, Critical Care, Hospitals, BLS, Health Education
Education
University of Southern Indiana
Master of Science in Nursing, Nursing Education
University of Southern Indiana 2005 — 2007
Master's degree, Health Administration
Indiana University-Purdue University at Indianapolis 1984 — 1987
BSN, Nursing
Tiburon March 2008 - September 2011
dNovus RDI June 2007 - March 2008
TML - IEBP January 2003 - May 2006
Community First Health Plans January 2001 - January 2003
FirstCare August 1998 - September 2000
Texas Hospital Association August 1989 - June 1995
Texas Instruments March 1983 - January 1989
Skills
Cobol, MySQL, VBA, Unix Shell Scripting, Microsoft SQL Server, EDI, XML, McKesson Health Care..., TriZetto, AMISYS, VSAM, TSO, VM/MVS
Education
University of North Texas
Bachelors Degree, Computer Science
Tiburon Inc March 2008 - September 2011
dNovus RDI, Veterans Administration June 2007 - March 2008
Texas Municipal League IEBP January 2003 - May 2006
Community First Health Plans January 2001 - January 2003
FirstCare Health Plans August 1998 - September 2001
Texas Hospital Association August 1989 - June 1995
Texas Instruments Inc March 1983 - January 1989
Education
University of North Texas
BS, Computer Science
Molina Healthcare October 2013 - Present
Molina Healthcare April 2012 - October 2013
Community First Health Plans May 2011 - April 2012
The Goddard School August 2010 - May 2011
Office Team February 2009 - July 2009
K.C. Salley Relocation June 2006 - December 2008
Skills
Microsoft Office 2010, Adobe Acrobat, SnagIt, PeopleSoft, TCS Acuity, Performance Logic
Education
The University of Texas at San Antonio 2009 — 2010
Bachelors of Arts, Communication
University of Houston 2007 — 2008
Communication
Community First Health Plans September 2013 - Present
Community First Health Plans May 2012 - September 2013
Community First Health Plans December 2010 - May 2012
A'GACI LLC January 2010 - November 2010
H-E-B Federal Credit Union March 2002 - September 2007
Prism Enterprises March 2000 - March 2002
ETHIX Southwest March 1994 - March 2000
Skills
Strategic Planning, Visio, EMR, Healthcare, HIPAA, Healthcare Information..., Project Management, Process Improvement, Team Building, Leadership, Management, Troubleshooting, Data Analysis, Microsoft SQL Server, VMware
Education
Colorado State University 1998 — 2000
MBA, Business
University of Nebraska at Omaha 1983 — 1985
BS, Mathematics, Educaton
University of Nebraska at Omaha 1979 — 1983
BS, Psychology
Hub International September 2012 - Present
JDW Insurance August 2007 - September 2012
El Paso Association of Health Underwriters July 2010 - June 2011
Wortham Insurance & Risk Management August 2001 - February 2007
Business Financial Group January 2000 - July 2001
Community First Health Plans November 1998 - January 2000
Benefit Alliance, Inc. February 1997 - November 1998
Skills
Insurance, Health Insurance, Brokers, Risk Management, Group Benefits, Workers Compensation, Life Insurance, Property & Casualty..., Underwriting, Commercial Insurance, Disability Insurance, Sales, Claim, Small Business, General Insurance, Health Savings Accounts, Legal Liability, Term Life Insurance, Long-term Care, Casualty, Account Management, Strategic Planning, Benefits Administration, Management, Customer Service, Medicare
Education
Leadership El Paso Class XXXIII 2011 — 2011
Alum
University of the Incarnate Word 2003 — 2006
Organizational Development
The University of Texas at El Paso 1990 — 1993
San Elizario High School 1986 — 1990
Leidos January 2015 - Present
TPOI LLC June 2013 - December 2014
Community First Health Plans, Inc. June 2011 - June 2013
COMMUNITY FIRST HEALTH PLANS November 2010 - June 2011
GROUP O MARKETING SOLUTIONS February 2010 - October 2010
Self Employed September 2009 - February 2010
WellMed Medical Management July 2008 - August 2009
Self Employed May 2008 - November 2008
Community First Health Plans, Inc. August 1998 - May 2008
Skills
Healthcare Information..., Software Documentation, Data Warehousing, Analysis, SQL, Program Management, Data Analysis, PL/SQL, Databases, Access, SSRS, Project Management, Microsoft SQL Server, Visio, Healthcare, Training, SharePoint, Project Planning, Requirements Analysis, Integration, Data Center, Management, Business Analysis, Leadership, Software Project..., SDLC, Process Improvement, HIPAA, System Administration, Business Intelligence, Disaster Recovery, Troubleshooting, Active Directory
Education
St. Mary's University
Master of Science, Software Engineering
Texas A&M University
Bachelor of Science, Computer Science
Tiburon March 2008 - Present
dNovus RDI June 2006 - March 2008
Texas Municipal League 2003 - 2006
Community First Health Plans 2001 - 2003
Texas Instruments 1983 - 1988
Education
University of North Texas 1978 — 1982
BS, Computer Science
DaVita Kidney Care August 2014 - Present
United Allergy Services August 2013 - August 2014
Kinetic Concepts May 2012 - August 2013
Kinetic Concepts October 2010 - May 2012
Kinetic Concepts November 2008 - October 2010
Kinetic Concepts October 2005 - November 2008
Kinetic Concepts November 2003 - October 2005
Community First Health Plans July 2002 - November 2003
Skills
Healthcare, Managed Care, Process Improvement, Medical Devices, Hospitals, Cross-functional Team..., Six Sigma, Team Building, Call Centers, Change Management, Business Analysis, Business Process..., Leadership, Management, Quality Assurance, Software Documentation
Education
Indiana University Bloomington 1998 — 2002
BS, Public Health Administration
Community First Health Plans October 2013 - Present
TeamBuilders Counseling Services/Pathways Youth and Family Services September 2011 - October 2013
Physicians Health Choice June 2009 - July 2011
KCI USA March 2003 - March 2009
Community First Health Plans August 2002 - March 2003
Palmetto GBA May 2000 - July 2002
South Carolina Department of Health and Human Services October 1990 - May 2000
Skills
Provider Relations, Medicaid, Medicare, Medical Coding, Medical Compliance, Insurance, Healthcare Management, HIPAA, Healthcare, Team Building, Program Management, Policy, Healthcare Industry, Privacy Law, Physicians, Healthcare Consulting, Health Insurance, Health Care Compliance, Medicaid Managed Care, Managed Care, Health Policy, Case Managment, Social Services, Behavioral Health, Medical Billing, Training
Education
University of South Carolina-Columbia
BA, Broadcast Journalism
Aetna November 2014 - Present
Community First Health Plans November 2008 - December 2014
Health Right Inc January 1998 - September 2008
Managed Care Assistance Corporation (MCAC) February 1997 - September 1998
PHP Health Care Corp September 1995 - January 1997
Skills
Managed Care, Policy, Healthcare Management, Provider Relations, Leadership, Medicaid Managed Care, Healthcare, Health Plan Operations, Claim, Strategic Planning, Medicaid, Health Policy, Utilization Management, Program Management, Public Speaking, Medicare, Disease Management, Healthcare Industry, Executive Management, HMO, Physicians, Hospitals, Credentialing, Healthcare Consulting, Pharmacy Benefit..., Network Development, Health Insurance, Insurance, Healthcare Information..., Revenue Cycle, Physician Relations, Medical Compliance, Practice Management
Education
Johns Hopkins Bloomberg School of Public Health 1994 — 1995
Masters of Public Health – Health Policy and Management, Health Policy and Management
The University of Texas at Austin School of Law, Austin, TX 1991 — 1994
Doctor of Jurisprudence, Law
The University of Texas at Austin School of Nursing, Austin, TX 1985 — 1989
Bachelor of Science, Nursing
Cleveland Clinic June 2011 - Present
Community First Health Plans July 2010 - April 2011
CEVA Logistics January 2000 - March 2009
Eagle Global Logistics January 2000 - January 2008
First National June 1998 - January 2000
Henri D. Morris & Associates March 1997 - June 1998
COPI January 1991 - May 1994
Shell Oil Company May 1980 - October 1990
Skills
SDLC, Integration, Microsoft SQL Server, Business Analysis, Process Improvement, SQL, Software Development, Requirements Analysis, Oracle, SharePoint, Software Project..., Business Intelligence, Agile Methodologies, XML, Project Management, IT Strategy, EDI, Software Documentation, Accounts Payable, SSRS, Enterprise Architecture, Crystal Reports, C#, SSIS, Business Process..., Change Management, Requirements Gathering, Visio, VMware, Windows Server
Education
Texas A&M University 1977 — 1981
Computer Science
Universal American November 2006 - Present
Community First Health Plans December 1999 - November 2006
ECCA Managed Vision Care December 1995 - November 1999
PacifiCare 1992 - 1995
Education
Ohio University
BS Journalism, Communications and History
Community First Health Plans January 2014 - Present
Sanford-Brown College San Antonio August 2013 - Present
Select Medical June 2013 - March 2014
Global Rehab Hospitals May 2012 - June 2013
United Medical Rehab Hospital June 2010 - May 2012
Jackson Hospital January 2010 - March 2010
Bryce Hospital May 2009 - July 2009
Baptist Health System May 2007 - June 2007
Skills
Medical Coding, HIM Operations, HIPAA, ROI Management, Medical Transcription, Healthcare Management, Medical Terminology, Medical Records, Hospitals, EHR, Healthcare Information..., Medical Billing, HCPCS, EMR, Health Information..., CPT, ICD-9, Revenue Cycle, Medicare, Leadership, JCAHO, ICD-10, Meditech, Software Documentation, Healthcare, Data Entry, Medicaid, ICD-9-CM, Healthcare Consulting, Revenue Cycle Management, Physician Relations, Physicians, Healthcare Industry, Cerner, Medical Compliance, Managed Care, Credentialing, Inpatient, Informatics, Practice Management, Quality Improvement
Education
University of New Orleans 2011 — 2012
Master of Science (MS), Health Care Management
Alabama State University 2006 — 2010
Bachelor of Science (BS), Health Information Management
US Army October 2014 - Present
Genesis Business Systems November 2013 - Present
Group O September 2012 - October 2013
Group O September 2012 - October 2013
Abacus Technology January 2012 - May 2012
Community First Health Plans February 2011 - January 2012
Information Innovators, Inc. September 2011 - December 2011
The Centech Group September 2007 - February 2011
The Scooter Store November 2003 - March 2007
Eye Care Centers of America 2001 - 2003
Skills
Microsoft SQL Server, SQL Report Writing, Oracle Discoverer 10g, Crystal Reports, Great Plains Software, TCS Acuity, Crystal Reports 10.0, Microsoft Office, Dreamweaver, Toad, .NET, Business Objects, Teradata SQL, Active Directory, Troubleshooting, Windows Server, SharePoint, System Administration, VMware, IT Management, Access, SQL, Business Intelligence, SSRS, Database Design, Visual Studio, Security, Integration, Teradata, Databases, Analysis
Education
McMurry University 1986 — 1991
Music Education
San Antonio College 1985 — 1986
Memorial High School 1981 — 1985
Health Care Service Corporation September 2014 - Present
Health Care Service Corporation February 2006 - September 2014
Community First Health Plans 2003 - 2006
University Health System 1999 - 2003
Skills
Health Insurance, Health Care Compliance, Insurance, Health Care Reform, Health Policy, Medicare, Medicare Part D, Medicare Advantage, Medicaid Managed Care, Managed Care, ERISA, Claim, Disease Management, HIPAA, Health Law, Medicaid
Education
The University of Texas at Austin 1989 — 1992
Doctorate, Jurisprudence
Rice University 1985 — 1989
B.A., Economics
Humana July 2006 - Present
MCCI of Texas 2011 - 2014
MCCI of Texas 2011 - 2014
MCCI of Texas 2011 - 2014
Premier Jewelry 2010 - 2010
Community First Health Plans January 2003 - June 2006
Skills
Case Managment, HMO, Managed Care, Medicaid, Medicare, Patient Advocacy, Provider Relations, Utilization Management, Utilization Review
Education
Nursing School 1983 — 1986
Diploma, Registered Nurse
Augustana University (SD) 1980 — 1983
Liberal Arts
Charles L Kight and Associates April 2010 - Present
Community First Health Plans April 1994 - March 2010
Skills
Medicaid, Managed Care, Medicare, Policy, Insurance, Team Building, HIPAA, Health Policy, Strategic Planning, Disease Management, Health Insurance, Healthcare, Healthcare Consulting, Healthcare Management, Healthcare Information..., Healthcare Industry, Revenue Cycle, Physicians, Pharmacy Benefit..., Medicare Part D, Provider Relations, Practice Management
Education
The University of Texas at Austin 1967 — 1969
MBA, Finance
J.P. Hart Lumber Company November 2014 - Present
Molina Healthcare April 2011 - July 2014
Molina Healthcare of Texas February 2012 - April 2013
Community First Health Plans October 2007 - April 2011
Harris Stratex/Harris Corporation March 2006 - October 2007
Gonzaba Medical Group 2003 - 2006
Skills
Financial Analysis, Health Insurance, Financial Reporting, Medicaid, Finance, Medicare, Process Improvement, Healthcare, Managed Care, Accounting, Sarbanes-Oxley Act, HIPAA, Forecasting, Budgets, Revenue Cycle, Data Analysis, Insurance, Analysis, Healthcare Consulting, Healthcare Industry
Education
The University of Texas at San Antonio
General Business, Accounting and Finance
Transnational ASO July 2010 - Present
Community First Health Plans February 2007 - February 2010
United Health Care June 1985 - November 2009
Education
Texas Christian University 1981 — 1985
Bachelor of Business Administration (B.B.A.), Marketing
Molina Healthcare January 2012 - August 2012
Molina Healthcare of Texas January 2012 - August 2012
Humana August 2008 - April 2012
Community First Health Plans March 2011 - September 2011
Community First Health Plan March 2011 - September 2011
Lockheed Martin October 2010 - March 2011
HUMANA, Inc August 2008 - April 2010
Comprehensive Health Services January 2007 - May 2008
Medical Site Reviewers (MSR) January 2006 - December 2006
San Antonio Independent School District March 2001 - May 2005
Skills
Utilization Management, Disease Management, Medicaid, HMO, NCQA, Managed Care, Medicare, Nursing, Case Managment, HIPAA, Healthcare, Hospitals, Software Documentation, Health Insurance
Education
Texas Woman's University 1974 — 1978
BSN, Nursing
Texas Woman’s University Denton
Community First Health Plans May 2012 - Present
Molina Healthcare January 2012 - July 2012
Physician's Health Choice 2007 - 2011
Skills
Medicare, Medicare Part D, Medicare Advantage, Medicaid Managed Care, HIPAA, Healthcare Management, Medical Compliance, Health Insurance, Privacy Law, Privacy Compliance, Regulatory Affairs, Healthcare Consulting, Provider Relations, Utilization Management, Disease Management, Health Care Compliance, Healthcare Information..., Physicians, Revenue Cycle
Education
St. Mary's University School of Law 1999 — 2002
JD, Law
University of Houston-Clear Lake 1997 — 1999
Bachelor's degree, Humanities/Humanistic Studies
Archer - the well company August 2011 - Present
Bluestar Directional Service August 2008 - August 2011
Crescent Directional Drilling July 2007 - August 2008
Accenture March 2006 - August 2007
Community First Health Plans February 1998 - December 2003
Linebarger Goggan Blair & Sampson, LLP November 1995 - February 1998
Skills
Java, SQL, Perl, Linux, C, MySQL, Microsoft SQL Server
Education
The University of Texas at San Antonio 2000 — 2006
Bachelor’s Degree, Computer Science
Community First Health Plans
Skills
Utilization Management, Case Managment, Clinical Research, Medicaid, Managed Care, Medicare, Home Care, Patient Safety, Medical Case Management, Disease Management, Acute Care, Healthcare Management, Healthcare, Case Management, Palliative Care, Medicaid Managed Care, Physician Relations, Behavioral Health, ICU, Nursing, Critical Care, Certified Case Manager, Hospitals, Elder Care, HMO, Utilization Review, Patient Education, HEDIS, Medical Social Work, NCQA, Registered Nurses, Wound Care, Medical/Surgical, Inpatient, HIPAA, Health Insurance, Quality Improvement, Disability Management, Provider Relations, Patient Advocacy
Education
Nassau Community College 1984 — 1986
Associate of Arts and Sciences (AAS), Registered Nursing/Registered Nurse
Community First Health Plans October 1996 - Present
Anthem Benefit Administrators November 1994 - October 1996
Gallagher Bassett Services, Inc. May 1994 - November 1994
Travellers Plan Aministrators March 1987 - May 1994
Skills
Healthcare, Medicaid, HIPAA, Managed Care, Revenue Cycle, Healthcare Management, Insurance, Medical Billing, Medicare
Education
Tarrant County College 1985 — 1992
Business Administration and Management, General
Eastern Hill High School 1982 — 1985
High School
United States Air Force 59th Medical Wing- Office of the Chief Scientist 2014 - Present
University of Phoenix January 2010 - Present
Southern New Hampshire University 2013 - 2014
Community First Health Plans March 2012 - 2013
Community First Health Plans October 2010 - March 2012
United States Air Force School of Aerospace Medicine July 2008 - September 2010
Iowa Health System May 2007 - June 2008
Skills
Technical and..., Survey development, Clinical data..., Statistical analysis,..., Outbreak Investigation, Disease and Injury..., Quantitative Research, Hospital Quality and..., Program Management, Exit Surveys, Analysis, Hospitals, Clinical Research, Healthcare, Statistics, Program Evaluation, Process Improvement, Managed Care, Quality Improvement
Education
Iowa State University
Bachelor of Arts (B.A.), Spanish Language and Culture
Iowa State University
Bachelor of Science (BS), Biology, General
University of Iowa
Master of Science (MS), Occupational and Environmental Health
Walden University
Doctor of Philosophy (PhD), Public Health/ Epidemiology
Community First Health Plans August 2010 - Present
Christus Santa Rosa Hospital May 2008 - October 2009
North Central Baptist Hospital July 2003 - March 2008
Skills
Case Managment, Utilization Management, Medicaid, Nursing, Healthcare, Healthcare Management, Disease Management, Managed Care, Hospitals, HIPAA, Medical Case Management
Education
University of Phoenix 2008 — 2010
Master's degree, Nursing
Texas Woman's University 1983 — 1985
Bachelor of Science (B.S.), Registered Nursing/Registered Nurse
Community First Health Plans December 2010 - Present
Community First Health Plans January 2010 - December 2010
Community First Health Plans February 2008 - December 2009
Community First Health Plans February 1999 - May 2005
Skills
HIPAA, Pricing configuration, Benefits configuration, Security configuration, Authorization/ARQ..., Medicaid Managed Care, Amisys, Project Management, Process Improvement, Microsoft Excel, Microsoft Word, Writing
Education
The University of Texas at San Antonio 1979 — 1981
Accounting
Community First Health Plans July 2005 - Present
Skills
Healthcare Management, Case Management, Healthcare, Nursing, Managed Care
Education
The University of Texas at Austin 1981 — 1983
Bachelor's Degree, Registered Nursing/Registered Nurse
DST Health Solutions July 2014 - Present
Intelli-Source Solutions January 2014 - July 2014
Health First August 2012 - December 2013
FirstCare Health Plans October 2009 - July 2012
Community First Health Plans November 1998 - June 2008
Skills
Managed Care, Medicare, Medicaid, Health Insurance, Software Documentation, System Testing, System Configuration, Oracle SQL Developer, ChIP, Commercial Insurance, Remote Employment, Amisys, Insurance, Integration, Employee Benefits, Leadership, Claim
Education
Ashworth University 2005 — 2007
Associate's degree, Accounting
Community First Health Plans March 2014 - Present
Community First Health Plans October 2008 - March 2014
Skills
Health Insurance, Managed Care, Healthcare Industry, Long-term Care, Healthcare Information..., Provider Relations, Healthcare Management
Education
Thomas Jefferson High School San Antonio TX 1996 — 2000
San Antonio College