Simply Health Care Plans
Industry: Company
DescriptionFounded: 2009 Parent organization: Simply Healthcare Holdings, Inc.
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Simply Health Care Plans Employees
Simply Health Care Plans April 2013 - Present
Freedom Health, Inc. July 2011 - April 2013
Freedom Health, Inc February 2008 - July 2011
Skills
Microsoft Office, Administrative..., Bookkeeping, Customer Service, Office Management, PowerPoint, Organization &..., Inventory Control, Microsoft Excel, Microsoft Word, Healthcare, Provider Relations, Medicare, Medicaid, HMO, Health Insurance, HIPAA, Credentialing, Healthcare Industry, Healthcare Management, Insurance, Claim, Medical Terminology, Network Development, Hospitals, Medical Records, Health Policy, Medicaid Managed Care, Provider Network..., Healthcare Consulting, Healthcare Reimbursement, Medical Compliance, Medical Billing, ICD-9, Healthcare Information..., Physician Relations, Physicians, Provider Networks, Medicare/Medicaid..., Claims Resolution, EMR, Managed Care, PPO, Revenue Cycle, Utilization Management
Education
University of Phoenix
InnoVage of Greater California July 2013 - March 2015
Simply Health Care Plans August 2012 - June 2013
DentaQuest February 2012 - August 2012
Medica/United Health May 2011 - February 2012
United Healthcare former Medica Plans May 2011 - February 2012
Humana January 2010 - May 2011
Chrysalis Health March 2008 - January 2010
Skills
Medicare, Medicaid, Managed Care, Dental Care, Dental Insurance, Medicare Advantage, Medicare Part D, Human Resources, Health Policy, Training, Provider Relations, Long-term Care, Access, Healthcare Management, Employee Benefits, HIPAA, Health Insurance, Healthcare, Hospitals, Customer Service, Healthcare Information..., Healthcare Industry, Physicians, Team Building, Home Care, Leadership, Public Speaking, Healthcare Consulting
Education
Northcentral University 2014 — 2019
Master Arts Marriage and Family Therapy, Counseling Psychology
University of Phoenix 2005 — 2007
Master of Business Administration (MBA), Human Resources Management and Services
University of Puerto Rico 1997 — 2001
Bachelor of Science (BS), Business Administration and Management, General
Simply Health Care Plans November 2010 - Present
1-800 We Answer Answering Service 2008 - 2010
Education
Miami Dade College 2010 — 2014
InComm Agent Soltutions January 2013 - June 2015
Simply Health Care Plans October 2012 - December 2012
University of Miami, Miller School of Medicine September 2011 - October 2012
Financial Services of N.Hinds & Associates October 2009 - May 2011
University of Guyana August 2004 - May 2011
Lancaster University 2008 - 2009
Caribbean Airline December 2001 - August 2005
Skills
Accounting, Managerial Finance, Economics, Research, Data Analysis, Supervising, Microsoft Excel, Communication, Spreadsheets, Account Reconciliation, Auditing, Internal Audit, Final Accounts, Executive Management, Presentations, Project Coordination, Coordinate Meetings, Internal Controls, Financial Statements, Financial Analysis, Accounts Payable, Invoicing, Training, Tax, Qualitative Research, Lecturing, Journal Entries, Valuation, External Audit, Staff Development, Public Speaking, Teaching, Administration, PowerPoint, Microsoft Office, Financial Accounting, GAAP, Variance Analysis, General Ledger, Financial Statement..., Management Accounting, Cost Accounting, US GAAP, Cash Flow, Bookkeeping, Business Valuation, Financial Reporting, Forecasting, Bank Reconciliation, Accounts Receivable
Education
Lancaster University 2008 — 2009
MSc, Accounting & Financial Management
University of Guyana 2006 — 2008
Post Graduate Diploma, Education Administration
University of Guyana 1999 — 2003
BSocSc, Accountancy
Independent Living Systems, LLC October 2013 - Present
Florida Healthcare Plus January 2013 - October 2013
Simply Health Care Plans May 2010 - August 2012
Total Health Care October 1997 - April 2010
PacifiCare Health Systems August 1993 - May 1997
Skills
Account Receivable..., Excellent interpersonal..., Corporate Accounting &..., Spreadsheets &..., Medicaid Enrollment and..., Team Building, Staff Supervision, Healthcare Systems (IKA..., Bilingual in both..., MS Office (Word, Excel,..., QuickBooks, Windows..., Medicaid, Accounts Receivable, Account Reconciliation, Training, Invoicing, Visio, Microsoft Excel, Health Insurance, Managed Care, Auditing, Medicare, Software Documentation, Healthcare, Management, Provider Relations, Insurance, Hospitals, Healthcare Information..., Physician Relations, HIPAA, Healthcare Management, Revenue Cycle, Healthcare Consulting, Healthcare Industry, Credentialing, Health Policy, Physicians, HMO, Process Improvement, Medical Billing, PPO, Disease Management, Claim, Access, Employee Benefits, ICD-9, CPT, Leadership, Quality Improvement
Education
Mercy College 1985 — 1989
Bachelor's degree, Accounting
Mercy College 1985 — 1989
Bachelor's degree, Accounting
Comprehensive Home Care July 2013 - June 2015
CareSouth Homecare Professionals January 2013 - July 2013
Simply Health Care Plans June 2012 - November 2012
Universal Health Care June 2011 - June 2012
Race Trac Petroleum December 2008 - February 2010
Comcast Spotlight January 1997 - July 2008
Lakeland Automall August 2002 - August 2003
Skills
Recruiting, Marketing, Sales, Training, Management, Marketing Strategy, Human Resources, Business Development, Microsoft Office, Strategy, Software Documentation, Customer Service, Team Building, Customer Satisfaction, Employee Benefits, Advertising, Leadership, Insurance, Budgets, Healthcare, Interviews, Retail
Education
Bartow High School 1980 — 1983
Fayetteville Community College
Polk State College
University of South Florida
Simply Health Care Plans February 2012 - Present
WellCare October 2007 - February 2012
ACS State Healthcare February 2007 - October 2007
ACS State Healthcare October 2003 - February 2007
Florida Medicaid July 2002 - October 2003
ACS Florida Systems March 2001 - July 2002
Tallahassee Memorial Hospital February 2000 - March 2001
KPMG April 1999 - February 2000
Interim/Spherion February 1996 - December 1999
Skills
Provider Relations, Medicaid, Network Development, Provider Contracting, Medicare, Claim Analysis, HEDIS, Quality Management, Data Analysis, HMO, Healthcare Industry, HIPAA, Healthcare Management, Credentialing, Healthcare Consulting, Health Policy, Managed Care, Medical Billing, Policy, Training, PPO, Health Insurance, Claim, Claim Investigation, Healthcare Information..., Hospitals, Healthcare, Software Documentation, EHR, Team Building, Strategic Planning, Disease Management, Medicare Part D
Education
University of Florida 2008 — 2010
MBA, Healthcare Management
Florida Agricultural and Mechanical University 1995 — 2005
BS, political Science
Humana February 2015 - Present
Simply Health Care Plans September 2013 - December 2014
WellCare May 2012 - August 2013
Benefit Security, Inc. November 2010 - May 2012
Suncoast Gymnastics Academy September 2006 - March 2012
Skills
Managed Care, Management, Insurance, Training, Leadership, Healthcare, Recruiting, Sales, Market Research, Strategic Planning, Medicare, Marketing, Team Building, Provider Relations, Health Insurance, Interviews, Negotiation, Network Development, Market Analysis, Contract Recruitment, CMS, HEDIS, Provider Recruitment, Product Differentiation, AHCA, Provider Credentialing, CAHPS, MSO Operations, Risk Contracting, Medicaid
Education
University of Phoenix 2009 — 2011
Masters, MBA
University of South Florida 2007 — 2009
Bachelors in Science, Marketing
University of Arizona 2005 — 2006
Associate in Arts, Business
Centene Corporation September 2015 - Present
Independent Living Systems, LLC May 2013 - July 2015
Simply Health Care Plans August 2011 - May 2013
Skills
Business Development, Managed Care, Healthcare, Healthcare Management, Medicaid, Public Speaking, Microsoft Word, Microsoft Excel, Outlook, Management, Long-term Care, Sales
Education
Florida International University 1999 — 2003
Bachelor of Business Administration (BBA), Business Administration and Management, General
MedPartners September 2014 - May 2015
Cirrus Medical Staffing May 2014 - August 2014
Simply Health Care Plans September 2012 - January 2014
HCA West Florida Hospital June 2008 - June 2012
Blue Cross and Blue Shield of Florida April 1998 - June 2008
Skills
Utilization Management, Case Management, Onsite Coordination, Remote Access, Care Coordination, Discharge Planner, Concurrent Review, Hospitals, Health Care Systems, Disease Management, Inpatient, Medicaid, Healthcare, Program Management, Utilization Review, HIPAA, Pediatrics, Medicare, Home Care
Education
Pensacola Junior College 1982 — 1985
Associate's degree, Registered Nursing/Registered Nurse
1Apeiron September 2015 - Present
Lalchandani Simon PL July 2015 - Present
Eat Train Live, LLC March 2012 - Present
Simply Health Care Plans September 2013 - February 2014
Antiochian Village Camp June 2012 - August 2013
Harris Media LLC August 2012 - December 2012
Howard Medical Center April 2004 - August 2011
Skills
Social Media, Event Planning, Microsoft Office, Public Speaking, Facebook, Nutrition, PowerPoint, Social Networking, Fashion, Mac OS, Customer Service, Research, Public Health, Public Relations, Sales, Microsoft Word, Microsoft Excel, Teamwork, Fitness, Entrepreneurship, Account Executives, Foreign Languages, Health Insurance, Small Business, Computer Proficiency, Mobile Technology, Cooking, Organization, Social Skills, Highly detail oriented, Close Attention to..., Sports, Data Entry, Sports Analysis, Office Administration, Social Media Marketing, Marketing, Web Design, Work Ethic, Works well with a team, Strongly self-motivated, Legal Research, Legal Writing, Legal Documents
Education
University of Miami School of Law 2014 — 2017
Doctor of Law (J.D.)
Nova Southeastern University 2013 — 2014
Master of Public Health (MPH), Public Health
University of Central Florida 2011 — 2013
Bachelor of Science (BS), Political Science and Government
The University of Connecticut 2009 — 2011
Prestige Health Choice June 2014 - Present
PCA Medical Group September 2013 - May 2014
Simply Health Care Plans September 2012 - September 2013
WellCare February 2006 - September 2012
Wellcare HMO February 2006 - September 2012
Kepro South July 2004 - September 2006
St. Vincent Medical Center March 2003 - May 2004
Lovelace Community Health Plan July 1996 - March 2003
Presbyterian Healthcare Services May 1991 - September 1999
Nurse Finders, Inc July 1993 - July 1996
Skills
Medicare, Managed Care, Medicaid, Utilization Management, Medicare Supplements, HMO, Health Insurance, Healthcare, NCQA, HEDIS, Photography, Disease Management, Case Managment, Health Policy, Case Management, Nursing, Home Care, HIPAA, Healthcare Management, Hospitals
Education
The University of New Mexico 1989 — 1992
Bachelor of Science, Nursing
Simply Health Care Plans November 2011 - Present
Lenlyn Ltd. May 2008 - October 2011
Skills
Microsoft SQL Server, Windows, Access, Microsoft Excel, SQL, Data Analysis, Microsoft Office, C++, Troubleshooting, Multisim, Matlab, Xilinx ISE, Visio, Technical Support, Testing, Programming, Management
Education
Florida International University 2010 — 2013
Bachelor of Science in Electrical and Computer Engineering, Electrical Engeneering
Miami Dade College 2009 — 2010
Associate of Arts (AA), Electrical & Computing
The English Center 2008 — 2009
Computer Support Assistant & Network Support Technician, Computing & Networking
Instituto Superior Politecnico Jose Antonio Echevarria. La Habana, Cuba 2001 — 2006
Automation control, control loops, automation, PID tunning
Simply Health Care Plans 2013 - Present
Simply Health Care Plans 2012 - 2013
Redbridge Network & Healthcare 2009 - 2012
Skills
Health Insurance, Customer Service, Microsoft Office, Microsoft Excel, Medicare, Marketing, Healthcare, Sales, Claim, PowerPoint, QNXT, Trizetto
Education
Florida International University 2006 — 2010
Bachelor of Arts (B.A.), Sociology
Prestige Health Choice March 2015 - Present
Compassionate Care Hospice May 2014 - March 2015
South Florida Research Phase 1 April 2014 - May 2014
Simply Health Care Plans June 2013 - April 2014
Preferred Care Partners/United Healthcare February 2011 - June 2013
Skills
Nursing, Case Managment, Patient Safety, Disease Management, Utilization Review, Pediatrics, Clinical Research, Patient Advocacy, Medicare, Medicaid, EMR, Hospitals, Healthcare Management, Managed Care, JCAHO, Home Care, Healthcare, Cpr Certified, Utilization Management, Palliative Care, Quality Of Care, Chronic Care Management, Discharge planning, Transition of care, Transition Management, Telephone Skills, Assessment Skills, Care Planning, Medicine, Diabetes, Nursing Process, Wound Care, Medical Case Management, Acute Care, Nursing Management, Certified Case Manager, HEDIS, Medical/Surgical, Physician Relations, NCQA, Home Health Agencies, Inpatient, Patient Education, Home Infusion, Nursing Education, Long Term Acute Care, Medication..., Registered Nurses, Medicaid Managed Care, End of Life
Education
Barry University 2008 — 2010
Bachelor's degree, Registered Nursing/Registered Nurse
Miami Dade College 2003 — 2006
Associate of Arts and Sciences (AAS), Nursing
Simply Healthcare Plans November 2014 - Present
Simply Health Care Plans June 2012 - November 2014
Jackson Health System January 2013 - June 2013
Total Wine & More August 2010 - June 2012
Sports Authority January 2008 - August 2010
Med Place Staffing Solutions April 2010 - June 2010
Skills
Microsoft Office, Microsoft Excel, Microsoft Word, PowerPoint, Customer Service, Outlook, English, Windows, Photoshop, Public Speaking, Teaching, Budgets, Customer Satisfaction, Healthcare Management, Sales, Strategic Planning, Administration, Negotiation, Hospitals, Team Building
Education
Florida International University 2015 — 2016
Master of Business Administration (M.B.A.), Health/Health Care Administration/Management
Florida International University 2011 — 2013
Bachelor of Science (BS), Health/Health Care Administration/Management
Magellan Health Services April 2013 - Present
Simply Health Care Plans August 2011 - April 2013
Prestige Health Choice June 2010 - August 2011
AvMed Health Plans August 1994 - June 2010
Skills
Managed Care, Medicare, Utilization Management, Medicaid, Credentialing, Disease Management, HIPAA, Employee Benefits, HMO, Access, Physician Relations, Provider Relations, Recruiting, Management, Insurance, Strategy
Education
Florida International University
Simply Health Care Plans March 2013 - Present
B.Braun November 2007 - March 2013
Humana August 2004 - March 2013
Bridgpoint Health Solutions 2007 - 2012
Apotex Corp. June 2001 - July 2004
Skills
Clinical Pharmacy, Customer Service, Diabetes, Healthcare, Healthcare Management, Leadership, Managed Care, Management, Medical Devices, Medicaid, Medicare, Medicare Part D, Medication Therapy..., Patient Safety, Pharmaceutical Industry, Pharmacists, Pharmacy, Strategic Planning, Utilization Management
Education
Nova Southeastern University
Simply Health Care Plans March 2013 - Present
Cigna-HealthSpring June 2012 - March 2013
NAES Corporation February 2007 - June 2012
Praxair, Inc January 2006 - October 2006
Macy Development July 2004 - December 2005
Petróleos y Servicios November 1998 - December 2003
Parque Histórico November 2000 - December 2002
Skills
Payroll, Human Resources, Recruiting, Accounting, Finance, Financial Analysis, Budgets, Accounts Payable, Strategic Planning, Customer Service, Leadership, Management, Microsoft Excel, Process Improvement, Analysis
Education
D'Youville College 2007 — 2008
Bachelors Degree, Business Management
D'Youville College
Masters Degree, Business Administration
D'Youville College
BS, Accounting
Health Alliance Plan March 2012 - July 2014
Molina Healthcare May 2006 - September 2012
Simply Health Care Plans September 2011 - February 2012
Skills
Healthcare Information..., EHR, HEDIS, HIPAA, Healthcare, Healthcare Management, Managed Care, Medicaid, Medicare, Access, Customer Service, EMR, Health Policy, Healthcare Consulting, Management, Healthcare Industry, Visio
Education
Central Michigan University 2007 — 2009
Master of Science (MS), Health Services Administration
Grand Valley State University 2001 — 2006
Bachelor of Science (BS), Public Administration
Simply Healthcare Plans August 2015 - Present
Simply Healthcare Plans January 2015 - Present
Simply Health Care Plans November 2012 - January 2015
Simply Health Care Plans March 2012 - November 2012
Simply Health Care Plans January 2010 - March 2012
Skills
Medicare, Healthcare Information..., Medicaid, Managed Care, Hospitals, Insurance, Healthcare Management, HIPAA, Healthcare Industry, Health Insurance, Healthcare, Long-term Care, Credentialing, Utilization Management, Data Analysis, Team Building, Network Development, Revenue Cycle, HMO, Healthcare Consulting, Physician Relations, Medical Billing, Physicians
Education
Florida International University 2013 — 2015
MBA, Healthcare
St. Thomas University 2008 — 2012
Bachelor of Business Administration (BBA), Business Administration and Management, General
Simply Health Care Plans January 2013 - Present
Miami Children's Hospital July 2012 - December 2012
DentaQuest May 2008 - July 2012
Atlantic Dental, Inc. June 2006 - May 2008
The UPS Store May 2004 - June 2006
Skills
Health Insurance, Insurance, Provider Relations, Network Development, Outstanding Customer..., Utilization Management, Customer Service, Medicare, Case Managment, Healthcare, Managed Care, Medicaid, HIPAA, HMO, Employee Benefits, Call Centers, Case Management, Medicaid Managed Care, Process Improvement, Team Building
Education
Florida International University 2012 — 2015
Bachelor's degree, Psychology
Miami Dade College 2005 — 2009
Associate's degree, Psychology
Miami Coral Park Senior High School 2001 — 2005
High School Diploma, General
GuideWell Sanitas 1, LLC January 2015 - Present
Healthcare April 2014 - Present
Simply Health Care Plans January 2011 - April 2014
SIster Emmanuel Hospital July 2005 - January 2011
Coral Gables Hospital 1996 - 2000
Skills
HIPAA, Onboarding, Employee Benefits, Health Insurance, Healthcare, Deferred Compensation, Managed Care, Medicare, Benefits Administration, HRIS, Healthcare Management, Applicant Tracking..., Conflict Resolution, Recruiting, Human Resources, FMLA, HR Policies, Healthcare Information..., Kronos, Leadership, Strategic Planning, Organizational..., Personnel Management, New Hire Orientations, Workforce Planning, Policy, Talent Acquisition, Payroll, Leadership Development, Employee Relations, Training, Performance Management, Compensation & Benefit, Employee Training, Hiring, Succession Planning, College Recruiting, Taleo, Job Descriptions, Labor Relations, Temporary Placement, Workers Compensation, Employee Engagement, COBRA, Job Fairs, Management, Team Building, Process Improvement, Customer Service, Hospitals
Education
Excelsior College
BSL, Liberal Arts and Sciences, General Studies and Humanities
Simply Healthcare Plans June 2014 - Present
Simply Health Care Plans October 2013 - May 2014
DHI Title of Florida September 2012 - October 2013
Humana February 2012 - September 2012
The Children's Place March 2010 - November 2011
Skills
Microsoft Office, Microsoft Word, Microsoft Excel, Bilingual-English/Spanis..., Medical Terminology, Notary Public, Spreadsheets, Healthcare, Customer Service, Outlook, HIPAA, CPR Certified, First Aid Certified, AED Certified, Yoga Instruction
Education
University of Central Florida 2007 — 2013
Bachelor of Science (B.S.), Psychology
Bertoni Holdings, LLC. September 2014 - September 2015
Florida International Bankers Association (FIBA) August 2014 - November 2014
Simply Health Care Plans September 2013 - August 2014
Beasley Broadcast Group September 2010 - September 2013
Skills
Event Planning, Marketing, Social Networking, Social Media, Advertising, Public Relations, Broadcast, Social Media Marketing, Event Management, Video Editing, Radio Promotions, Copywriting, Journalism, Microsoft Office, Video, YouTube, Photography, Writing, Radio Advertising, Audio Editing, Digital Marketing, Final Cut Express, Social Skills, Sound Forge, Grammar, Media Relations, Adobe Design Programs, PromoSuite, Staff Management, Hootsuite, QuickBooks, Google Adwords, Multi-media Marketing..., Corporate Website..., Marketing Material...
Education
Florida International University 2011 — 2013
Bachelor of Science (B.S.), Mass Communication/Media Studies & Marketing, 3.0 GPA
Miami Dade College 2009 — 2011
Associate of Arts (A.A.), Mass Communication/Media Studies, 3.21 GPA
HealthSun Health Plans, Inc August 2015 - Present
Da Factory - Training Facility December 2013 - September 2015
Independent Living Systems, LLC March 2013 - August 2015
Key Health Plans October 2010 - October 2012
GEF, Inc August 2011 - September 2011
Simply Health Care Plans January 2011 - April 2011
Simply Health Care Plans January 2010 - October 2010
Renaissance Health Systems March 2008 - January 2010
Skills
Employee Relations, Policy, Employee Training, Operations Management, Government, Medicare, Medicaid, Healthcare Management, Managed Care, HIPAA, Quality Improvement, Insurance, Healthcare, Health Insurance, Healthcare Information..., Healthcare Industry, Project Management, Customer Service, Vendor Management, Process Improvement, Executive Management, Team Building, Management, Training, Human Resources, Coaching, Contract Negotiation, Health Policy, EMR, Hospitals, Leadership, Strategic Planning, Analysis, Microsoft Excel, Integration, Software Documentation, Consulting, Program Management, EHR, Information Technology, Marketing, Sales, Data Analysis, Change Management, Business Analysis, Databases, Public Speaking, SDLC, Budgets
Education
Florida International University 2007 — 2008
Masters of Science, Human Resources Management
Florida International University 2007 — 2008
Masters of Science, Healthcare Administration
Florida International University 2002 — 2006
BA, Business Management, International Business
DaVita Kidney Care November 2013 - Present
Simply Health Care Plans November 2012 - April 2013
Care Solutions Medical Group June 2010 - September 2012
Universal Medical Center October 2008 - May 2010
US Navy February 2004 - August 2006
Skills
Cpr Certified, Healthcare, Medical Terminology, Microsoft Office, Healthcare Management, PowerPoint, Microsoft Word, Customer Service, Microsoft Excel, Leadership, Hospitals, Critical Thinking, Data Entry, Military Experience, Medical Records, Medicare, Medicaid, Administration, Insurance, Access, HIPAA, Managed Care, Medical Billing, Healthcare Information..., EHR, Data Analysis, Medical Coding, Healthcare Industry, Healthcare Consulting, Health Insurance, Team Building, Revenue Cycle, Outlook, Home Care, Patient Safety, Physicians, Disease Management, Quality Improvement, Health Policy, Utilization Management, Physician Relations
Education
Florida National University 2011 — 2013
Bachelor of Science (B.S.), Health Services Administration
Florida National University 2006 — 2009
Associate of Science (AS), Diagnostic Medical Sonography/Sonographer and Ultrasound Technician
Florida National University
Master of Science (M.S.), Health Services Administration
Simply Health Care Plans Program Support SpecialistPinellas Opportunity CouncilOctober 2009 - October 2011
Skills
Microsoft Office, Customer Service, Microsoft Excel, Microsoft Word, PowerPoint, English, Windows, Outlook, Public Speaking, HTML, Strategic Planning, Access, Data Entry, Data Analysis, Event Planning, Healthcare, HIPAA, Training, Team Building
Education
Cortiva Institute-Florida 2011 — 2012
Licentiate degree, Massage Therapy/Therapeutic Massage
Florida Agricultural and Mechanical University 1996 — 2004
Bachelor's degree, Psychology
TEAM Enterprises December 2014 - Present
HealthSun Health Plans, Inc February 2014 - Present
Clinica Las Mercedes February 2014 - Present
Simply Health Care Plans August 2011 - February 2014
Nordstrom February 2010 - August 2011
Skills
Sales, Customer Service, Microsoft Office, Health Insurance, Employee Benefits, Healthcare, Marketing, Insurance, Medicare, Managed Care, Long-term Care, Medicaid, Microsoft Excel, HIPAA, Leadership, Sales Management, Benefits Administration, Health Care Reform, Provider Relations, Health Policy, Utilization Management, Healthcare Industry, Healthcare Management, Project Management, Outlook, HMO, Brokers, Medicare Part D, Healthcare Consulting, Call Centers, Management, Social Media Marketing, Account Management, Social Networking, Marketing Strategy, Social Media, Negotiation, Sales Operations, Training, Event Planning, Event Management, Product Marketing, Brand Ambassadorship, Brand Awareness, Branding, Relationship Building, Presentation Skills, Sales Presentations
Education
Miami Dade College 2007 — 2015
Bachelor of Applied Science (BAS), Supervision and Managment
Christopher Columbus High School 2001 — 2005
Highschool Diploma
Simply Health Care Plans April 2014 - Present
FAREHD ( Federation des Associations Regionales Haitiennes de la Diaspora ) March 2009 - Present
CHRISNET CORPORATION 2006 - Present
CABINET ARIS & ENTREPRISE KENAR January 1995 - June 2005
Ministere de la Justice-Haiti July 1997 - September 1999
Bureau de Credit Agricole-Haiti October 1985 - June 1996
Skills
Insurance, Health Insurance, Healthcare, Long-term Care, Medicare, Small Business, Team Leadership, Program Management, Leadership Development, Organizational..., Budgets, Fixed Annuities, Medicaid, Customer Service, Public Speaking, Team Building, Strategic Planning, Employee Benefits, Term Life Insurance, Nonprofits, Contract Negotiation, New Business Development, Microsoft Word, Leadership, Training, Financial Analysis, Microsoft Excel, Project Management, Disability Insurance, Public Relations
Education
Walden University 2013 — 2017
Doctor of Philosophy (PhD), Health Services Administration
University of Phoenix 2007 — 2009
Master of Science (MS), Psychology
Faculte de Droit & des Sciences Economiques de Port-au-Prince 1984 — 1988
Bachelor of Science (BS), Law
Simply Health Care Plans 2012 - January 2014
Converge Southeast 2006 - 2008
Great Lakes Church Planting 1997 - 2007
Skills
Problem Solving, Quality Improvement, Outlook, Microsoft Word, Microsoft Excel, Customer Satisfaction, Public Relations, Event Planning, New Leader Assimilation, Organizational..., Cross Functional Team..., Coaching, Corporate Events, Leadership, Analysis, Recruiting, Training, Public Speaking, Prayer, Management, Nonprofits, Strategic Planning, Policy, Community Outreach, Process Improvement, Fundraising, Team Leadership, Social Media, Sales, Provider Relations, Physician Relations, Network Development, HMO, Utilization Management
Education
Baptist Bible College and Seminary
Simply Health Care Plans SRNSouthcoast College of HealthJanuary 2015 - August 2015
Jersey College 2013 - 2014
Jersey College 2013 - 2014
Moffitt Cancer Center 2002 - 2008
Cigna December 1998 - April 2002
Cigna March 1995 - August 1998
Time Customer Service, Inc. October 1988 - October 1994
Time Warner Inc. April 1986 - September 1988
Skills
Utilization Management, Medicare, Medicaid, Disease Management, Managed Care, Case Managment, Health Insurance, Provider Relations, Healthcare, Healthcare Management, HIPAA, HEDIS, Long-term Care, Claim, Insurance, NCQA, Medicaid Managed Care, Network Development, HMO, Certified Case Manager, Case Management, Nursing, Patient Safety
Education
Ramapo College of New Jersey
Mercy January 2014 - Present
Family Practice May 2012 - December 2013
Simply Health Care Plans February 2012 - May 2012
Education
Maryville University of Saint Louis 2013 — 2014
Doctorate, Nursing Practice, 4.0
University of Miami 2010 — 2011
Master of Science, Family Nurse Practitioner
University of Miami 2006 — 2010
Bachelor of Science, Nursing, Psychology
CMC Dallas December 2014 - Present
Health springs February 2013 - Present
Colorado Access June 2014 - December 2014
Molina HealthCare September 2013 - June 2014
Simply Health Care Plans November 2012 - January 2013
The TriZetto Group November 2011 - January 2013
Info Now/ ChannelInsight February 2011 - January 2012
InfoNow Corporation February 2011 - December 2011
Global Tech October 2010 - February 2011
U.S Navy November 2005 - June 2010
Skills
Buisness Objects, PL/SQL, SaaS, Cloud Computing, Salesforce.com, Business Intelligence, Data Management, Enterprise Software, SDLC, Requirements Analysis, SharePoint, Agile Methodologies, Software Implementation, Integration, Software Project..., Account Management, Oracle, Agile Project Management, HIPAA, Project Management, Analytics, Team Leadership, EDI, SSIS, Team Building, Business Objects, Data Analysis, Databases, Business Analysis, SQL
Education
Hastings College 2005 — 2006
Bachelors, Communications / Media Relations
University of Northern Colorado 2002 — 2006
BA, Communications
Henao Strategies, Inc. May 2015 - Present
Simply Health Care Plans June 2013 - May 2015
Time Inc. May 2007 - June 2013
Zubi Advertising 1997 - 2007
Skills
Advertising, Integrated Marketing, Media Planning, Marketing Communications, Digital Strategy, Marketing Strategy, Digital Media, Online Advertising, Advertising Sales, Strategic Thinking, Direct Marketing, Social Media Marketing, Brand Management, Market Research, Strategic Planning, Marketing
Education
University of Miami 1992 — 1994
Bachelor of Science, School of Communication, Dual major in Advertising and Sociology, minor in Marketing
Simply Health Care Plans July 2013 - Present
Simply Health Care Plans February 2012 - June 2013
WellCare October 2010 - February 2012
WellCare March 2009 - October 2010
WellCare Health Plans June 2007 - March 2009
WellCare May 2006 - July 2007
WellCare November 2005 - May 2006
Skills
Provider Relations, Network Development, HMO, PPO, Health Insurance, Claim, Provider Network..., Medicare, HIPAA, Healthcare Management, Medicaid Managed Care, Physician Relations, Credentialing, Customer Service, EHR, Healthcare, Healthcare Industry, Managed Care, Management, Medicaid, Insurance, Strategic Planning, Team Building, Healthcare Consulting, Healthcare Information..., Hospitals
Education
Troy University
Business Administration and Management, General
Simply Health Care Plans September 2012 - Present
DentaQuest February 2012 - Present
Medica HealthPlans May 2011 - February 2012
Humana January 2010 - May 2011
The Chrysalis Center March 2008 - January 2010
ChildNet August 2004 - February 2007
Skills
Employee Benefits, Onboarding, HRIS, New Hire Orientations, Employee Relations, Workshop Facilitation, Recruiting, Case Managment, Human Resources, Policy, Leadership Development, Social Services, Coaching, Public Speaking, Benefits Administration, Technology Needs..., Event Planning, Leadership, Outlook, Crisis Intervention, Training, Management, Program Management
Education
University of Phoenix 2005 — 2007
MBA, Human Resources
Universidad de Puerto Rico 1997 — 2001
BBA, Management
Beacon Health Options 2015 - Present
Simply Health Care Plans June 2013 - 2014
TFI Resources October 2012 - June 2013
Archcare April 2012 - September 2012
ValueOptions August 2011 - May 2012
CIGNA March 2011 - August 2011
UnitedHealthcare March 2009 - March 2011
Broward Health November 2007 - March 2009
Healthcare Resolution Services, Inc October 2006 - June 2007
Mecklenburg County Area Mental Health March 2003 - August 2005
Skills
Program Integrity, Compliance, Medicare, Healthcare, Managed Care, Auditing, Accreditation, Microsoft Office, Process Improvement, Healthcare Compliance, Quality Management, Quality Assurance, Team Building, Problem Solving, Regulatory Affairs, Customer Service, Healthcare Recruiter, MS Project, Microsoft Excel, Microsoft Word, Medical Compliance, HIPAA, Healthcare Management, Provider Relations, Employee Benefits, Analysis, Insurance, Medicare Part D, Network Development, Credentialing, Agent Oversight, Brokers, FMO Oversight, Special Investigations, Medicaid Managed Care, Fraud Prevention, HMO, Healthcare Industry
Education
University of Delaware 1995 — 2000
Quality Performance Advantage, LLC January 2014 - Present
Simply Health Care Plans October 2011 - January 2014
Magellan Health Services October 2010 - October 2011
AmeriChoice November 2004 - October 2010
UnitedHealth Group 2005 - 2007
United Behavioral Health 2004 - 2004
Blue Cross Blue Shield of Florida 1999 - 2003
Neighborhood Health Partnership 1998 - 1998
AvMed Health Plans 1996 - 1998
Skills
Managed Care, Medicaid, NCQA, Medicare, Healthcare Management, Utilization Management, Disease Management, Health Insurance, Healthcare, HIPAA, Credentialing, HMO, Healthcare Information..., HEDIS, Quality Improvement, Insurance, Process Improvement, Quality Management, Health Policy, Healthcare Consulting
Education
Florida International University - College of Business 2001 — 2003
M.B.A., Business
Florida State University 1988 — 1991
B.A., Psychology
Gwinnett County Public Schools July 2014 - Present
Baptist Health South Florida June 2013 - July 2014
Simply Health Care Plans April 2012 - May 2013
Preferred medical plan July 2006 - April 2012
Skills
Business Intelligence, SSRS, Crystal Reports, Business Objects, Healthcare Information..., Query Writing, Microsoft SQL Server, Oracle SQL Developer, SQL, SSIS, Data Warehousing, Health Care Systems, ETL Tools, Data Management, Data Mapping, Process Improvement, Data Analysis, Training, Healthcare, Microsoft Excel, Microsoft Office, Financial Analysis, Data Extraction, Data Mining, Data Modeling, Data Manipulation, Microsoft Word, Customer Service, Troubleshooting, IT Solutions, Trizetto QNXT, Cognos
Education
University of Michigan 1991 — 1995
Simply Health Care Plans April 2012 - March 2013
WellCare September 2004 - April 2012
Florida Blue 1999 - 2004
Skills
Provider Relations, Network Development, Medicare, Provider Contracting, Managed Care, Ancillary Services, Medicaid Managed Care, Vendor Management, HMO, Healthcare, Medicaid, PPO, Healthcare Information..., HIPAA, Credentialing, Healthcare Consulting
Education
Montclair State University 1980 — 1982
BS, Business Administration
Prout Memorial
Carnival Corporation July 2012 - Present
Simply Health Care Plans 2010 - Present
Town of Miami Lakes January 2005 - 2009
Vista Health Plan of Florida January 2002 - January 2005
Vista Health Plan January 1997 - January 2002
United HealthCare January 1993 - January 1997
Skills
Databases, Microsoft Excel, VB.NET, ETL, Data Warehousing, T-SQL, Database Design, OLAP, Microsoft SQL Server, Business Intelligence, Visio, SQL, .NET, Software Development
Education
Anahuac University - Mexico
Bachelor, Computer Science
Universidad Anáhuac
BS, Computer Science
BankUnited June 2014 - Present
Independent Living Systems, LLC September 2012 - June 2014
Simply Health Care Plans December 2011 - August 2012
Dell - Palmetto General Hospital - TenetHealth South Florida August 2005 - December 2011
All Computer Techniques April 2003 - August 2005
Skills
MCSE, CCNA, Active Directory, Project Management, Network Security, LAN-WAN, VMware Infrastructure, IT Infrastructure..., DHCP, DNS, Microsoft Exchange, WSUS, Cisco Technologies, Disaster Recovery, VMware, Networking, VMware ESX, Security, Network Administration, System Administration, Microsoft Certified..., Routers, Switches, Troubleshooting, Group Policy, WAN, IIS, System Deployment, Integration, Software Documentation, Servers, Cisco Nexus, Infrastructure, Software Installation, Backup Exec
Education
Florida Computer College 2001 — 2003
Associate of Science (A.S.), Network Engineer
Florida International University 1999 — 2001
Miami Dade College 1997 — 2000
Associate of Arts (A.A.)
Sunshine Health March 2014 - October 2014
Simply Health Care Plans October 2012 - January 2014
Health Integrated July 2011 - October 2012
Universal Healthcare October 2008 - July 2011
Universal Health Care Group, Inc. October 2008 - July 2011
Wellcare Health Plan 2008 - 2008
HIMS 1997 - 2000
Skills
Utilization Management, Medicaid, Disease Management, Managed Care, Medicare, NCQA, Healthcare Management, Healthcare, Provider Relations, Case Managment, Health Insurance, HIPAA, Utilization Review, Network Development, Healthcare Industry, Hospitals, Medicare Part D, HMO, Health Policy, Process Improvement, Quality Improvement, Healthcare Consulting, Emergency Room, Informatics
Education
Galen Health Institue 2007 — 2008
ASN, Nursing
D G Erwin Technical Center 1983 — 1984
ASN, Nursing
Simply Healthcare Plans September 2014 - Present
Simply Healthcare Plans November 2013 - Present
Simply Health Care Plans November 2012 - Present
Bupa Worldwide Corporation March 2011 - November 2012
AvMed Health Plans September 2008 - March 2011
UnitedHealth Group January 2006 - August 2008
Neighborhood Health Partnership April 2003 - May 2005
UnitedHealth Group October 1997 - April 2003
Skills
Health Insurance, Insurance, Medicare, Employee Benefits, Medicaid, Managed Care, HMO, Utilization Management, Healthcare, HIPAA, Claim, Process Improvement, Provider Relations, Call Center, Data Analysis, Benefits Administration, Risk Management, Business Analysis, Network Development, Performance Management, Vendor Management, Team Building, Strategic Planning, Medicare Part D, Leadership, Healthcare Industry, Coaching, Claims Management, Call Centers, Analysis, Access
Education
Keller Graduate School of Management of DeVry University 2009 — 2014
Masters, MBA
Trinity International University 2004 — 2009
Bachelors, Communications and Organizational Leadership
Magellan Health February 2015 - Present
Florida Healthcare Plus June 2013 - January 2015
Simply Health Care Plans May 2011 - July 2013
Jackson Health System July 2002 - May 2011
Florida International University June 1998 - December 2001
Skills
Group Therapy, Public Speaking, Management, Mental Health, Hospitals, Healthcare, Managed Care, Family Therapy, Medicare, Medicaid, Clinical Research, Training, Social Services, Leadership, Process Improvement, Physician Relations, HIPAA, Healthcare Industry, Healthcare Management, Case Managment, Policy, Customer Service, Program Development, Coaching, Health Insurance, Teaching, Disease Management, Utilization Management, Case Management, Credentialing, EHR, EMR, HEDIS, Health Policy, Healthcare Consulting, HMO, Healthcare Information..., Home Care, Long-term Care, Medical Billing, Medicine, NCQA, PPO, Physicians, Provider Relations, Public Health, Quality Improvement
Education
Florida International University 1982 — 1988
BSW/MSW, Social Work
Simply Health Care Plans May 2013 - Present
Simply Health Care Plans November 2011 - May 2013
Jackson Health System February 2011 - November 2011
Jackson Health System January 2009 - February 2011
University of Miami June 2008 - December 2009
University of Miami June 2006 - June 2008
Skills
Healthcare Management, Quality Improvement, Hospitals, Managed Care, Healthcare, Healthcare Information..., HIPAA, Medicare, Physician Relations, Public Health, Credentialing, Health Policy, Healthcare Consulting, Healthcare Industry, Medicaid, Physicians, Provider Relations
Education
Florida International University 2005 — 2008
MHSA, Health Care Administration
University of Florida 2001 — 2004
Bachelor's degree, Health
Cognizant September 2015 - Present
Invidasys, Inc. December 2013 - Present
Oleen Pinnacle Healthcare Consulting September 2013 - November 2013
Simply Health Care Plans October 2012 - September 2013
Molina Healthcare May 2011 - May 2012
Aetna January 2009 - May 2009
US Capital Mortgage 2008 - 2009
American Discount Mortgage May 2005 - May 2008
US Capital Mortgage December 2002 - May 2005
American Discount Mortgage October 2000 - December 2002
Skills
SQL, Linux, HIPAA, Healthcare IT, Data Analysis, ICD-10-CM/PCS, HIPAA Standard Code Sets, QNXT, CAYLX POINT, Healthcare Information..., Policy, Claims, Medicare, Medical Billing, Business Analysis, Billing, Documentation, Data Entry, Customer Service, Auditing, Analysis, Team Building, Excel, Medical Coding, Microsoft Office, Revenue Cycle, Medicaid, PowerPoint, Word, Outlook, Visio, Problem Solving, Workflow Analysis, Requirements Analysis, Business Intelligence, EHR, Claim, CPT, Software Documentation, ICD-9, Leadership, Healthcare, ICD-10
Education
ICD-10CodersAcademy 2011 — 2013
Cert, Comprehensive ICD-10 Online Training
Phoenix College 2010 — 2013
HIT AAS (RHIT), Health Information Technology, 3.8
Phoenix College 2010 — 2013
Computer Information Systems Certification, 3.8
Penn Foster 2010 — 2011
Certifcation, HIPAA Compliance Certification
AAPC 2010 — 2010
ICD-10-CM Boot Camp
Gatlin College 2009 — 2010
CERT, ICD-10-CM/PCS, 3.8
Everest College 2008 — 2009
MIBC, Medical Insurance Billing and Coding, 3.8
Northern Arizona University 1997 — 1999
BA
Simply Health Care Plans September 2012 - Present
UHC February 2012 - September 2012
Health Management Associates, Inc. May 2011 - July 2012
Montefiore Medical Center August 2009 - April 2011
Montefiore Medical Center July 2008 - August 2009
Montefiore Medical Center July 2007 - June 2008
Montefiore Medical Center July 2004 - June 2007
Skills
Medicine, Healthcare Management, Healthcare, Managed Care, Board Certified, Internal Medicine, Clinical Research, Medical Education, Hospitals, Critical Care Medicine, Healthcare Information..., CMS Medicare Coverage..., Florida Medicaid Manuals, McKesson Interqual
Education
State University of New York Downstate Medical Center College of Medicine 2000 — 2004
M.D.
College of the Holy Cross 1996 — 2000
B.A., Biological Sciences, Biological Psychology
Regis High School 1992 — 1996
High School
Simply Health Care Plans May 2012 - Present
Miami Jewish Health Systems May 2004 - February 2012
Miami Jewish Health Systems May 1994 - May 2004
Skills
ALF Administrator
Education
University of Miami 1982 — 1986
Bachelor's degree, Double Major Sociology & English
Health Central Hospital March 2013 - Present
Simply Health Care Plans September 2011 - August 2012
Amerigroup September 2008 - November 2011
Amerigroup September 2007 - November 2008
Amerigroup March 2007 - September 2007
Skills
Healthcare, Provider Relations, Contract Negotiation, Event Planning, Project Management, Community Relations..., Microsoft Excel, PowerPoint, Clinical Research, Microsoft Word
Education
University of Central Florida 2004 — 2006
Master of Science (MS), Health Services Administration
Florida Agricultural & Mechanical University 1999 — 2004
Bachelor of Science (BS), Health Care Management
KIPP Houston Public Schools September 2013 - Present
Simply Health Care Plans October 2012 - July 2014
School District of Hillsborough County 2007 - 2012
Skills
Mathematics Education, Community Outreach, Employee Training, Teacher Training, Recruiting, Algebra, Classroom, Lesson Planning, Classroom Management, Public Speaking, Geometry, Leadership Development, Leadership, Secondary Education, PowerPoint, K-12
Education
Florida Agricultural and Mechanical University 1997 — 2001
Bachelor's degree, Health Information/Medical Records Administration/Administrator