Lovelace Health Plan
Industry: Company
DescriptionFounded: 1922 Parent organization: AHS New Mexico Holdings Inc. Subsidiaries: New Mexico Heart Institute, LLC, CFO: Gary Whittington, Andrea Solin, Misty Gordon, Matt Maes COO: Nancye Cole, Dawn Tschabrun Chief nursing officer: Patti Bennett, Nancye Cole, Sharon Prudhomme, Joanne Sedei BSN
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Lovelace Health Plan Employees
At Your Service Virtual Admin Solutions August 2015 - Present
Association of Equipment Manufacturers (AEM) December 2013 - December 2014
Lovelace Health Plan August 2010 - May 2013
TRI Appraisals, LLC January 2004 - 2013
Alliant Energy September 2007 - May 2010
TDS TELECOM May 2005 - November 2006
Harley-Davidson Motor Co July 2001 - September 2002
Meriter Hospital May 1999 - July 2001
Skills
Time Management, Administrative..., Training, Customer Service, Microsoft Office, Marketing, Public Speaking, Program Management, Budgets, Event Management, Microsoft Excel, Administration, PowerPoint, Process Scheduler, Outlook, Event Planning, Editing, Sales, Executive..., C-Level Executive..., Executive Support, Executive..., Executive-level..., Travel Arrangements, Travel Management, Executive Calendar..., Heavy Calendaring, Conference Coordination, Accounting, Project Planning, Project Coordination, Business Process..., Office Management, Office Administration, Redundancy Handling, Report Writing, Corporate Communications, Internal Communications, Project Status Reporting, Team Motivation, Meeting Planning, Meeting Scheduling, Presentation Development, Public Relations, Marketing Communications, Training Delivery, Employee Training, CAP, Collateral Materials..., Conference Management
Education
Madison Area Technical College 2007 — 2008
Completed numerous administrative assistant and meeting/event planning courses
Concordia University 1996 — 1997
BA, Management Communications
University of Wisconsin-Madison
CDIS-Consumer Direct Insurance Services-Senior June 2014 - Present
United Medical Supply July 2011 - May 2014
Lovelace Rehabilitation Hospital May 2008 - June 2011
Lovelace Health Plan July 2002 - May 2008
Skills
Sales, Account Management, Sales Operations, Selling, Marketing Strategy, Cold Calling, Healthcare, Sales Management, Leadership, Team Building, Marketing, Strategic Planning, Training, Management, Customer Service, Sales Process, Medicare
Education
National American University-Rio Rancho
Associate of Arts (A.A.), Business and Marketing, 3.8
Lovelace Health Plan November 2001 - January 2013
Skills
Business Analysis, Process Improvement, Visio, Business Intelligence, Requirements Gathering, Crystal Reports, Access
Education
New Mexico State University
Bachelor of Business Administration (BBA), Accounting, 4.0
UnitedHealth Group April 2014 - Present
United Healthcare September 2013 - April 2014
Lovelace Health Plan September 2011 - September 2013
Presbyterian Healthcare Services June 2005 - September 2011
Presbyterian Healthcare Services February 1998 - June 2005
Skills
Microsoft Word, PowerPoint, Management, Project Management, System Configuration, Human Resources, Access, Databases, Leadership, Networking, Process Improvement, Analysis, Team Building, Data Analysis, Negotiation, Time Management, MS Project, Software Documentation, Enterprise Software, Business Analysis, Healthcare, Training, Strategy, Healthcare Management, Employee Benefits, Visio, Program Management, HIPAA, Project Planning, SDLC, Team Leadership, Business Process..., Call Centers, Policy, Administration, Insurance, SharePoint, Requirements Gathering, Vendor Management
Education
The University of New Mexico 1987 — 1991
Bachelor of Arts (B.A.), Theatre/Theater
Vantage Oncology February 2014 - Present
Lovelace Health System July 2013 - Present
Lovelace Health Plan April 2013 - Present
Lovelace Health Plan November 2012 - April 2013
Lovelace Health Plan January 2011 - November 2012
Skills
EHR, Healthcare, Healthcare Information..., Strategic Planning, Healthcare Consulting, Managed Care, Health Policy, Revenue Cycle, Insurance, Medicare, Healthcare Management, Medicaid, Leadership, Healthcare Industry, Disease Management, Provider Relations, Hospitals, HIPAA, Program Management, Cross-functional Team..., Claim, Process Improvement, Customer Service, Utilization Management, EMR, Credentialing, Health Insurance, Medical Billing, HMO, Physician Relations, Case Managment, Physicians, Network Development, Medicine, PPO, Quality Improvement, Medicaid Managed Care, Informatics, Medical Compliance, Health Information..., Medical Education, Revenue Cycle Management, HEDIS, Medical Coding, Patient Safety, Inpatient, Home Care, Practice Management
Education
Texas Tech University 2005 — 2007
Master of Business Administration (M.B.A.), Health/Health Care Administration/Management, Magna Cum Laude
Indiana University School of Medicine
Doctor of Medicine (MD), Medicine
University of Louisville
Biology/Biological Sciences, General
ABQ Health Partners (Davita HealthCare Partners) April 2015 - Present
New Mexico Health Insurance Exchange November 2013 - March 2015
Lovelace Health Plan August 2011 - November 2013
Lovelace Health Plan April 2010 - August 2011
Lovelace Health Plan May 2009 - April 2010
Lovelace Health Plan March 2008 - May 2009
Lovelace Health Plan December 2006 - March 2008
Medical Site Reviewers December 2004 - November 2006
Sterling Bank - TrusteSolutions October 2002 - October 2004
Singal Source November 2001 - October 2002
Skills
Integration, Business Analysis, Software Documentation, Process Improvement, SDLC, Business Intelligence, Databases, Business Process..., Healthcare Information..., Project Management, Leadership, Disaster Recovery, Requirements Analysis, Business Process, Analysis, Healthcare, Testing, Management, Microsoft SQL Server, Software Project..., Vendor Management, Strategic Planning, Access, Visio, SharePoint, HIPAA, IT Strategy, Crystal Reports, Enterprise Architecture, Database Design, Systems Analysis, Agile Project Management, Solution Architecture, Data Analysis, SQL, PMP, Strategy, Business Requirements, Resource Management, Data Warehousing, ASP.NET, IT Management, Software Development, Requirements Gathering, PMO, Security, MS Project, Cross-functional Team..., Change Management, Agile Methodologies
Education
University of Houston-Clear Lake 1999 — 2001
Masters Degree, Software Engineering
University of Mumbai 1993 — 1997
Bachelor of Engineering, Computer Engineering
The University of New Mexico 2007 — 2008
Master Certificate, Project Management
Main Event Management Corporation 2010 — 2010
Certification, Model- Netics
Marjie Montano 2000 - Present
City Of Albuquerque February 2012 - July 2013
Mesa Mental Health June 2006 - March 2011
Lovelace Health Plan January 2003 - June 2006
Skills
Teaching, Research, Public Speaking, PowerPoint, Customer Service, Microsoft Excel, Microsoft Office, Microsoft Word, English, Outlook, Strategic Planning, Windows, Administration, Event Planning, Healthcare, Mental Health Counseling, Grief Counseling, Couples Work, EAP Counseling, Psychotherapy, Case Management, Mental Health, Psychology, Treatment, Adolescents, Family Therapy, Behavioral Health, Quality Management, Process Improvement
Education
Brown University 1978 — 1982
Bachelor's degree, Sociology
LexiCode Corporation December 2012 - Present
Transcend Services September 2011 - December 2012
Lovelace Health Plan March 2011 - September 2011
MedQuist September 2007 - February 2011
Skills
CCS, CPC-A, Familar with 3M and..., Dedicated to quality..., Medical Coding, Medical Transcription, ICD-9, Medical Records, Medical Terminology, Inpatient
Education
Career Step 2010 — 2010
Coding Certificate, Inpatient and Outpatient Medical Coding
The University of New Mexico 2000 — 2004
Bachelor of Arts (B.A.), Anthropology
Utica Park Clinic April 2014 - Present
Lovelace Health Plan April 2012 - December 2013
Lovelace Health Plan August 2010 - April 2012
CIGNA Healthcare August 2008 - August 2010
Sandia National Labs August 2004 - August 2008
Skills
Wellness, Disease Management, Case Managment, Health Education, Case Management, Healthcare, Employee Wellness..., Managed Care, Health Insurance, Healthcare Management, Leadership, Behavioral Health, Employee Benefits, Medicare, Training, Behavior Change, Rehabilitation, Health Promotion, Home Care, Medicaid, Public Health, Utilization Management, Hospitals, Nursing, Wellness Coaching
Education
The University of New Mexico
Master of Science (MS), Community Health Education
Lovelace Women's Hospital May 2014 - Present
Lovelace Health Plan June 2010 - May 2014
Lovelace Health Plan June 2010 - November 2011
Verizon Wireless February 2010 - June 2010
Graybar March 2001 - September 2009
Qwest August 1998 - March 2001
Skills
Management, Leadership, Analysis, Customer Satisfaction, Quality Assurance, Testing, Time Management, Access, Customer Service, Coaching, Medicare, Medicaid, Call Center Development, Networking, Troubleshooting, HIPAA, Process Improvement, Training
Education
Texas Tech University 1996 — 1997
Course work toward Master's Degree in Technical Theatre, Technical Theatre/Theatre Design and Technology
Eastern New Mexico University 1991 — 1996
Bachelor of Fine Arts (BFA), Technical Theatre/Theatre Design and Technology
UnitedHealth Group March 2015 - Present
New Mexico Department of Health September 2012 - 2015
UNM September 2008 - July 2012
Cedar Creek Consulting July 2007 - September 2008
Molina Healthcare July 2006 - August 2007
Lovelace Health Plan September 2001 - August 2006
Presbyterian Medical Services August 1994 - September 2001
Skills
Government, Community Outreach, Prevention, Public Policy, Policy, Program Management, Nonprofits, Program Development, Grant Writing, Policy Analysis, Program Evaluation, Community Development, Public Speaking, Fundraising, Local Government, Public Relations, Strategic Communications, Case Management, Social Services, Media Relations, Medicaid Managed Care, Healthcare Management, Healthcare improvement, Nursing, Management, Project Management, Medical Staff..., Medicare Advantage, Marketing, Development Of Employees, Public Health Education, Health Education, Leadership Development, Healthcare, Public Health
Education
New Mexico State University 2014 — 2016
Master's of Public Health, 3.7
New Mexico State University 2005 — 2007
Bachelor Human and Community Services, Health/Health Care Administration/Management
New Mexico State University 1984 — 1991
Nursing
ABQ Health Partners August 2014 - Present
ABQ Health Partners June 2012 - Present
ABQ Health Partners May 2010 - December 2012
Lovelace Health Plan August 2008 - May 2010
BR Gordon Construction Company, Inc July 2004 - January 2008
Presbyterian Healthcare Services August 1998 - July 2003
Skills
Healthcare, HIPAA, Managed Care, Medicare, Provider Relations, Medicaid, Healthcare Management, Revenue Cycle, Healthcare Industry, Construction, Process Improvement, Physician Relations, EHR, Health Insurance, Medical Billing, Budgets, Strategic Planning, Leadership, Contract Negotiation, Team Building, Contract Management, Employee Relations, Microsoft Excel, Data Analysis, Network Development, Vendor Management, Microsoft Office, Project Planning, HMO, Claim, Customer Service
Education
University of Phoenix 2012 — 2014
Bachelor of Science (BS), Business Administration and Management, General
La Cueva High School 1988 — 1991
New Mexico State University
Presbyterian Healthcare Services October 2014 - Present
Lovelace health plan April 2012 - June 2014
Hcsc Blue Cross Blue Shield of New Mexico August 2009 - February 2012
Skills
Claim, Employee Benefits, Hospitals, Healthcare Information..., Medical Terminology, Medicare, HIPAA, Healthcare Management, Nursing, Health Insurance, Healthcare, Insurance, Medical Billing
Education
Carrington College-Albuquerque 2014 — 2016
Registered Nursing/Registered Nurse
Central New Mexico Community College
WellCare Health Plans December 2014 - Present
Deloitte Consulting LLP January 2014 - December 2014
Lovelace Health Plan October 2012 - December 2013
MVP Health Care 2011 - October 2012
MVP Health Care September 2007 - August 2011
MVP Health Care May 2005 - August 2007
Keane 1996 - 2005
Kemper Insurance 2000 - 2001
General Electric 1986 - 1993
Skills
Business Process..., Management, Business Analysis, Healthcare, Health Insurance, Project Management, Vendor Management, Insurance, Business Requirements, Process Improvement, SDLC, Medicare, Requirements Gathering, Requirements Analysis, Program Management, Project Planning, Training, Visio, Change Management, PMP, Provider Relations, PMO, Analysis, Business Process, HIPAA, Software Documentation, Data Analysis, Business Development, Integration, Quality Assurance, Cross-functional Team..., Healthcare Industry, Human Resources, Technical Writing, Risk Management, Business Intelligence, Healthcare Information..., Managed Care, Leadership, Project Portfolio..., Resource Management, Testing
Education
State University of New York College of Environmental Sciences and Forestry 1993 — 1995
MS, Environmental Science/Information Systems
University of San Francisco 2009 — 2010
Master Certificate, Internet Marketing
Le Moyne College
BS, Management of Information Systems
University of New Mexico March 2015 - Present
University of New Mexico January 2013 - Present
University of New Mexico February 2015 - May 2015
Global Mamas February 2014 - May 2014
Lovelace Health Plan October 2008 - December 2013
Skills
Insurance, HMO, Process Improvement, Health Insurance, Healthcare Industry, Training, Medicare, Medicaid, Healthcare, Strategic Planning, Teaching, Software Documentation, Project Management, Microsoft Office, Project Planning, Health Education, Journalism, Blogging, Lesson Planning
Education
The University of New Mexico 2013 — 2015
Express Scripts June 2014 - Present
Lovelace health plan December 2012 - June 2014
Lovelace Health System December 2011 - November 2012
Lovelace Health System September 2007 - 2011
Lovelace Health System July 2002 - August 2007
Walgreens June 2001 - June 2007
Skills
Pharmacy Benefit..., Pharmacy, Pharmacists, Clinical Research, Medicare, Managed Care, Utilization Management, Medicare Part D, Medicaid, Pharmacy Automation, Disease Management, Clinical Trials, Nursing, Health Policy, Medication Therapy..., Healthcare
Education
University of New Mexico College of Pharmacy 2004 — 2009
Doctor of Pharmacy (PharmD), Pharmacy
University of New Mexico College of Pharmacy 1994 — 1998
Bachelor of Science Pharmacy, Pharmacy
The University of New Mexico 1990 — 1998
Bachelor's degree, Biology, General
Lovelace Womens Hospital July 2015 - Present
Lovelace Medical Group/Southwest Medical Associates February 2014 - September 2014
Lovelace Health Plan February 2011 - January 2014
Lovelace Health Plan January 2009 - February 2011
Lovelace Health Plan March 2008 - January 2009
Skills
Health Insurance, Change Management, Employee Benefits, Human Resources, HIPAA, Medicaid, Insurance, Benefits Administration, Healthcare, Process Improvement, Policy, Performance Management, Training, Payroll Administration, Employee Counseling, OSHA Record Keeping, FMLA Administration, Event Planning, Conflict Resolution, Employee Relations, Time Management, New Hire Orientations, Organizational..., Software Documentation, Employee Engagement, Leadership, Onboarding, Workforce Planning, Leadership Development, Deferred Compensation, Personnel Management, HR Policies, FMLA, Payroll, Team Building, Hiring, Performance Appraisal, Management, Succession Planning, Talent Acquisition
Education
National American University-Albuquerque 2012 — 2017
Bachelors of Business Administration, Human Resources Management/Personnel Administration, General, Currently attending
National American University-Albuquerque 2012 — 2015
Bachelor's degree, Human Resources Management/Personnel Administration, General
Lovelace Medical Center and New Mexico Heart Hospital April 2013 - Present
Lovelace health Plan 2012 - 2014
Good Samaritan Medical Center December 1999 - April 2011
Skills
Healthcare, Hospitals, Customer Service, Community Outreach, Case Managment, Public Speaking, Microsoft Office, Mental Health, Non-profits, Research, Leadership, Healthcare Management, Utilization Management, Social Services, Acute Care, Critical Care, Medical/Surgical, Patient Safety, Patient Advocacy, EMR, Physician Relations, Clinical Research, Nonprofits, Home Care, Healthcare Information..., Disease Management, Managed Care, Nursing, Inpatient, Medicare, Medicaid
Education
University of Phoenix-San Diego Campus 1994 — 1996
BSN, Registered Nursing/Registered Nurse, Very High
Palomar College 1989 — 1991
ADN, Registered Nursing/Registered Nurse
California State University-Long Beach 1972 — 1976
Bachelor of Arts, Business Administration and Management, General
UNM Hospitals February 2013 - Present
Lovelace Health Plan April 2011 - February 2013
Moss Adams LLP January 2003 - March 2011
Skills
Internal Controls, Accounting, Financial Reporting, US GAAP, CPA, Auditing, SEC filings, Financial Analysis, Assurance, Financial Accounting, Financial Statements, GAAP, General Ledger, Insurance, Internal Audit, Microsoft Excel, Revenue Recognition, Sarbanes-Oxley Act
Education
The University of New Mexico 1999 — 2002
Bachelor of Business Administration (BBA), Accounting
Colorado HealthOP May 2014 - Present
New Mexico Health Connections October 2012 - April 2014
Lovelace Health Plan August 2009 - October 2012
UnitedHealthcare January 2007 - August 2008
Platinum Insurance Agency November 2006 - December 2007
Lovelace Health Plan September 2004 - November 2006
Health Care Horizons, Inc. January 1995 - September 2004
Skills
Business Analysis, Project Delivery, Program Management, Vendor Management, Requirements Analysis, Project Management, MS Project, Process Improvement, Resource Management, Requirements Gathering, Insurance, Management, Employee Benefits, Change Management, Team Building, Health Insurance, Sales, Cross-functional Team..., Software Documentation, Leadership, Healthcare, Managed Care
Education
Central New Mexico Community College 2002 — 2004
New Mexico Institute of Mining and Technology 1993 — 1995
UNM Continuing Education January 2015 - Present
Lovelace Medical Group August 2014 - Present
Dermatology & Skin Cancer Center of New Mexico January 2014 - July 2014
Lovelace Health Plan April 2012 - January 2014
American Toyota June 2011 - April 2012
Vanderstyne Toyota July 2005 - May 2011
Sylvan Learning Center 1999 - 2003
Skills
Medical Coding, Auditing, ICD-9, CPT, HIPAA, E/M coding, EHR, Healthcare, Healthcare Management, Medicare, Revenue Cycle, Software Documentation, Process Improvement, Managed Care, Healthcare Information..., Medicaid, Cerner, Hospitals
Education
The University of New Mexico 2011 — 2011
Medical Billing and Coding
Nazareth College 1995 — 1998
M.S. Ed, Secondary English Education
SUNY Binghamton
Bachelor of Arts, English
Lovelace Medical Group March 2014 - Present
Lovelace Health Plan June 2010 - April 2014
Kforce September 2009 - April 2010
Elkhart Clinic October 2000 - February 2008
Skills
Medicare, HIPAA, Health Insurance, Insurance, EHR, Healthcare, Healthcare Information..., Healthcare Consulting, Process Improvement, Software Documentation, Hospitals, Medical Coding, Medical Records, Medicare Advantage, Credentialing, Data Analysis, Training, CPT, Disease Management, Health Policy, Medical Compliance, Health Information..., HMO, Healthcare Industry
Education
University of Phoenix 2013 — 2015
Bachelor of Science (BS), Health/Health Care Administration/Management, Currently 4.0
Ball State University 1992 — 1994
Speedway High School 1988 — 1992
Christus St. Vincent October 2014 - Present
Lovelace Health Plan March 2013 - July 2014
Lovelace Health System October 2011 - March 2013
Lovelace Health System June 2010 - September 2011
Lovelace Health System January 2010 - May 2010
Lovelace Health System October 2008 - December 2009
Skills
Process Improvement, Program Management, Requirements Gathering, Claim, HIPAA, Vendor Management, Managed Care, Health Insurance, Provider Relations, Software Documentation, Health Policy, Utilization Management, Healthcare, Employee Benefits, Management, Medicaid, Healthcare Information..., Medicare
Education
Oregon State University 2003 — 2008
Bachelor of Science (B.S.), Human Development, Family Studies, and Related Services
American General Media March 2012 - Present
Lovelace Health Plan May 2009 - March 2012
Lovelace Health Plan November 2006 - March 2012
Lovelace Health Plan November 2006 - May 2009
Clear Channel Communications September 2004 - November 2006
Delta Zeta Sorority May 2004 - September 2004
New Mexico State University October 2000 - May 2004
Education
New Mexico State University
Bachelor of Arts (B.A.), Communication, Journalism, and Related Programs
Tesoro Corporation June 2015 - Present
Spurs Sports & Entertainment January 2012 - June 2015
Air Force Personnel Center July 2010 - January 2012
Spurs Sports & Entertainment January 2010 - July 2010
Lovelace Health Plan May 2008 - July 2009
ABQ Health Partners October 2006 - May 2008
City of San Angelo January 2000 - July 2006
Skills
Customer Service, Windows, Microsoft Office, Microsoft Excel, Microsoft Word, PowerPoint, Outlook, Photoshop, Research, Human Resources, HRIS, HIPAA, Employee Benefits, Time Management, Event Planning, Fast-paced, Communication Skills, Critical Thinking, Detailed Organization, Highly detail oriented, English, Proofreading, Accurate Data Entry, Typing, Web Design, Event Management, Data Entry, Organization, Social Networking
Education
Park University 2013 — 2016
Bachelor's Degree, Human Resource Management
Central New Mexico Community College 2007 — 2009
Stericycle February 2014 - Present
Self Serve September 2011 - October 2014
Lovelace Health Plan October 2011 - February 2014
True Self Counseling July 2010 - October 2011
University of New Mexico April 2008 - October 2011
Comforce Staffing Services September 2007 - March 2008
Skills
Microsoft Excel, Microsoft Office, Public Speaking, Instructional Design, Healthcare, Program Development, Fundraising, Analysis, Non-profits, Community Outreach, Event Planning, Technical Writing, Curriculum Development, Leadership Development, Public Relations, Photoshop, Coaching, Adult Education, Project Planning, Performance Improvement, Team Building, Leadership, Social Media Marketing, Marketing, Contract Negotiation, Social Media, Curriculum Design, Program Management, Higher Education, Program Evaluation, Organizational..., Process Improvement, PowerPoint, Negotiation, Software Documentation, Teaching, Distance Learning, Editing, Captivate, Performance Management, Outlook, Customer Service, E-Learning, Training, Strategic Planning, Staff Development, Workshop Facilitation, Change Management, Instructional Technology, Management
Education
The University of New Mexico 2010 — 2012
MA, Organizational Learning and Instructional Technology
University of Illinois at Urbana-Champaign 2003 — 2007
BS, Community Heath Education and Promotion
Cardon Outreach 2014 - Present
Lovelace Health Plan April 2012 - Present
Outcomes Health February 2010 - July 2011
LifeMasters Self Supported Healthcare, Inc April 2004 - February 2010
Accenture Consulting I Call Center Operations I CRM 2002 - 2003
Sprint PCS Customer Care June 1998 - July 2001
AT&T Wireless 1994 - 1998
Skills
Strategy, Call Center, CRM, Process Improvement, Business Process, Coaching, Strategic Planning, Change Management, Budgets, Start-ups, Customer Experience, Organizational..., Customer Satisfaction, Product Development, Business Strategy, Program Management, Management, Leadership, ICD-9, Team Building, Health Insurance, BPO, Business Process..., Healthcare, Vendor Management, Product Management, Analytics, Outsourcing, SaaS, Analysis, Call Centers, Business Intelligence, Operations Management, Sales, Cross-functional Team..., Customer Service, Team Leadership, Enterprise Software, Project Management, Performance Management, Training, HIPAA, Executive Management, Six Sigma, Healthcare Information..., Business Development, Medicare, Consulting, Mentoring
Education
The University of New Mexico 1970 — 1978
Business Administration
Express Scripts April 2014 - Present
Lovelace Health Plan July 2012 - April 2014
Lovelace Health Plan April 2011 - July 2012
Lovelace Health Plan October 2006 - March 2011
Lovelace Health System April 2003 - October 2006
Skills
Pharmacy Benefit..., Medicare Part D, Medicare Advantage, Medication Therapy..., Pharmacy, Rebates, Medicare Prescription..., Medicare Stars, Medicaid, Clinical Pharmacy, Medicaid Managed Care, HEDIS, Formulary, NCQA, Managed Care, Medicare
Education
The University of New Mexico 1994 — 2002
Doctor of Pharmacy (Pharm.D.), Pharmacy
Lovelace Health Plan November 2009 - December 2013
Lovelace Health Plan June 2008 - November 2009
Accounting Principals February 2008 - June 2008
Walgreens December 2007 - March 2008
CC&G Company, LLC February 2007 - November 2007
Skills
Bilingual: Spanish;..., Completed 32hrs of..., Trainer - Mental Health..., Computer Skills:..., Software Knowledge:..., Horizon Physician...
Education
The University of New Mexico
n/a
Marana Healthcare March 2015 - Present
American Lung Association January 2013 - March 2015
Cenpatico Behavioral Health of Arizona, LLC 2015 - 2015
Cenpatico Behavioral Health of Arizona, LLC 2015 - 2015
Cenpatico Behavioral Health of Arizona, LLC 2015 - 2015
Lovelace Health Plan October 2011 - July 2012
Ready Set Go (owner) October 2002 - December 2011
StayWell Health Management February 2009 - June 2011
LifeMasters (purchased by StayWell Health Management) June 2008 - February 2009
UNM Prevention Research Center July 2003 - June 2008
Skills
Instructional Design, Systemic Change, Certified Professional..., College Teaching, Learning Management, Disease Management, Training Needs Analysis, Program Evaluation, Motivational..., Project Management, Training, Health Education, Psychotherapy, Leadership, E-Learning, Healthcare, Program Management, Public Health, Teaching, Program Development, Organizational..., Process Improvement, ADDIE, Clinical Research, Case Management, Workshop Facilitation, Adult Education, Public Speaking, Strategic Planning, Coaching, Nonprofits
Education
Eastern Illinois University 1987 — 1989
MA, Clinical Psychology
Miami University 1984 — 1986
BA, Psychology
New Mexico Environment Department June 2014 - Present
Lovelace Health Plan February 2013 - January 2014
Self Employed November 2011 - February 2013
GSA July 2010 - December 2011
Los Alamos National Laboratory May 2005 - August 2009
RhinoCorps September 2003 - May 2005
Ethicon Endo-Surgery 1994 - 2000
Skills
Java, JavaScript, SQL Server, Databases, Software Development, Data Warehousing, DB2, XML, HTML, PL/SQL, SQL, Application Development, Programming, Requirements Analysis, Unix, Linux, C, Windows, CSS, Visio, Systems Analysis, PowerBuilder, ColdFusion, Microsoft SQL Server, Oracle, Database Design, Software Project..., Integration, IT Service Management, IT Strategy, IT Operations, Visual Basic, C#, VB.NET
Education
The University of New Mexico - Robert O. Anderson School of Management 2002 — 2004
MBA, Business Administration
San Diego State University-California State University 1982 — 1985
BA, Computer Science
Presbyterian Healthcare Services September 2014 - Present
ACS, A Xerox Company, Government Healthcare Solutions January 2012 - August 2014
Lovelace Health Plan October 2007 - January 2012
Lovelace Health Plan December 2004 - October 2007
Health Care Horizons/Molina Healthcare April 2003 - December 2004
Health Care Horizons November 2002 - April 2003
Health Care Horizons September 2000 - November 2002
Healthcare Horizons May 1997 - September 2000
Lovelace Health Plan July 1995 - May 1997
Skills
Medicare, Medicaid, Healthcare, Managed Care, Health Insurance, Provider Relations, Process Improvement, HIPAA, Healthcare Management, Insurance, Claim, Healthcare Information..., Data Analysis, Customer Service, Strategic Planning, Team Building, Software Documentation, Health Policy, Healthcare Consulting, Network Development, Hospitals, Training, Medical Billing, EMR, Disease Management, Account Management, Revenue Cycle, HMO, Policy, Healthcare Industry, Credentialing, Utilization Management, EHR, Management, Leadership, Medicare Part D, Vendor Management, Medical Compliance, Program Management, Budgets, CRM, Physicians, PPO, Strategy, Time Management, Call Centers, Quality Improvement, Claims Resolution, Physician Relations, Employee Benefits
Education
Lake Forest College 1991 — 1995
BA, Sociology; Anthropology and French
Centre d'Etudes Françaises 1994 — 1994
Santa Fe High School 1987 — 1991
New Mexico Heart Institute May 2014 - May 2015
Lovelace Health Plan May 2011 - January 2014
Presbyterian Healthcare Services March 2005 - May 2011
Presbyterian Healthcare Services April 2001 - March 2005
Presbyterian Healthcare Services July 1998 - April 2001
Cigna August 1996 - April 1998
Skills
Process Improvement, Vendor Management, Integration, IT Strategy, Leadership, Information Technology, Project Management, Management, Security, Project Planning, Business Process, Telecommunications, Training, Strategic Planning, Networking, Budgets, Analytics, Technical Support, Service Delivery, -DRBC Planning and..., Creative Problem..., Cost..., Team Enrichment, HIPAA, ICD-10, Facets, Medicaid Managed Care, Medicare
Education
Wayland Baptist University 1993 — 1994
Bachelor of Sciences, Business Administration; Minor: Economics
Texas Tech University 1988 — 1992
University of New Mexico Hospital May 2014 - Present
Albuquerque Public Schools August 2007 - August 2013
Albuquerque Public Schools January 2007 - May 2007
Farmers Insurance Company November 2004 - July 2006
Lovelace Health Plan October 2002 - July 2004
Sparton Technology, Inc October 1999 - September 2002
Sandia National Laboratories June 1998 - August 1999
University of New August 1996 - June 1997
Enterprise Rent-A July 1994 - July 1995
Morgan Stanley May 1993 - April 1994
Skills
Public Speaking, Customer Service, Analysis, Microsoft Office, Auditing, Accounting, Research, Editing, Cost Accounting, Cost Variance Analysis, Cost analysis, Financial Analysis, Manufacturing, Activity Based Costing, Routers, bills of materials, Bill of labor, ERP Software, Investments, Inventory Analysis, Cost Benefit, Microsoft Word, Curriculum Design, Microsoft Excel, Nonprofits, Bill of Materials, Teaching, PowerPoint
Education
Robert O. Anderson Schools of Management, University of New Mexico 1995 — 1997
Master, Business Administration; Financial Management and Production and Operations Management
The University of New Mexico 1995 — 1997
MBA, Finance, Accounting, Operations and Business, 4.0
Robert O. Anderson Schools of Management, University of New Mexico 1986 — 1992
Bachelor, Business Administration; Financial Management
Medwise Partners January 2005 - Present
Priority Health March 2011 - February 2014
Lovelace Health Plan January 2004 - January 2005
Mayo Clinic May 2001 - January 2004
Anthem BCBS / Wellpoint November 1990 - May 2001
Skills
Financial Modeling, Insurance, Underwriting, Strategic Financial..., Financial Analysis, Corporate Finance, Commercial Insurance, Finance, Risk Management, Reinsurance, Due Diligence, Portfolio Management, Mergers & Acquisitions, Executive Management, Health Insurance, Strategic Human...
Education
Butler University 1997 — 2000
MBA
University of Notre Dame 1983 — 1987
BBA, Finance
TriZetto Corporation October 2013 - Present
Lovelace Health Plan January 2012 - October 2013
Lovelace Health Plan June 2001 - December 2011
Lovelace Sandia Health System May 1997 - June 2001
UnitedHealthcare July 1992 - May 1997
International House of Pancakes July 1988 - May 1992
Skills
Access databases, Word, Facets Rate..., Excel, Project Management, Process Scheduler, Insurance, Healthcare, Process Improvement, Access, Hospitals, Microsoft Excel, Outlook, Leadership, Employee Training, Team Leadership, Customer Satisfaction, Microsoft Word, Data Analysis, Claim, Management, Software Documentation, Team Building, Healthcare Management, Troubleshooting, Testing, Requirements Analysis
Education
CNM
The University of New Mexico
State of New Mexico August 2014 - Present
Albuquerque Museum Foundation February 2014 - July 2014
Lovelace Health Plan March 2011 - January 2014
Holy Cross Hospital 2005 - 2010
Questa Independent Schools August 2001 - June 2005
Presbyterian Healthcare Services June 1998 - July 2001
Skills
Technical Writing, Project Management, Certified Fund Raising..., Teaching Writing, College Teaching, Business English, Qualified Teacher, event planning, Strategic Planning, Marketing Communications, Corporate Communications, Event Planning, Teaching, Public Relations, Program Management, Writing, Cross-functional Team..., Proposal Writing, Leadership, Project Planning, Visio, Organizational..., Change Management, Access, Microsoft Office, Data Analysis, Process Improvement, Provider Relations, Training, Management, Team Leadership, Healthcare, Leadership Development
Education
The University of Texas at Austin 1978 — 1981
JD, Law
University of North Texas 1985 — 1987
MA, English, History, 4.0 GPA (4.0 scale)
The University of Texas at Austin 1975 — 1978
BA, History, 3.75 GPA (4.0 Scale) Cum Laude
Holy Trinity Episcopal Academy June 2012 - Present
Lovelace Health Plan February 2011 - July 2012
Santa Ana Star Casino September 2007 - February 2011
Santa Ana Star Casino July 2006 - September 2007
REDW, LLC January 1999 - July 2006
Skills
Budgets, General Ledger, Payroll, GAAP, Tax, Strategic Planning, Financial Reporting, Financial Statement..., Accounts Payable, Auditing, Human Resources, Customer Service, Internal Controls, Gaming Industry, Health Insurance, CPA, Strategic Leadership, Account Reconciliation, Accounts Receivable, Finance, Internal Audit
Education
The University of New Mexico - Robert O. Anderson School of Management 1996 — 1998
BBA, Accounting
Presbyterian Healthcare Services April 2014 - Present
Lovelace Health Plan October 2012 - Present
Sun Healthcare Group May 2010 - October 2012
New Mexico Student Loans January 2010 - May 2010
Intel Corporation October 2000 - January 2008
Skills
GAAP, Financial Reporting, Financial Analysis, Financial Accounting, Internal Controls, General Ledger, Accounting, Cost Accounting, Internal Audit, Account Reconciliation, Managerial Finance, CPA, Forecasting, Budgets
Education
The University of New Mexico
Bachelor of Business Administration (BBA), Accounting
McCormack Consultants, Inc. September 2015 - Present
Lovelace Health Plan April 2012 - December 2014
Lovelace Health Plan March 2013 - August 2013
Lovelace Health Plan April 2012 - March 2013
QualityLogic November 2009 - March 2012
BBW Capital February 2009 - September 2009
Life Simplified, LLC June 2003 - January 2009
Skills
Projects, Social Skills, Organization, Project Management, Microsoft Excel, Public Speaking, Leadership, PMO, Project Planning, Time Management, Customer Service, Team Leadership, Business Development, Public Relations, Research, Quality Assurance, Sales, Management, Process Improvement
Education
San Francisco State University 1993 — 1995
BA, Journalism
Landmark Education
California State University-Northridge
Journalism
Youth Music Initiative 2014 - 2015
OptumHealth New Mexico March 2009 - March 2014
Lovelace Health Plan 2006 - 2008
AmeriChoice 1996 - 2004
Medicus Systems 1980 - 1986
Skills
Managed Care, Healthcare, Healthcare Management, Medicaid, Health Insurance, Provider Relations, Program Management, Medicare, HIPAA, Health Policy, Medicaid Managed Care, Behavioral Health, Quality Improvement, Team Building, Utilization Management, Healthcare Consulting, Disease Management, HMO, Medicare Part D, Healthcare Industry, Software Documentation, Revenue Cycle, Credentialing, Healthcare Information..., Medical Compliance, Network Development, PPO, Case Managment, Accreditation, Physician Relations, Hospitals, EMR, EHR, Physicians, Policy, Employee Benefits, Home Care, Claim, Case Management
Education
Claremont Graduate University
MA, Government and Finance
Syracuse University - Maxwell School of Citizenship and Public Affairs
none, public administration
University of Miami
BA, Government
Presbyterian Healthcare Services July 2012 - Present
UPS June 2012 - July 2013
ElderCare Financial Solutions November 2010 - November 2011
Ambercare June 2010 - October 2010
Lovelace Health Plan September 2006 - September 2009
Apple Accounting January 2006 - June 2006
Hardin Memorial Hospital July 2002 - May 2004
OptionCare Home Health Infusion June 2000 - May 2001
Education
University of Phoenix
Masters, Business Administration
EDUCATIONAL TRAINING
The University of New Mexico
Bachelor of Science, Biology and
Verisk Health January 2014 - Present
Lovelace Health Plan June 2012 - January 2014
Strategic Analytics July 2010 - June 2012
ING May 2007 - June 2009
Prudential Financial June 2005 - May 2007
Skills
Actuarial Science, Financial Risk, Risk Management, Credit Risk, Analysis, Analytics, Valuation, Financial Analysis, Insurance, Financial Modeling, Statistics, Access, Leadership, Investments
Education
Georgia State University 2003 — 2005
MAS, Actuarial Science
Georgia Institute of Technology 1999 — 2003
BS, Math, Economics, Physics
Vantage Oncology February 2014 - Present
Lovelace Health Plan December 2010 - August 2013
UnitedHealthcare March 2007 - April 2010
Concentra September 2001 - March 2007
Bell Canada Enterprises (United Payors & United Providers) August 1998 - September 2001
Independant Consultant October 1997 - December 1998
First Health September 1993 - October 1997
Skills
Executive Management, Business Strategy, Turnaround Experience, Growth Strategies, Culture Change, Organizational Culture, Microsoft Office, Insurance, Strategic Partnerships, Leadership, Medicare, PowerPoint, Strategy, Mergers & Acquisitions, Business Development, Outsourcing, Marketing, Budgets, Healthcare, Microsoft Excel, Management, Employee Benefits, Strategic Planning, Sales, Analysis, Health Policy, Physicians, Marketing Strategy, Microsoft Word, Managed Care, Medicaid, Customer Service
Education
University of Pennsylvania 1989 — 1993
Business, Management, Marketing, and Related Support Services
Purdue University 1985 — 1986
Certified Health Consultant, Health Care Finance and Management
New Mexico Health Insurance Exchange April 2015 - Present
New Mexico Health Insurance Exchange June 2014 - April 2015
Lovelace Health Plan December 2010 - May 2014
Lovelace Health Plan December 2007 - December 2010
Lovelace Health Plan April 1996 - December 2007
FHP of New Mexico March 1991 - April 1996
New Mexico Family Practi June 1988 - March 1991
Skills
Medicare, Management, Medicaid, Process Improvement, Health Policy, Insurance, Healthcare, Enrollment Management, Data Analysis, PMO, Employee Benefits, Health Insurance, Project Management, Leadership Development, Social Services, Managed Care, Leadership, HIPAA, Strategic Planning, Healthcare Industry, Healthcare Management, Healthcare Consulting, Revenue Cycle, Training, Healthcare Information..., Public Speaking, Software Documentation, Customer Service, Vendor Management, Organizational..., Change Management, Business Analysis, Hospitals, Analysis, Team Building, Program Management
Education
University of New Mexico-Valencia County Campus 1987 — 1988
Business Technology
New Mexico State University 1981 — 1982
Communication, Journalism, and Related Programs
Los Lunas High School
Atrinea Health September 2015 - Present
Atrinea Health LLC May 2014 - Present
Atrinea Health LLC July 2013 - April 2014
Lovelace Health Plan March 2012 - July 2013
Presbyterian Healthcare Services October 2010 - December 2011
Presbyterian Healthcare Services December 2007 - October 2010
Presbyterian Healthcare Services August 2006 - December 2007
Excel Staffing April 2006 - August 2006
Barking Dog Communications, LLC March 2005 - April 2006
Lovelace Health System March 2004 - April 2005
Skills
Health Insurance, Credentialing, Healthcare, Microsoft Office, Provider Enrollment, Data Analysis, Delegation Oversight..., Dispute Resolution, Professional..., Data Entry, Analysis, Medicaid, Process Improvement, Health Policy, Medicare, Provider Relations, Physicians, Medicine, Revenue Cycle, Healthcare Management, HIPAA, Healthcare Consulting, Hospitals, Epic Systems, Healthcare Industry, Medical Coding, Meditech, Medical Records, ICD-9, Health Information..., Medical Billing, EHR, Medical Terminology, EMR, Quality Improvement, CPT, Managed Care, Cerner
Education
The University of New Mexico 1984 — 1986
None, Fine and Studio Arts
Invoca June 2015 - Present
Turing School of Software & Design October 2014 - May 2015
CNM - Central New Mexico Community College May 2012 - August 2014
Lovelace Health Plan October 2011 - February 2012
Grant Thornton LLP September 2010 - April 2011
First Community Bank March 2009 - September 2010
Toastmasters 2009 - 2010
Skills
Financial Accounting, Internal Audit, Sarbanes-Oxley Act, Financial Reporting, Project Management, Process Improvement, Process Automation, SQL Report Writing, Federal Grants..., Grant Monitoring, JavaScriptMVC, Ruby, Strategic Planning, Finance
Education
The University of New Mexico - Robert O. Anderson School of Management 2008 — 2010
Masters, Accounting, 4.0
Turing School of Software & Design
University of Florida
HealthInsight July 2009 - Present
Lovelace Health Plan January 2006 - June 2009
Capital One June 2005 - August 2006
Skills
Managed Care, Workforce Planning, Report Writing, Public Speaking, Budget Management, Medicaid, Health Insurance, Microsoft Office, Academic Writing, SQL
Education
Union Presbyterian Seminary 2002 — 2005
Master's degree
Presbyterian College 1998 — 2002
Bachelor's degree
Presbyterian Healthcare Services April 2015 - Present
Presbyterian Healthcare Services April 2014 - April 2015
Lovelace Health System March 2013 - April 2014
Lovelace Health Plan March 2012 - March 2013
Red Lobster July 2006 - February 2012
Skills
Medical Staff..., Health Insurance, Communication Skills, Customer Service, Highly detail oriented, Highly Dedicated, Highly Reliable, Fast-paced, Midas Plus, Microsoft Excel, Microsoft Word, PowerPoint, Microsoft Office, ImageNow, SnagIt, Managed Money, Lean Thinking, Dedicated, HIPAA, Healthcare, Healthcare Management, Managed Care, Software Documentation, Process Improvement, Hospitals, Medicare, Medicaid, Credentialing, Strategic Planning, Training, Team Building
Education
The University of New Mexico 2009 — 2011
Bachelor of Arts (BA), Communication, General
Central New Mexico Community College 2006 — 2009
Associate of Arts (AA), Liberal Arts and Sciences/Liberal Studies
Presbyterian Health Plan April 2015 - Present
Presbyterian Health Plan July 2014 - April 2015
Lovelace Health Plan September 2010 - January 2014
Randomville April 2009 - January 2013
Lovelace Health Plan January 2010 - September 2010
Skills
Adobe Acrobat, Outlook, Photoshop, Microsoft Word, InDesign, Microsoft Office, Access, Marketing, Microsoft Excel, SurveyMonkey, GoToMeeting, Constant Contact, Wellness, Project Management, Copywriting, Copy Editing, Event Scheduling, Data Analysis, Reports, Graphic Design, Pick-A-Time, Writing
Education
The University of New Mexico 2003 — 2008
Bachelor of Arts (BA) in Communications & Journalism
Cloud Peak Energy February 2013 - Present
Lovelace Health Plan 2011 - 2013
Loveless Health Plan 2011 - 2013
Focal Point HR 2009 - 2011
Conergy, AG 2006 - 2009
Gap Inc 2001 - 2007
McKesson Pharmaceutical, Financial Services 1999 - 2001
Pennzoil Technology/Jiffy Lube Intl 1981 - 1994
Skills
Talent Acquisition, Performance Management, Executive Coaching, Job Coaching, Talent Management, Employee Relations, Employee Engagement, Employment Law, Succession Planning, Mentoring, Individual Development, Myers-Briggs Certified, HRCI Certified, Personnel Management, Budgets, Change Management, Onboarding, Coaching, Policy, Human Resources, Organizational..., Leadership, Training, Employee Benefits, Management, Leadership Development, New Hire Orientations, Interviews, Staff Development, Payroll, HRIS, Program Management, Workforce Planning, Career Development, Time Management, Performance Appraisal, Benefits Administration, Project Planning, Organizational..., Strategic Planning, Conflict Resolution, Team Leadership, Recruiting, Hiring, Employee Training, Organizational Design, Career Counseling, Deferred Compensation, Strategy, HR Policies
Education
The University of New Mexico - Robert O. Anderson School of Management
Anderson School of Management, Human Resources Management
The University of Texas at El Paso
Pharmacy and Medical Technology
Emergenetics
Lovelace Health Plan September 2008 - June 2014
Skies HealthCare and Rehabilitation April 2006 - February 2008
Turquoise Trail Physical Therapy August 2002 - May 2006
Skills
Medicaid, Disease Management, Utilization Management, Case Management, Medicare, Managed Care, Healthcare, Healthcare Management, Case Managment, Behavioral Health, Health Insurance, Nursing, Hospitals, HIPAA, Medical Records, Employee Benefits, Claims Handling, Healthcare Information..., Claims Resolution, Prior Authorization
Education
Central New Mexico Community College
Seeking BSW Social Work, Social Work
Luna Vocational Technical Institute
Dental Assistant Certificate, Dental Assisting/Assistant
Consumers Mutual Insurance of Michigan May 2015 - Present
Universal American May 2009 - April 2015
Universal American September 2008 - May 2009
Universal American January 2006 - August 2008
Lovelace Health Plan August 2003 - December 2005
TeraHealth July 1999 - August 2003
Fallon Community Health Plan April 1998 - July 1999
Fallon Community Health Plan July 1995 - March 1998
Fallon Community Health Plan 1986 - July 1995
Skills
Microsoft Excel, Microsoft Word, Customer Service, PowerPoint, English, Research, Windows, Outlook, Public Speaking, Budgets, Strategic Planning, Analysis, Forecasting, Finance, Auditing, Financial Reporting, Accounting, Financial Analysis, Sarbanes-Oxley Act, Internal Audit
Education
Clark University 1990 — 1993
Master of Business Administration (M.B.A.), Accounting
College of the Holy Cross 1983 — 1987
Bachelor of Arts (B.A.), Economics
Molina Healthcare of New Mexico May 2015 - Present
Magellan Healthcare May 2013 - March 2015
Lovelace Health Plan April 2003 - April 2013
Lovelace Health Plan April 2001 - April 2003
Presbyterian Health Plan November 2000 - April 2001
CIGNA Behavioral Health July 1998 - November 2000
Charter-Heights Behavioral Health System July 1992 - July 1998
Heights Psychiatric Hospital November 1987 - July 1992
Skills
Healthcare, Medicaid, Medicare, Health Insurance, HIPAA, Healthcare Management, Revenue Cycle, Managed Care, Healthcare Information..., Healthcare Consulting, EMR, Medicaid Managed Care, Medical Terminology, HMO, Claim, Health Policy, Employee Benefits, Provider Relations, Home Care
Education
The University of New Mexico
Master of Arts (M.A.), Communication
University of Albuquerque
Bachelor of Arts (B.A.), History and Political Science
University of New Mexico Emergency Medical Services Academy
HealthMarkets April 2008 - Present
International Mission Board October 2005 - March 2008
Lovelace Health Plan March 2004 - September 2005
Ernst & Young, LLP September 2000 - February 2004
Harris Methodist Health Plan June 1991 - September 2000
Skills
Microsoft Excel, Financial Reporting, SQL, Statistical Data..., Budgets, Access, Business Analysis, Insurance, Health Insurance, Pricing, Team Building, Leadership, Medicaid, Medicare, Analysis, Provider Relations, Management, Managed Care, Process Improvement, Human Resources, Claim, Network Development, Employee Benefits, Health Policy, Healthcare, Sales, Data Analysis, HIPAA, HMO, PPO, Customer Service, Healthcare Industry, Healthcare Information..., Underwriting
Education
Baylor University 1983 — 1987
Bachelor of Business Administration, Finance/Marketing
UnitedHealthcare February 2013 - Present
ikaSystems August 2009 - February 2013
Lovelace Health Plan April 2007 - August 2009
Molina Healthcare 1997 - 2005
Prudential 1991 - 1997
Skills
Health Insurance, Documentation, Integration, Healthcare, HIPAA, Visio, Claims, Medicare, Business Analysis, Data Analysis, MS Project, Excel, Requirements Analysis, Problem Solving, Microsoft Office, Medicaid, Customer Service, SharePoint, Software Project..., PowerPoint, Software Documentation, Claim, SDLC, Healthcare Industry, Healthcare Information..., Process Improvement, Program Management, Microsoft Excel, Training, Project Management, Change Management, Management, Healthcare Information..., Requirements Gathering, Team Leadership, Vendor Management, Business Requirements, Software Implementation, Troubleshooting, Business Intelligence, Databases, Quality Assurance
Education
Central New Mexico Community College 1999 — 2004
no degree, computer science
CompIQ March 2015 - Present
CompIQ August 2013 - March 2015
Lovelace Health Plan March 2013 - August 2013
Lovelace Health Plan October 2011 - March 2013
Lovelace Health Plan January 2010 - October 2011
Blue Cross Blue Shield of New Mexico November 2007 - July 2009
Blue Cross Blue Shield of New Mexico November 2006 - November 2007
Blue Cross Blue Shield of New Mexico February 2005 - November 2006
Blue Cross Blue Shield of New Mexico September 2001 - February 2005
Skills
Employee Benefits, Leadership, Access, Training, Health Insurance, Analysis, Management, Insurance, Process Improvement, HIPAA, Medicare, Customer Service, Healthcare, Claim, Microsoft Excel, Healthcare Management, Managed Care, Project Management, SQL, Behavioral Interviewing, SQL Server Management..., EDI, Filezilla, HTML, Medicaid, Business Analysis, SharePoint, File Servers, Database Design, Relational Databases, CRM, Workflow Management, Product Development, Software Development, T-SQL Stored Procedures, File Transfer, Third Party Vendor..., Health Insurance..., Landscaping, Lawn Care
Education
American InterContinental University 2006 — 2007
Bachelors, Business Administration - Healthcare Management
The University of Texas at El Paso 1992 — 1996
Undergraduate, Psychology, Criminal Justice
Sandia National Laboratories May 2015 - Present
Sandia National Laboratories February 2013 - May 2015
Lovelace Health Plan Albuquerque,NM November 2010 - February 2013
Lovelace Health Plan July 2010 - December 2010
Clifton Gunderson September 2007 - March 2009
Skills
General Ledger, Financial Reporting, GAAP, Accounting, Accounts Payable, Internal Controls, Accounts Receivable, Financial Analysis, Account Reconciliation, Financial Statements, Journal Entries, Accruals, Financial Accounting, Analysis, Invoicing, Finance, Access
Education
The University of New Mexico - Robert O. Anderson School of Management 2003 — 2007
BBA, Finance
The University of New Mexico - Robert O. Anderson School of Management 2003 — 2007
BBA, Accounting
Geneva Community High School
DaVita Healthcare Partners - ABQ Health Partners January 2014 - Present
Lovelace Health Plan June 2010 - June 2014
Genzyme Genetics February 2005 - May 2010
Skills
Analysis, Process Improvement, Leadership, Management, Analytics, SQL, Strategic Planning, Business Intelligence, Team Leadership, Project Management, Business Analysis, Data Analysis, Healthcare Information..., Software Documentation, Visio, Managed Care, Healthcare, HIPAA, Business Process..., Health Policy, Cross-functional Team..., Business Process, Business Objects, Crystal Reports, Requirements Analysis, Access, Vendor Management
Education
The University of New Mexico - Robert O. Anderson School of Management 2007 — 2010
MBA
New Mexico State University 1999 — 2003
Business Computer Systems
TEKsystems September 2013 - Present
Presbyterian Healthcare Services June 2010 - June 2013
Lovelace Health Plan March 2006 - April 2010
New Mexico VA Healthcare System October 2004 - January 2006
West Palm Beach VA Medical Center November 2003 - October 2004
Department of Veterans Affairs June 2001 - November 2003
VA Health Administration Center June 1997 - June 2001
VA Health Administration Center June 1995 - June 1997
VA Health Administration Center June 1993 - June 1995
Department of Veterans Affairs 1986 - June 1993
Skills
Medicare, Medicaid, HIPAA, Health Insurance, Process Improvement, Healthcare Consulting, Medical Compliance, Provider Relations, Medical Billing, Managed Care, Healthcare Management, Human Resources, Insurance, Claim, Healthcare Information..., Home Care, Healthcare Industry, Policy, Health Policy, Revenue Cycle, EHR, Healthcare, Medicare Part D, Disease Management, Network Development, Utilization Management, Credentialing, EMR, Physician Relations, HMO, Hospitals, Physicians, Health Information..., Quality Improvement, Informatics
Education
Eastern Illinois University 1980 — 1985
B.A., History, Social Science, Military Science
Health Ethics Trust
CCP, Compliance
Presbyterian Healthcare Services November 2014 - Present
Presbyterian Healthcare Services November 2012 - November 2014
Lovelace Health Plan January 2009 - November 2012
Delta Dental March 2007 - January 2009
O'Connell & Associates May 2004 - March 2007
Skills
New Business Development, Health Insurance, Dental Insurance, Life Insurance, Disability Insurance, HRAs, FSA, COBRA, Advertising Sales, Advertising, Copywriting, Corporate Communications, Direct Sales, Sales, Medicare, Customer Service, Employee Benefits, Healthcare, Insurance, Leadership, Management, Medicaid, Negotiation, Selling, Strategic Planning, Brokers, Budgets, Healthcare Industry, Account Management, Cold Calling
Education
Providence College 1999 — 2003
BS, Marketing
Providence Country Day School 1995 — 1999
High School
LeanAnalytics.com, LLC August 2013 - Present
Aetna July 2012 - August 2013
Lovelace Health Plan September 2009 - June 2012
Axene Health Partners, LLC 2009 - September 2009
MHN 2003 - 2008
MHN: a Health Net Company 2003 - 2008
Health Net 2003 - 2007
Towers Perrin July 1999 - April 2003
Milliman 1995 - 1999
Ernst & Young 1994 - 1995
Skills
Analytics, Analysis, Data Analysis, Insurance, Healthcare, Strategic Planning, Financial Modeling, Business Strategy, Forecasting, Risk Management, Pricing, Predictive Analytics, Healthcare Management, Contract Negotiation, Predictive Modeling, Underwriting, Enterprise Risk..., Business Intelligence, Complex System Modeling, Care Management, Benchmarking, Data Models, Pay For Performance, Decision Trees, Competency Mapping, Organizational Change, Risk, Expert Witness, Statements of Actuarial..., Government Programs, CMS Innovation Awards, Health & Welfare
Education
California State University-Fullerton 1976 — 1981
BA
Troy High School, Fullerton 1972 — 1976
Iron Mountain April 2012 - Present
CVTY August 2007 - October 2011
Lovelace Sandia Health System November 2006 - August 2007
Lovelace Health Plan January 2005 - November 2006
United Health Care 1996 - 2005
Skills
Training, Managed Care, Leadership, Employee Benefits, Medicaid, Process Improvement, Health Insurance, Customer Service, Business Process..., Medicare, Management, Healthcare, Strategic Planning, Employee Relations
Education
State University of New York - System
Lovelace Health Plan September 2009 - October 2011
Lovelace Health Plan March 2009 - September 2009
Structured Portfolio, Inc. January 2004 - September 2009
National American University June 2004 - January 2009
Charles Stephen and Company, Inc. September 2001 - August 2003
ProLaw Software - now a division of Thomson Reuters 1999 - 2001
Eastside Gymnastics, Inc. 1990 - 1997
Skills
Financial Modeling, Data Modeling, Variance Analysis, Excel, Financial Analysis, Financial Reporting
Education
The University of New Mexico - Robert O. Anderson School of Management 1999 — 2005
MBA, 3.74
Michigan State University
BA, Economics
University of New Mexico January 2013 - Present
e-Controller, Inc. December 2011 - September 2012
Lovelace Health Plan March 2010 - February 2011
Select Portflio Servicing 2002 - 2010
Skills
Financial Analysis, Financial Reporting, Accounting, Forecasting, Access, Process Improvement, Business Objects, Budgets, Payroll, Analysis, Cash Management, Microsoft Excel, Data Analysis, Business Analysis, Finance, Crystal Reports, Hyperion Enterprise, Accounts Receivable, Variance Analysis, Software Documentation, Management, Financial Modeling, Business Process...
Education
New Mexico State University 2010 — 2012
MBA, Business Administration
Utah State University - Jon M. Huntsman School of Business 2007 — 2009
BS, Business Administration
Salt Lake Community College 2003 — 2007
Associate of Science (A.S.), Business
New Mexico Sinus Institute October 2014 - Present
New Mexico Sinus Institute October 2012 - Present
Lovelace Health System 2006 - October 2012
Lovelace Health Plan 2006 - 2009
Skills
Healthcare, Medicare, Insurance, Managed Care, Healthcare Information..., Leadership, Healthcare Management, Medicaid, Marketing, PowerPoint, Hospitals, Strategic Planning, Marketing Strategy, Process Improvement, Software Documentation, Sales, Newsletters, Management, Physician Relations, Healthcare Consulting, Health Insurance, Creative Direction, Public Speaking, HIPAA, Team Building, Time Management, Data Analysis, Healthcare Industry, Community Outreach, EMR, Public Relations, EHR
Education
Brigham Young University 2000 — 2005
Bachelor of Fine Arts (B.F.A.), Communications
Phyllis E. Simone March 2011 - Present
Humana - Senior Bridge February 2015 - July 2015
Gentiva Health Services September 2009 - June 2012
Lovelace Health Plan January 2006 - August 2008
Skills
Hospitals, Leadership, Home Care, Management, Quality Assurance, Staff Development, Healthcare, Healthcare Management, Nursing, Healthcare Information..., Medicare, HIPAA, Managed Care, Clinical Research, Patient Safety, EMR, Medicaid, Inpatient, Acute Care
Education
University of California, Berkeley 1986 — 1987
Boston University
Master of Science in Nursing, Public Health/Community Nurse/Nursing
Villanova University
Bachelor of Science (BS), Nursing Science
UnitedHealthcare September 2014 - Present
Cigna October 2011 - September 2014
UMR a UnitedHealthcare Company March 2011 - October 2011
UnitedHealthcare July 2006 - March 2011
Lovelace Health Plan May 2003 - July 2006
Skills
Managed Care, Health Insurance, HMO, Medicare, Health Savings Accounts, PPO, Insurance, Health Policy, Stop Loss, Healthcare, Disease Management, HRA, Key Account..., Disability Insurance, Sales, Employee Benefits, Account Management, Health Care Reform
Education
Eastern New Mexico University
Bachelor of Business Administration (BBA), Marketing
St. Mary's Hospital & Regional Medical Center October 2013 - Present
Lovelace Health Plan October 2010 - October 2013
Lovelace Health System July 2007 - September 2010
St. Mary's Hospital & Regional Medical Center June 2003 - June 2007
First Health Strategies 1996 - 1999
CompHealth 1992 - 1996
Holy Cross Hospital of Salt Lake City 1985 - 1992
Skills
Revenue Cycle, Process Improvement, Financial Reporting, Healthcare Management, Financial Analysis, Accounting, Hospitals, Medicare, Medicaid, CPA, Health Insurance, Physician Relations, Healthcare Industry, Revenue Cycle Management, Provider Relations, Budgets, HIPAA, Health Policy, Healthcare Consulting, Leadership, Managed Care, Healthcare, Executive Management
Education
University of Utah - David Eccles School of Business 1990 — 1992
MBA, Business
Brigham Young University 1976 — 1980
Bachelor of Science, Accounting
WellCare Health Plans March 2014 - Present
Lovelace Health Plan March 2012 - March 2014
WellCare May 2005 - March 2012
Benesch Friedlander Coplan & Aronoff January 1999 - April 2005
Ohio Department of Insurance September 1997 - January 1999
Skills
Healthcare Compliance, Medicaid, Litigation, Corporate Governance, Medicare
Education
Capital University Law School 1994 — 1998
Juris Doctor, Law, Magna Cum Laude
The Ohio State University 1987 — 1991
Bachelor of Arts, Political Science
Lovelace Health Plan December 2010 - Present
Health Evolution Partners April 2010 - January 2011
UnitedHealthcare, Northern California April 2007 - April 2010
Concentra September 2001 - March 2007
Bell Canada Enterprises August 1998 - September 2001
Skills
Strategic Growth and..., Market and...
Education
University of Pennsylvania - The Wharton School 1988 — 1991
Business, Management, Marketing, and Related Support Services
Purdue University 1984 — 1987
Certified Health Consultant, Healthcare Finance and Risk
Agile Group USA August 2013 - Present
American Society for Quality Section 1400 June 2008 - December 2013
Lovelace Health Plan January 2012 - August 2013
University of New Mexico April 2008 - March 2013
Agile Group USA April 2009 - December 2011
PMC Solutions December 2006 - March 2009
US Coast Guard Academy July 2000 - September 2006
U.S. Coast Guard March 1999 - May 2000
Skills
Qualitative Research, Leadership Development, Process Improvement, Conflict Resolution, Homeland Security, Organizational..., Program Management, Instructional Design, Six Sigma, Training, Quality Management, Leadership, Project Management, Lean Manufacturing, PMP, Operations Management, Change Management, Team Building, Performance Management, Management, Analysis, Policy, Strategic Planning, Government, Data Analysis, Workshop Facilitation, Software Documentation, Project Planning, Public Speaking, Performance Improvement, Management Consulting, Business Process..., Team Leadership, Coaching, Cross-functional Team..., Quality Assurance, Visio, Employee Training, Technical Writing, Proposal Writing, Process Engineering, E-Learning, Staff Development, Adult Education, Career Counseling, Organizational..., Instructor-led Training, Executive Coaching, Program Evaluation, Organizational...
Education
The National Graduate School of Quality Management (NGS)
Master of Science, Quality Systems Management
Excelsior College
Bachelor of Science, Psychology
University of Phoenix
Associate of Arts, Electronics Technology
Lovelace Health Plan June 2013 - Present
Lovelace Health Plan January 2007 - Present
Lovelace Health Plan June 2006 - Present
Lovelace Health Plan January 2005 - January 2007
Lovelace Health Plan January 2004 - January 2005
First Choice Community Health Care October 1996 - January 2004
First Choice Health Care Albuquerque, NM January 1996 - January 2004
UNM Mental Health Hospital March 2001 - August 2002
UNM Mental Health January 1999 - January 2000
Skills
Healthcare, Medicare, Health, Teaching, Health Insurance, Customer Service, Research, Public Speaking, Healthcare Management, Medicaid, Revenue Cycle, Managed Care, Clinical Research, Employee Benefits, Hospitals, Utilization Management, EMR, Disease Management, Medical Terminology, CPT, HIPAA, Insurance, Case Managment, Health Policy, Medical Records, Patient Safety, Healthcare Information..., Claim, Healthcare Consulting, Home Care, Nursing, Data Entry, Policy, Team Building, Data Analysis, Mental Health, Software Documentation, Network Development, Provider Relations, EHR, Credentialing, HMO, Behavioral Health, PPO, Healthcare Industry, Medicare Part D, Physician Relations, Medical Billing, Inpatient, Health Information...
Education
Full Sail Real World Education 2011 — 2014
Bachlors, English
Full Sail University
Bachelor of Science Degree; High School Diploma, Internet Marketing
Central New Mexico Comm College 1993 — 1995
No, Nursing
Sandia High Scholl
Segal Consulting December 2014 - Present
Aetna January 2013 - Present
Lovelace Health Plan April 2008 - December 2012
UnderwritingPresbyterian Health Plan October 2005 - April 2008
Kaiser Permanente of Ohio January 2004 - September 2005
BSBSWI (currently Anthem/Wellpoint) December 2001 - December 2003
UnderwritingTexas Health Choice January 1999 - December 2001
Ochsner Health System September 1997 - December 1998
Blue Cross Blue Shield May 1997 - August 1997
Blue Cross Blue Shield June 1988 - April 1997
Skills
Health Insurance, Team Leadership, Pricing, Analysis, Underwriting, Strategic Planning, Executive Management, Financial Analysis, Leadership, Forecasting, Healthcare, New Business Development, Process Improvement, Management, Employee Benefits, Insurance, Customer Service, Strategy, Training, Brokers, Medicare, Budgets, Actuarial Science, Claim, Managed Care, Marketing, Financial Risk, Risk Management, Finance, Health Policy, Reinsurance, Medicaid, Financial Reporting, Disability Insurance, Life Insurance, Workers Compensation, Long-term Care, Professional Liability, Property & Casualty..., Medicare Part D, HIPAA, Healthcare Industry, HMO, Health Care Reform, PPO, Commercial Insurance, Healthcare Consulting, Health Savings Accounts, Revenue Cycle, Term Life Insurance
Education
Bowling Green State University 1975 — 1979
BS, Mathematics
Triumph Structures Los Angeles September 2012 - Present
Lovelace Health Plan June 2009 - August 2012
Eclipse Aviation September 2006 - February 2009
Cardinal Health August 2003 - August 2006
Cell Robotics March 2000 - August 2003
University of New Mexico August 1999 - March 2000
University of New Mexico August 1997 - August 1999
University of New Mexico August 1995 - August 1997
Skills
Contract Management, Supply Chain Management, Program Management, Process Improvement, Contract Negotiation, Procurement, Six Sigma, Cross-functional Team..., Strategic Sourcing, Strategic Planning, Materials Management, Purchasing, Supply Chain, Negotiation, Forecasting, Operations Management, Change Management
Education
The University of New Mexico 1992 — 1995
Business Finance
Adams State University 1991 — 1992
Business Finance
New Mexico Health Connections September 2012 - Present
ABS Consulting September 2010 - October 2012
Self Employed 2005 - 2006
Lovelace Health Plan 2002 - 2005
CIGNA HealthCare/Lovelace Health Systems January 1999 - January 2002
Lovelace Health Plan January 1997 - January 1999
CIGNA/Lovelace Health Plan January 1990 - January 1997
Skills
Strategic Planning, Contract Management, Program Management, Leadership, Management, HIPAA, Healthcare, Process Improvement, Managed Care, Strategy, Healthcare Management
Education
The University of New Mexico
B.A. Degree, Economics
Walmart August 2015 - Present
Home State Health Plan (Centene) October 2014 - June 2015
Amerigroup - FL (WellPoint) February 2012 - October 2014
Aetna Workers Comp Access and Cofinity 2007 - 2011
Coventry Health Care 2005 - 2007
Lovelace Health Plan 2004 - 2005
CPM Enterprises, Inc. 2002 - 2004
Northwest Washington Medical Bureau (Blue Shield)/ Regence Blue Shield 2000 - 2002
Ardent Health System/Hillcrest Health Care System 1997 - 1999
Pacificare of Oklahoma 1989 - 1997
Skills
Contract Negotiation, Project Management, Healthcare Operations, Managed Care, Provider Network..., Provider Relations, Risk Contracting, Healthcare, PPO, HMO, PCMH, Medicaid, Medicare, Workers Compensation, Behavioral Health, Healthcare Industry, Physician Relations, Network Development, Health Policy, EMR, Healthcare Information..., Process Improvement, Program Management, Hospitals, Physicians, Medicaid Managed Care, Health Insurance, Utilization Management, HIPAA, Healthcare Consulting, Revenue Cycle, Claim, Healthcare Management, Credentialing, Leadership, Medicare Part D, Case Managment, Disease Management, Medical Billing, Practice Management, Executive Management, Quality Improvement, Insurance, Employee Benefits, Medical Compliance, Diplomacy, Risk Management
Education
Oral Roberts University
MA, Counseling Pyschology
Point Loma Nazarene University
BA, History/ Political Science
Westmont College
Psychology
Lovelace Health Plan April 2009 - April 2011
Mercy Health Plans January 1999 - January 2006
PRUDENTIAL INSURANCE COMPANY - GROUP CREDIT INSURANCE OPERATIONS January 1997 - January 1998
PRUDENTIAL INSURANCE COMPANY January 1993 - January 1997
PRUDENTIAL INSURANCE COMPANY - GROUP CREDIT INSURANCE OPERATIONS(GCIO) January 1986 - January 1993
Education
Princeton University 1969 — 1973
AB, Art History
Princeton University
A.B
Professional Designations
ASA, M.A.A.A, CLU
Lovelace Health Plan May 2013 - October 2014
Lovelace Health Plan July 2004 - May 2013
Lovelace Health Plan October 1995 - July 2004
Skills
Healthcare Management, NCQA..., Medicare Advantage..., Managed Health Care..., State of New Mexico..., Nursing, Healthcare, Medicare Advantage, Project Management, Quality Auditing, NCQA, Process Improvement, Managed Care, Medicare, Utilization Management, Disease Management, Health Policy, Medicaid, Healthcare Consulting, Health Insurance
Education
Lake Michigan College
Associate's Degree, Nursing, Graduated with Honors
CHRISTUS Health August 2014 - Present
Cook Children's Health Care System April 2013 - May 2014
Lovelace Health Plan March 2012 - September 2012
UNM Hospitals May 2004 - March 2012
UNM Hospitals April 2004 - April 2006
International Project September 2001 - March 2004
Avaya September 2001 - September 2002
Lucent Technologies February 1998 - September 2001
Lutheran Laymen's League of USA February 1997 - February 1998
RR Donnelley April 1993 - January 1997
Skills
Financial Analysis, Accounting, Contract Negotiation, Telecommunications, Strategic Planning, Digital Photography, International Business, Project Management, Visio, Marketing Management, Interpreter and..., Philantrophy, Process Improvement, Program Management, Integration, Leadership, Management, Change Management, Cross-functional Team..., Healthcare, Strategy, Project Planning
Education
Tampa College (currently Everest University) 1991 — 1993
MBA, Business Administration
Universidad Interamericana de Puerto Rico (UIPR) 1985 — 1990
BBA,, Business Administration and Marketing
Universidad Interamericana de Puerto Rico (UIPR) 1985 — 1990
BA, Fine Arts
Stevens Institute of Technology 1999 — 2001
Master Certification in Project Management, Project Management
Villanova University 2011 — 2011
Non Degree - Professional Certification, Advance Strategic Project Management
Molina Healthcare of California April 2014 - Present
Molina Healthcare November 2011 - Present
Molina Healthcare November 2008 - Present
Lovelace Health Plan July 1998 - November 2008
Skills
Healthcare, Medicaid, Provider Relations, Medicare, Network Development, Healthcare Management, HMO, Health Insurance, Healthcare Industry, Hospitals, Credentialing, Medicaid Managed Care, Provider Network..., HIPAA, Health Policy, EHR, Managed Care, PPO, Process Improvement, Performance Improvement, Employee Benefits, Contract Negotiation, Healthcare Consulting, Contract Management, Physician Relations, Revenue Cycle
Education
The University of New Mexico
University of Phoenix
Management with focus on Healthcare
Lovelace Health System May 2014 - Present
Lovelace Health Plan September 2011 - May 2014
Albuquerque Vision Clinic February 2007 - June 2011
Albuquerque Redi Mix June 2006 - February 2007
SpringStone Montessori School August 2004 - May 2006
Skills
Medical Coding, Healthcare, Microsoft Excel, Medical Billing, ICD-9, CPT, Accounts Receivable, Insurance, Optometric billing, Customer Service, Adaptive Leadership, Adaptability, Health Insurance, Medical Staff..., HIPAA, Credentialing, Job Coaching, Staff Development, Leadership, Managed Care, Problem Resolution, Revenue Cycle Management, EMR, Revenue Cycle, Hospitals, Problem Solving, Process Improvement, Strategic Planning, Medicaid, Healthcare Information..., Employee Benefits
Education
St. Mary's College 2001 — 2004
Bachelor's degree, English Language and Literature, General, Graduated with Honors
Brentwood Private School 1998 — 2001
Advanced Level High School Diploma, English Language and Literature, General
Lafayette School Corporation March 2006 - Present
Witham Health Services December 2001 - March 2006
Interactive Intelligence January 2000 - July 2001
Lovelace Health Plan 1997 - 2000
Indian Health Service 1996 - 1997
Skills
Active Directory, Healthcare Information..., Windows Server, VoIP, Microsoft Office, Telephony, Telecommunications, System Administration, Networking, Network Administration, Network Engineering, Network Security, Wireless Networking, Cisco Technologies, Cisco IOS, Cisco Routers, Cisco Wireless, Avaya IP Telephony, Nortel, K-12, Educational Technology, IPTV, Routing Protocols, Email Systems, Microsoft Exchange, Internet Security, Cisco VPN, Cisco Firewall Security, Network Management
Education
Indiana University—Purdue University Fort Wayne 1990 — 1995
Management Information Systems
DeKalb High School 1984 — 1988
Presbyterian Healthcare Services April 2013 - Present
Lovelace Health Plan July 2012 - April 2013
Genzyme Genetics November 2006 - July 2012
Skills
SQL, Microsoft Office, SPC, ANOVA, Crystal Reports, Cognos, geocoding, TOAD, Health Insurance, Healthcare, Business Analysis, Data Analysis, Toad, Access, Analysis
Education
University of Arizona 2001 — 2005
BS, Optical Sciences
The University of New Mexico 1996 — 2000
BS, Chemical Engineering
Corazon Family Health March 2013 - Present
Presbyterian Medical Services July 2002 - March 2013
Lovelace Health Plan July 1997 - June 2002
Skills
Hospitals, Healthcare Management, Healthcare, Medicine, Quality Improvement, Quality Management, Health Plan Operations, EMR, Managed Care, Healthcare Consulting, Health Policy, EHR, Utilization Management, Medicare, Healthcare Industry, HIPAA, Medical Education, Healthcare Information..., Board Certified, Clinical Research
Education
Jefferson Medical College of Thomas Jefferson University 1972 — 1976
Doctor of Medicine (M.D.), FP
St. Joseph's University 1968 — 1972
Bachelor of Arts (B.A.), German Language and Literature
Sandia National Laboratories April 2014 - Present
Lovelace Respiratory Research Institute November 2012 - June 2013
SabioSystems July 2011 - March 2013
Clifton Gunderson LLP June 2010 - July 2011
Lovelace Health Plan July 2009 - January 2010
Forest City Enterprises/Mesa del Sol, Inc. March 2007 - November 2008
Sotheby's International Realty June 2005 - February 2007
NCA Architects, P.A. 2000 - 2005
Skills
Administrative..., Marketing, Proposal Writing, PowerPoint, Newsletters, SAP, Leadership, Management, Employee Relations, Budgets, Payroll, Process Improvement, Editing, SharePoint, Customer Service, Event Planning, Office Administration, Real Estate, Accounts Receivable, Administrative..., Microsoft Excel
Education
Central New Mexico 2008 — 2009
The University of New Mexico 1990 — 1992
Presbyterian Healthcare Services August 2015 - Present
Premera Blue Cross April 2014 - July 2015
Lovelace Health Plan April 2010 - April 2014
Education
Oregon State University 2005 — 2009
BS, Mathematical Sciences; minor Actuarial Sciences
The Diocese of Charleston November 2014 - Present
The Diocese of Charleston July 2013 - October 2014
Lovelace Health Plan March 2011 - February 2013
Santa Ana Star Casino August 2007 - January 2011
Fonatur Cancun September 2004 - June 2006
Intermatic Juarez January 1999 - May 2004
Elamex February 1997 - December 1998
Skills
Internal Controls, Budget, Analysis, Inventory Management, Accounting, General Ledger, Microsoft Excel, Financial Reporting, Accounts Payable, Accounts Receivable, Payroll, Account Reconciliation, Financial Analysis, Auditing, GAAP
Education
The University of New Mexico - Robert O. Anderson School of Management 2008 — 2014
Master's Degree, Accounting, Masters in Accounting
Universidad Autónoma de Chihuahua 1982 — 1986
Contador Publico, Accounting
PacificSource Health Plans February 2014 - Present
Lovelace Health Plan August 2013 - Present
Lovelace Health Plan October 2012 - July 2013
Lovelace Health Plan July 2010 - September 2012
Skills
Medicare, Utilization Management, Healthcare, Healthcare Management, Managed Care
Education
The University of New Mexico 2012 — 2014
Master of Business Administration (MBA)
Washburn University 1996 — 1998
Bachelor of Science (BS) Nursing, Nursing Science
Gap Inc. April 2014 - Present
Lovelace Health Plan March 2013 - December 2013
City of Albuquerque July 2012 - March 2013
TriCore Reference Lab December 2008 - June 2012
Eclipse Aviation October 2006 - August 2008
Intel Corporation May 1997 - October 2006
Skills
Financial Analysis, Corporate Finance, Financial Reporting, Managerial Finance, Data Analysis, Financial Forecasting, PeopleSoft, Capital Budgeting, Strategic Planning, SAP, Accounting, Public Relations, Leadership
Education
The College of Santa Fe
BBA, Finance
The University of New Mexico 1987 — 1991
St. Pius X High School
Coventry Health Care of Florida February 2013 - Present
Lovelace Health Plan November 2009 - February 2013
Pulte Homes January 2005 - December 2008
Skills
Contract Management, Healthcare, Medicare, Process Improvement, Managed Care, Provider Relations, Health Insurance, Contract Negotiation, Strategic Planning, Budgets, Healthcare Consulting, Medicaid
Education
The University of New Mexico - Robert O. Anderson School of Management 2010 — 2012
Master of Business Administration (MBA), Public Policy and Planning
CareNational Healthcare Services 2014 - March 2015
HealthCare Support Staffing January 2014 - April 2014
Lovelace Health Plan September 2011 - May 2012
Berkley Home Healthcare November 2010 - August 2011
BAYADA Home Health Care March 2010 - April 2011
Presbyterian Healthcare Services 2008 - 2009
Core Medical Group 1999 - 2000
Core Medical Group 1999 - 2000
Skills
Medicare, Medicaid, Managed Care, Healthcare, Healthcare Management, Healthcare Information..., Hospitals, Health Insurance, EHR, HIPAA, Clinical Research, Home Care, Nursing, Healthcare Consulting, Physicians, Case Managment, EMR, Long-term Care, Pediatrics, Health Education, Acute Care, Quality Improvement, Healthcare Industry, Physician Relations, Patient Safety, Critical Care, Disease Management, Epic Systems, Informatics, Revenue Cycle, Utilization Management, Health Policy, Patient Advocacy, Medicine, JCAHO, HEDIS, Patient Education, Orthopedic, NCQA, Medical/Surgical, ICU, Provider Relations, Case Management
Education
University of Northern Colorado 1996 — 1998
MPH, Community Health Program Planning
The University of New Mexico 1987 — 1991
BSN, Nursing
New Mexico Health Connections October 2013 - Present
Lovelace Health Plan July 2012 - October 2013
Riverside Physician Network August 2004 - June 2012
Inland Empire Health Plan 2003 - 2004
Skills
Medicare, Hospitals, HIPAA, Healthcare Information..., EMR, Case Management, Managed Care, Health Insurance, Healthcare, Nursing, Healthcare Management, Health Policy, Utilization Management, Disease Management, Patient Safety
Education
The University of Akron 1972 — 1977
BS, Nursing
Lovelace Health System January 2014 - Present
Lovelace Health System April 1999 - December 2013
Lovelace Health Plan April 1999 - December 2013
Skills
Healthcare, Case Managment, Hospitals, Social Services, Medicare, Medicaid, Health Insurance, Managed Care, Public Speaking, Healthcare Management, HIPAA, Home Care, Utilization Management, EMR, Case Management, Nursing, Disease Management, Treatment, Provider Relations, Medical Billing, EHR, Revenue Cycle, Healthcare Information..., Physician Relations, Mental Health, Long-term Care, Healthcare Consulting, Medicaid Managed Care, Healthcare Industry, HMO, Patient Advocacy, Inpatient, Health Policy, Quality Improvement, PPO, Network Development, Medical Records, CPT, Medical Terminology, Medication...
Education
Career Center of Texas El Paso 1997 — 1998
Registered Medical Assistant, Medical/Clinical Assistant
The University of Texas at El Paso 1991 — 1992
Scott & White Health Plan January 2012 - Present
Lovelace Health Plan January 2007 - October 2010
Lovelace Health Plan March 2003 - December 2006
St. Joseph Health Care October 2001 - March 2003
Lovelace Health Plan October 2000 - October 2001
St. Joseph Health Care February 2000 - October 2000
Lovelace Health Plan June 1998 - February 2000
Lovelace Health Plan June 1994 - June 1998
Village Inn Restaurant June 1992 - June 1994
All American Security Systems, Inc June 1992 - June 1994
Education
The University of New Mexico
The University of New Mexico - Robert O. Anderson School of Management
University of New Mexico September 2007 - Present
Lovelace Health Plan August 1997 - September 2007
Lovelace Health System June 1977 - July 1997
Education
The University of New Mexico 1974 — 1980
Bachelor of Science (B.S.), Pharmacy
College of St Francis
Masters of Science, Health Services Administration
New Mexico Heart Institute July 2014 - Present
Lovelace Health Plan September 2012 - Present
TriCore Reference Laboratories December 2013 - July 2014
Albuquerque Urology Associates August 2010 - September 2012
Albuquerque Urology Associates March 2008 - August 2010
Skills
Medicare, EMR, Healthcare Management, HIPAA, Healthcare Industry, Managed Care, Financial Analysis, Access, Hospitals, Healthcare Information..., Physicians, Revenue Cycle, Medical Billing, Claim, Healthcare, Microsoft Office, Revenue Cycle Management, Accounts Receivable, Program Management, Practice Management, Process Improvement, Budgets, Strategic Planning, Team Building, Physician Relations, Health Insurance, Healthcare Consulting, Leadership, EHR, Customer Service, Epic Systems, Medicaid, Insurance, Employee Benefits, Data Analysis
Education
The University of New Mexico - Robert O. Anderson School of Management 2008 — 2010
MBA, Finance
Lovelace Health Systems Inc April 2015 - Present
First nations health care January 2014 - January 2015
Lovelace health plan January 2012 - December 2013
Lovelace Health System June 2011 - January 2012
Lovelace CBO June 2010 - June 2011
Kidney specialist of nm November 2008 - June 2010
Skills
Provider Relations, Medicare, Healthcare Management, Medicaid, Physician Relations, Hospitals, Managed Care, Healthcare Consulting, Healthcare, HIPAA, Revenue Cycle, Medical Terminology, Meditech, Healthcare Information..., Nursing, Medical Billing, Network Development, HMO, Patient Safety, Health Policy, Credentialing, Healthcare Industry, CPT, EMR, Epic Systems, EHR, Cerner, Health Information..., HCPCS, Medicine, Medical Coding, ICD-9, JCAHO, Medical Records, Physicians, Health Insurance, Ambulatory, Utilization Management, PPO, Practice Management, Revenue Cycle Management, Medical Compliance, Facets, Careplanner,..., Claim, IDX, Invoicing, Phlebotomy, Quality Improvement
Education
National American University-Albuquerque 2011 — 2015
Bachelor's degree, Health/Health Care Administration/Management, 3.5
National American University-Albuquerque 2008 — 2011
Asscociates, Allied Health and Medical Assisting Services, 3.5
New Mexico Mutual April 2014 - Present
Lovelace Health Plan 2012 - 2013
United Healthcare 2002 - 2012
Skills
Property & Casualty..., Claim, Medicare, Employee Benefits, Insurance, HIPAA, Health Insurance, Health Policy, Hospitals, Microsoft Excel
Education
Central New Mexico Community College 2001 — 2014
Associate's degree, Accounting
Central New Mexico Community College
Associate of Arts and Sciences (AAS), Accounting and Related Services
UNM Cancer Center October 2013 - March 2015
UnitedHealth Group 2015 - 2015
UnitedHealth Group 2015 - 2015
Lovelace Health Plan November 2012 - October 2013
Lovelace Health System August 2011 - March 2013
Flowserve Corporation October 2000 - March 2009
Skills
Certified Six Sigma..., Process Improvement, Training, Cross-functional Team..., Vendor Management, Business Process..., Healthcare, Purchasing, Team Building, Program Management, Change Management, Leadership, Quality Assurance, Software Documentation, Management, Operations Management, Data Analysis, Manufacturing, Process Engineering, Six Sigma, Quality Management, Operational Excellence, Visio, Project Planning, Lean Manufacturing, Project Management, Analysis, Supply Chain Management, Value Stream Mapping, Budgets, Performance Management, DMAIC, Accreditation, Continuous Improvement, Root Cause Analysis, Kaizen, Organizational..., ISO
Education
The College of Santa Fe 1999 — 2001
Master of Business Administration (M.B.A.), Management
CNM - Central New Mexico Community College August 2011 - Present
HealthInsight August 2011 - December 2013
Lovelace Health Plan January 2011 - May 2013
Blue Cross Blue Shield November 1999 - October 2011
Mesa Mental Health April 1994 - July 2007
VA Medical Center October 2001 - January 2004
Skills
Higher Education, Teaching, Nursing, Customer Service, Public Speaking, Healthcare, Research, Medicaid, Motivation, HEDIS, Mental Health, Hospitals, New Skills, Expertise, Treatment, Training, Patient Safety, HIPAA, EHR, Healthcare Management, Home Care, EMR, Medicine, Healthcare Consulting, Physician Relations, Case Management, Medicare, Health Policy, Disease Management, Managed Care, Medical Coding, Utilization Management, Medical Billing, Healthcare Industry, Revenue Cycle, Quality Auditing, Distance Learning
Education
University of New Mexico 2011 — 2012
Bachelors of Science, Registered Nursing/Registered Nurse, A
Central New Mexico Community College 2005 — 2010
Associate of Arts and Sciences (AAS), Health Information/Medical Records Technology/Technician, A
Central New Mexico Community College 2005 — 2009
Associate of Arts and Sciences (AAS), Liberal Arts and Sciences/Liberal Studies, A
Monroe Community College 1977 — 1979
AAS in Registered Nursing, Nursing
Albuquerque Public Schools November 2012 - Present
Lovelace Health Plan 2012 - 2012
University of New Mexico 2007 - 2012
Education
Central New Mexico Community College 2008 — 2012
Associate of Science (A.S.), Registered Nursing/Registered Nurse
University of Phoenix 2003 — 2006
Master of Business Administration (M.B.A.), Business Administration and Management, General
The University of New Mexico 1996 — 2000
Bachelor of Science (B.S.), Kinesiology and Exercise Science
Lovelace Rehabilitation Hospital September 2014 - Present
Lovelace Health Plan August 2010 - Present
Skills
Health Insurance, HIPAA, Customer Service, Medicaid, Healthcare Management, Insurance, Managed Care, Business Planning, Medicare, Healthcare Information..., Employee Benefits, Process Improvement, Healthcare
Education
Central New Mexico Community College
Southwest CARE Center 2014 - Present
Various 2014 - 2014
Lovelace Health Plan 2012 - 2014
Clear One Health Plans 2009 - 2011
Clear Choice Health Plans 2007 - 2009
Self-Employed 2005 - 2007
Women's Care 1999 - 2005
Skills
Internal Audit, Health Insurance, Medical Compliance, Editing, Medicare, Research, Technical Writing, CPT, ICD-9, Employee Training, Microsoft Office, Adobe Acrobat, Fraud, Finance, Regulatory Requirements, Healthcare, Healthcare Management, Regulations, Legal Compliance, Healthcare..., Healthcare compliance, Grant Writing, Contract Management, Persuasive Writing, Project Management, Medical Staff..., QuickBase, Interviewing Skills, Regulatory Submissions, Grant Administration, Compliance, Healthcare contracting, Regulatory research, HIPAA, ERISA, Privacy Law, Privacy Compliance, Privacy Regulations, Privacy Policies, Privacy Issues, Root Cause Analysis, Medicare Part D, PBM, Medicaid, Analysis, Pharmacy Benefit...
Education
Colorado State University-Global Campus 2015 — 2016
Master of Healthcare Administration and Management (MHA), Health/Health Care Administration/Management
Portland State University 2005 — 2006
Master of Science (MS), Professional, Technical, Business, and Scientific Writing
University of Oregon 1997 — 2001
Bachelor of Arts (BA), Anthropology
Individual Therapist June 2014 - Present
Lovelace Rehabilitation Hospital January 2014 - Present
Lovelace Health Plan January 2010 - December 2013
Lovelace Health Plan August 2005 - January 2011
Skills
Behavioral Health, Quality Management, Case Management, Health Policy, Healthcare, Social Services, Medicine, Medicaid, Healthcare Management, Employee Benefits, Hospitals, Medicare, Management, Inpatient, HIPAA, Patient Advocacy, Healthcare Consulting, Managed Care, Medical Case Management
Education
Louisiana State University
Master of Social Work (MSW)
UTC Chattanooga
Bachelor of Arts (BA), Music
Lovelace Health Plan May 2008 - Present
Education
The University of Texas at El Paso 1972 — 1977
Bachelor's of Science, Registered Nursing/Registered Nurse
Lovelace Health Plan 2008 - 2014
Education
Central New Mexico Community College
Verisk Health September 2013 - Present
University of New Mexico October 2014 - Present
Presbyterian Healthcare Services August 2010 - September 2013
Lovelace Health Plan March 2007 - August 2010
Presbyterian Healthcare Services June 2002 - March 2007
Skills
Health Insurance, Third Party Vendor..., Vendor Contracts, Medicare Advantage, Medicaid, Medicare Part D, Affordable Care Act, Managed Care, Healthcare Management, Healthcare Information..., Healthcare Industry, Revenue Cycle, Insurance Claims, Healthcare Consulting, Provider Relations, Data Operations, Financial Reporting, Project Management, Data Analysis, Process Improvement, Medicare, Leadership, Management, Information Technology, Healthcare, HIPAA
Education
Capella University 2012 — 2017
Doctor of Philosophy (Ph.D.), Non-Profit/Public/Organizational Management
Grand Canyon University 2014 — 2018
Doctor of Education (Ed.D.), Organizational Leadership with Emphasis in Organizational Development
Capella University 2009 — 2011
Master’s Degree, Project Management
The University of New Mexico
Certification, Six Sigma - Green & Black Belt
Baker College of Flint 2005 — 2007
Master’s Degree, Business Administration Finance
University of Phoenix 2002 — 2004
Bachelor’s Degree, Information Technology