Jorge Vega Aguayo
Rio Grande
Summary
Working in a consumer company or services offered my professional experience for achieving the goals and growth of the company, which eventually contributes to economic and professional development. In turn experience opportunities and challenges in my administrative role which can demonstrate my leadership skills, teamwork equipment and initiative for a management position.
I am currently in a Leadership Academy with Triple S where I am being given information and tools to be a leader in the future, in which I currently consider myself prepared to assume responsibility since the experience, skills and workshops acquired are helping me. in my personal and professional character.
Overview
13
13
years of professional experience
Work History
Provider Performance Executive
Triple-S Salud
10.2023 - Current
- Enhanced provider satisfaction by streamlining communication channels and improving response times.
- Developed innovative solutions to complex problems, resulting in improved organizational performance.
- Established long-term client relationships through consistent delivery of high-quality products and services.
- Collaborated with stakeholders to develop actionable strategies that aligned with corporate goals and objectives.
- Assessed and analyzed departmental budgets to find ways to minimize expenses and optimize profits.
- Identified trends and assessed opportunities to improve processes and execution.
Credentialing Quality Audit Specialist
Triple-S Salud
01.2019 - 10.2023
- Maintained accurate records of audit findings, allowing for effective tracking of progress toward quality goals and identification of recurring issues.
- Streamlined the audit process by developing standardized checklists and templates, increasing efficiency without sacrificing attention to detail or accuracy.
- Led cross-departmental collaboration efforts aimed at understanding the impact of new materials or technologies on overall product quality.
- Enhanced company reputation for high-quality products through consistent and detailed quality audit practices.
Care Review Processor
Molina Healthcare
03.2015 - 01.2019
- Conducted authorization requests and provider inquiries by phone, mail or fax to verify member eligibility and benefits.
- Assisted in the development of training materials to enhance the knowledge and skills of new Care Review Processors within the organization.
- Enhanced the quality of care review processes by updating policies, procedures, and guidelines in accordance with industry best practices.
- Increased efficiency in responding to provider inquiries about case status updates or clarifications needed in submitted documents through effective communication techniques.
- Maintained confidentiality of client records to comply with HIPAA guidelines.
- Expedited patient access to appropriate levels of care through careful evaluation of their needs based on medical documentation and provider recommendations.
- Contacted physician offices to obtain missing information from authorization requests as requested by medical director.
- Streamlined workflows for healthcare providers by promptly identifying discrepancies in patient documentation and recommending corrective actions.
Customer Service Officer
Triple-S Salud
10.2011 - 02.2015
- Enhanced customer satisfaction by efficiently addressing and resolving their inquiries and concerns.
- Helped large volume of customers every day with positive attitude and focus on customer satisfaction.
- Addressed customer complaints and mitigated dissatisfaction by employing timely and on-point solutions.
- Maintained a high level of product knowledge to effectively assist customers with accurate information and recommendations.
- Assisted call-in customers with questions and orders.
- Streamlined communication between customers and internal departments for timely issue resolution.
Education
MBA - Health Management
Universidad Del Este
Carolina06-2018
BBA - Business Administration And Management
Metro Universidad Interamericana
San Juan, Puerto Rico05-2012
GED -
Liceo De Arte Y Technologic
San Jua05-2003
Skills
- Executive support
- Team leadership
- Problem resolution
- Motivation
- Performance improvements
- Problem-solving abilities
- Effective communication
- Multitasking Abilities
- Professionalism
- Strategic Partnerships
- Leadership
- Self motivation
Timeline
Provider Performance Executive
Triple-S Salud
10.2023 - Current
Credentialing Quality Audit Specialist
Triple-S Salud
01.2019 - 10.2023
Care Review Processor
Molina Healthcare
03.2015 - 01.2019
Customer Service Officer
Triple-S Salud
10.2011 - 02.2015
MBA - Health Management
Universidad Del Este
BBA - Business Administration And Management
Metro Universidad Interamericana
GED -
Liceo De Arte Y Technologic
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