Yelissa López Figueroa
Summary
To continue my professional development by facing new challenges and contributing to the development of the company. Committed to contributing to the company with my knowledge, but prepared to acquire constant knowledge that allows me to achieve departmental and company goals. Focused on leading my team, but also being a facilitator.
Overview
24
24
years of professional experience
Work History
Providers Network Education Director
Medical Card System, Inc.
01.2019 - Current
- Supervise and monitor the tasks required to fully comply with my role
- Prepare and monitor compliance with the internal and external educational plan
- Monitor the development of all educational materials and presentations according to the plan
- Establish and implement the clinical and operation educational plan for the providers network
- Collaborated with other teams to identify opportunities and created plans to resolve training gaps.
- Implemented policies, procedures and programs to carry out educational standards and goals.
- Created and maintained budgeting plans for educational programs and activities.
- Prepare and submit reports periodically to the AVP of the educational interventions offered
- Review the education unit operational guides and monitor compliance with them.
Education Manager at Provider Network Management
Medical Card System, Inc.
03.2013 - 12.2018
- Supervise and monitor the tasks required to fully comply with my role
- Prepare and monitor compliance with the internal and external educational plan
- Monitor the development of all educational materials and presentations according to the plan
- Prepare and submit reports periodically to the SVP of the educational interventions offered
- Review the education unit operational guides and monitor compliance with them.
- Collaborated with other departments to ensure that all goals were met within the allotted timeline.
- Monitored budget allocations for educational programs and activities.
Education Specialist at Premium Management
Medical Card System, Inc.
01.2010 - 03.2013
- Provides education to internal and external clients related to documentation standards and clinical coding directed to the "CMS-HCC" payment model to IPA’s, doctors, administrator, and billers
- Educational training as: CHRA, STARS-HEDIS, ICD-10-CM coding & documentation, CMS Risk Adjustment Model, Risk Adjustment Data Validation, among others
- Preparation of presentations and creation of educational materials.
Clinical Coding Technician
Medical Card System, Inc.
01.2008 - 01.2010
- Analysis medical record tu assure compliance with CMS documentation requirement.
- Coding of medical records and annual health assessment.
- RAPS corrections, among others.
- Use variety of tools to documentation and coding: RAPS, ADS, CHRA, etc.
- Due query's to providers for improving diagnosis documentation.
Health Profile Evaluator
Medical Card System, Inc.
05.2006 - 01.2008
- Qualitative data analysis and coding of Comprehensive Health Risk Assessment (CHRA).
- Due query's to primary care physicians for improving diagnosis documentation.
Technical Outreach
Medical Card System, Inc.
01.2006 - 05.2006
- Home visit, Conduct Assessment Questionnaire and check for social needs of patients
- Contact and coordinate with Public Agencies services to meet those needs and provide adequate monitoring.
Pharmacy Technician
Farmacia Medianía
01.2000 - 01.2005
- Data entry and billing process prescriptions to medical plan
- Preparation, dispensing, and recipe archive
- Maintaining optimum material, tools, and equipment and work area
- Educate customer in the instructions for use of the drugs.
Education
Master in Health Information Management (HIM) -
University of Puerto Rico, Medical Sciences Campus
03.2024
Health Services Administration Management -
Program AHORA Metropolitan University
01.2020
Pharmacy Technician with Registry Certificate -
Center for Multidisciplinary Studies
01.2001
Skills
- Responsible
- Disciplined
- Communicative
- Proactive
- Staff Supervision
- Professionalism
- Interpersonal Communication
- Task Prioritization
- Organized
- Budget Administration
- Work under pressure
- Excellent communication skills in spoken and written Spanish
- Teamwork and Collaboration
- Adaptability
- Flexible Schedule
- Multitasking
- Public speaking
- Expertise in staff training
- Continuous Improvement
- Policies and Procedures Enforcement
Affiliations
AHIMA Membership 2023
References
Available as required
Training
- ICD-10-CM Update FY2024
- Third Privacy and Security Symposium 2023
- PRHIMA Coding Congress PRHIMA: 2022 & 2023
- Puerto Rico Health Information Management Association (PRHIMA): 2018
- Clinical Documentation Improvement (CDI) Academy: 2017 AHIMA
- Coding Boot Camp (CPT, HCPCS, and ICD-9-CM): 2016 GoCode
- ICD-10-CM Advanced Course: 2015 MCS
- Principles of Medical Record: 2010- Sacred Heart University
- Coding System ICD-9-CM: 2010- MCS
- Coders Boot Camp (CPT, HCPCS, and ICD-9-CM): 2008- MCS
Languages
Spanish
First Language
English
Intermediate (B1)
B1
Timeline
Providers Network Education Director
Medical Card System, Inc.
01.2019 - Current
Education Manager at Provider Network Management
Medical Card System, Inc.
03.2013 - 12.2018
Education Specialist at Premium Management
Medical Card System, Inc.
01.2010 - 03.2013
Clinical Coding Technician
Medical Card System, Inc.
01.2008 - 01.2010
Health Profile Evaluator
Medical Card System, Inc.
05.2006 - 01.2008
Technical Outreach
Medical Card System, Inc.
01.2006 - 05.2006
Pharmacy Technician
Farmacia Medianía
01.2000 - 01.2005
Master in Health Information Management (HIM) -
University of Puerto Rico, Medical Sciences Campus
Health Services Administration Management -
Program AHORA Metropolitan University
Pharmacy Technician with Registry Certificate -
Center for Multidisciplinary Studies
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