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yyyyyy x. yyyyyy                                                            0000 xxxxxx xxxx , xxxx , xxxxx 00000

(xxx-xxx-xxxx

                                                                                                                                               abc@xyz.com

objective

business professional eager to contribute dynamic administrative, grievance/appeals, customer service, public relations and coordination skills in a challenging assignment.

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career profile

ø  b.s., business and management.

ø  over 18 years of successful business experience.

ø  career built in the healthcare and personal services sectors.

ø  expertise in delivery of exceptional customer service.

ø  highly capable administrator.

ø  strong leadership skills.

ø  knowledgeable in member eligibility, benefits and training material development.

ø  proficient in medi-cal, medicare, healthy families and healthy kids programs.

ø  capacity in policy/procedures, regulations and administrative methodologies.

ø  adept in internal audits relating to state and federal regulations.

ø  computer knowledge encompassing diamond, hms, maxmc and ms office suite.

ø  outstanding communicator and speaker.

ø  well-organized multi-tasker with strong detail orientation.

ø  self-motivated, self-directed.

ø  manage document and report origination.

ø  contributor in critical process improvement.

ø  comprehensive understanding of business and operations management.

ø  proven accomplishments in coordination, strategic planning and project management.

ø  spanish linguist.

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professional experience

inland empire health plan                                                                                                         1999 c present

grievance supervisor

         recruited to design policies/procedures for grievance and appeals department.

         effectively achieve ncqa, dhs and dmhc guidelines,

         contribute to new product application processes.

         direct grievance staff and ensure timely resolution of grievance cases.

         launch effective use of maxmc and procenter

         designated to serve on critical c& l subcommittee.

         facilitate community health fairs/ events promoting medi-cal and healthy families products.

         act as liaison among grievance, internal and external entities.

         design and implement training materials for new/current employees.

         train internal and external customers in company processes.

         coordinate internal audit of grievance files.

         conduct all responsibilities of grievance coordinators

         achieve on-going compliance with ncqa, dhs, and dmhc.

         selected for unit translation team.

 

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earlier background

prior to 1999, served as manager, salon luis xv, and receptionist, signa healthplans.  in these assignments, built outstanding administrative, coordination, organizational, hr, financial control, scheduling and medical records skill sets.

 

---

education

university of redlands

bachelor of science, business and management, 2006

 

american college of health professions

healthcare administrative services, 1999

 


yyyyyy x. yyyyyy                                                            0000 xxxxxx xxxx , xxxx , xxxxx 00000

(xxx-xxx-xxxx

                                                                                                                                               abc@xyz.com

 

 

cover letter text

 

date

 

 

 

hiring agent name

title

company name

address

city, state   zip code

 

dear                   :

 

i am currently seeking a challenging career opportunity in a supervisory/administrative capacity and am submitting my resume for your review.  in advance, i thank you for your time and consideration.

 

as demonstrated in the accompanying resume, my professional qualifications include a b.s., business and management, and over 18 years of highly successful experience in the health insurance and personal services sectors.   to complement this background, i possess demonstrated expertise in grievance/appeals, customer service, administration, program management, member eligibility, training materials, regulation compliance and internal audits, as well as strong analytical, problem-solving and managerial capabilities.  as an employee, you will find me to be an enthusiastic and disciplined team player, committed to supporting you in achieving your objectives through superior performance. 

 

i am confident that i could be a valuable asset to your firm, and look forward to interviewing with you in the near future to further discuss my areas of experience and expertise that would be a contribution to your organization.

 

 

 

 

sincerely,

 

 

 

yyyyyy x. yyyyyy

 

 

 

 

 

attachment

 

 

 

 

 

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