LA RONDA NELSON
Msg: (323) 792-8239 • email@example.com
Masters Certification Adult Education Grad date – 05/2014
Master of Science-Management Grad date -06/2013
Bachelors of Science-Health Administration Grad date-05/2009
University of Phoenix- Gardena, CA
SUMMARY OF QUALIFICATIONS
*15 years progressive experience in Human Resources * Healthcare Administration * Social and Community Service * Experienced using ADP Payroll Software and other budgeting and payroll programming* Several years of Compliance & Quality Improvement/Assurance experience and HEDIS Project *Project Rehabilitation & Re-Entry program for the ex-offender population (Special Project) *Excellent communication & interpersonal skills with general public and performing administrative office duties * Goal and Task Oriented * Experience program building and representing agency interests & services during conferences and meetings with partners and potential partners * Proven ability to plan and implement special events & activities * Effective reflective and double-loop skills and systems based thinking
COVERED CALIFORNIA – Los Angeles, CA
Certified Enrollment Counselor - 09/2013- Present
Provide in person counseling and assistance to consumers in need of help with applying for Covered California (Affordable Care Act) programs. Provided assistance in culturally and linguistic appropriate manners to consumers throughout California.
Maintain expertise in eligibility, enrollment, and program specifications. Provide information and services (Medi-Cal and Children’s Health Insurance Program) in a fair, accurate, and impartial manner. Comply with privacy and security standards established by the Exchange pursuant to 45 C. F. R. § 155-260.
Collect and maintain updated information to help understand the composition of the communities in the service area, including individuals with limited English proficiency as required by 45 C.F.R. §§ 155.205(c)(2) and 155.210(e)(5).
REFUGE AND STRENGTH OUTREACH – Los Angeles, CA
Social and Community Service Manager - 10/2012- Present
• Organized and designed a successful Family Support Program to meet the needs of at-risk families in the South Los Angeles.
• Successfully created methods of gathering quantitative information about the impact of the program.
• Supervise case managers and clerical staff who provide services and resources to our families.
• Analyze data to determine the effectiveness of the program.
• Successfully implement suggested improvements to program and services.
• Developed and manage budgets for programs and organizations.
• Established networks to find and develop a pool of qualified candidates in advance of need.
PERSONAL INVOLVEMENT CENTER, INC. (P.I.C.)-Los Angeles, CA
Quality Improvement Support (Compliance) 01/2012 – 10/2012
Managed the evaluation of service delivery data and progress notes for the organization (Family Preservation, Mental Health, Wrap Around, and Family Support) programs; analyzed data for patterns and trends in service delivery; discovered the root causes for specific service delivery concerns; implemented training and education methodologies for the organization's staff to promote good quality practices and ensure compliance with all applicable laws and regulations; collaborated with the organization’s Directors and Program Managers to create policies and procedures in response to program audits; retained and disbursed information on all federal and state laws and regulations; and constantly performed follow-up evaluations of data and organizational performance to ensure consistent improvement. Created, designed, and implemented a quality improvement (QI) program that met the goals of the Agency.
PERSONAL INVOLVEMENT CENTER, INC. (P.I.C.)-Los Angeles, CA
Ex-Offender Re-Entry/Rehabilitation Program Manager 01/2010 – 1/2012
Project Manager for integrating recently paroled individuals back to society to prevent the probability of recidivism; networked with other service providers and represented the Agency’s interests & services during conferences and meetings with partners and potential partners; facilitated recruitment, intake, case management, work readiness and job training and placement, mentoring and parenting classes to reestablish relationship with their children; 6 month follow-up with ex-offenders; provided referrals for housing assistance, legal and medical services, mental health referrals and training; provided individual and group training and mentoring to ex-offenders; maintained consistent contact with probation and parole officers as well as provided reports for probation and parole officers as needed; and provided social support for consumers and families.
• Championed the “Welcome Home Re-Entry Resource Meeting” for recently released parolees and juveniles after the closing of the DOC PACT Meeting.
• Championed the “Re-Engage Program” for recently released parolees and their children.
• Referred ex-offenders to an ongoing treatment programs for drug and alcohol rehabilitation;
• Coordinated Warehouse Operation/Green Technology Training Program (Santa Monica College) Resulting in 95% completion, graduation and job placement rate.
• Founded the on-site GED program (LA City College) and college admission referral program for ex-offenders and dislocated workers.
• Coordinate the Outreach Program for youth of low-income, homeless, and dislocated workers in the South Los Angeles communities. The program is available to at-risk youth who are first and second time juvenile offenders who have not committed a serious crime against a person; are not gang members; and are not on probation.
PERSONAL INVOLVEMENT CENTER, INC (P.I.C.)-Los Angeles, CA
Manager, Human Resources/Compliance 01/2008-01/2010
Manager of the supportive and clinical services for the Human Resources department (staff of 100); monitored the Agency’s policies to ensure compliance with federal regulations (CFRA, OSHA, Wage and Hour laws, Fair Labor Standards Act, Equal Employment regulations, Workers’ Compensation, American with Disabilities Act, FMLA, COBRA); Completed and performed audits on employee records relating to EDD, UI, WC claims; payroll processing; monitored guidelines and coordinated management training relating to employment opportunity, ****** harassment, compensation, labor relations, and employee relations; analyzed internal processes and recommended and implemented procedural or policy changes to improve operations; performed difficult staffing duties, including recruitment, terminating employees, and administering disciplinary procedures; facilitating team building workshops, and conducting new employee orientation to foster positive attitude toward organizational objectives; and processed personnel action forms affecting pay in accordance with organization established policies and procedures.
ROYAL ACCOMMODATIONS-Los Angeles, CA 09/2006-12/2007
A Mortuary Transportation Service company.
Human Resources Specialist
Primary duties included assisting and performing a variety of clerical duties as directed by Human Resources Director, for staff of 10. Other duties included maintaining personnel files, scheduling, filing, running classified ads in area newspaper for employment opening; screening applicants, including applicant resumes and applications. Scheduled interviews with applicants, and completed EDD and Workers Compensation files
UHP HEALTHCARE- Inglewood, CA 12/1999 –08/2006
UHP is a Regional health maintenance organization (HMO) with $180M in annual revenues. The 150 UHP employees provide Denti-Cal, MediCal, Medicare and Commercial health insurance products to 80,000 Californians.
Delegated Provider Analyst 02/2005-05/2006
Responsible for providing specialized analytical support to Provider Network Services with regard to the credentialing, reviewing, maintenance and improvement of the Organization’s contracted and non-contracted provider records and database. Identified problem areas in provider database and assisted in structuring a process to eliminate the number of errors that are uploaded to LA Care and member transfer between providers.
Delegated Credentialing Specialist/HEDIS PROJECT 06/1999-02/2005
Primarily responsible for processing and oversight of the provider credentialing documents in a timely and efficient manner; including an initial thorough, review and evaluation of application and provider profiles, in order to ensure that applications were complete and accurate, verification of credentials from a variety of primary sources, obtaining results of provider/site review and provider performance information and assisting in preparing the file for presentation to Committee for approval and review; conducting audits of provider profiles from delegated networks and evaluated and monitored the delegated functions of delegated contracted network for compliance; utilized company database to produce reports, and rosters of providers, in order to update provider profiles, as applicable; assisted the Quality and Operations Manager with the maintenance of PMG required report files; conducted research to locate members medical records used to update the statistical data of members participating in the HEDIS Project.
WESTERN BAPTIST STATE CONVENTION 2001-present
A statewide organization of Missionary Baptist Churches (237) that fosters the work of Christian Mission, Christian education and Christian ministry.
Operations and Event Coordinator-Board Meetings and Christian Education Events during Mid-Winter and Annual Sessions
Plan, direct, coordinate and monitor event activities to ensure compliance with applicable regulations and laws, satisfaction of participants, including resolving any problems; confer with staff at each event site to synchronize details; inspect event facilities to ensure that they conform to customer requirements; manage services for events: accommodation and transportation for participants, facilities, catering, signage, displays, special needs requirements, printing and event security.