Mario Jaramillo

Background

About Mario Jaramillo

A highly motivated and dependable professional with nearly 2 decades of experience navigating the complexities of healthcare regulations, and influencing critical business partners, including executive leadership. Consistently meets business unit and enterprise goals while promoting company culture, mission, and values. Strong research background and communication skills. PROJECT MANAGEMENT •Lead task forces/meetings to implement inter-department alignment, and mitigate risks which resulted in lower inventories across multiple departments from 40 hours work on hand to 24 hours •Spearheaded project to initiate operational impact work plans related to new federal and state legislations that resulted in a 50% reduction of out-of-compliance processes. •Lead on HHS Portal Release Manager project to manage a multidisciplinary team including Product, Actuary, Finance, Underwriting, Marketing, and IT to ensure all HHS requirements are met by the HHS Health Insurance Oversight System (HIOS) and HHS Rate & Benefits Information System (RBIS)which avoided all fines and penalties. Scope of project included 14 states. REGULATORY/COMPLIANCE •Managed and processed internal audits, Department of Insurance (DOI) inquiries, member responses, grievances and other related examinations. •Drove successful implementation of key corporate/department initiatives including Guidance Tracker (Compliance Log) to ensure compliance with new Enrollment and Billing regulations. OPERATIONAL/ADMINISTRATIVE •Provide consultative expertise and data analysis for Adult Primary Care (APC) and Urgent Care (UC) service line; Provide guidance and judgment within practices/policies in selecting methods and techniques for obtaining results; Monitor and provide department and medical center specific performance to ensure regulatory standards are met. •Developed internal and external communications related to P & Ps, QRGs and other procedural documentation for various initiatives, business changes and updates. •Developed reports including Operating Reports for VP, Service Operations Flash Report, and Quality-MTM-At Risk Report that utilizes enterprise data to help manage inventories, resource allocation and opportunities. •Provided analytical and project management support on cost containment initiatives to Health Care Management for California, Nevada and Colorado which led to cost of care savings of 20M.