Roxanna Rosario Serrano
Senior Consultant
- Nagnoi, LLC
Professional Information
Roxanna
K.
Rosario Serrano
Senior Consultant
Nagnoi, LLC
Education, Honors & Awards
University of Puerto Rico, Medical Sciences Campus
Bachelor of Sciences in Community Health Education
(2006)
University of Puerto Rico Medical Science Campus
Master of Science, Health Systems Research and Evaluation
(2011)
Ramón Emeterio Betances Award for Outstanding Undergraduate Achievement
Personal Information
Puerto Rico
San Juan
ACHE, ACEI
Music-Drummer, Volunteer with Children,Travel, Hiking.
Roxanna is a highly organized, self-motivated and goal oriented leader with a solid experience in operations, quality procedures and data analytics in the healthcare field.
6-10 Years
Organization and Prioritization, Team Leadership and Team Work, Planning and Time Management, Customer Service and Business Relations
Roxanna K. Rosario Serrano is currently a Senior Consultant at Nagnoi, LLC., were she is the expert matter subject for healthcare solutions. With over 10 years of experience in the healthcare field, she has worked at Constellation Health, LLC., Medical Card System, Inc.; and the PR Department of Health among others. During her career as a Director in the Medicare Advantage Sector she has implemented the operations of Enrollment, Claims, Customer Service and Financial Recovery Departments and the mechanisms and quality procedures among the operations to serve the Medicare Advantage members in compliance with the Center for Medicare and Medicaid Services (CMS). Roxanna managed the business relations and monitoring of third parties for claims processing, EDI transactions, and provider solutions, among others, in Puerto Rico and US. During her endeavor in the health insurance sector she implemented strategies focused on member retention, access to care, provider network engagement, and CMS-STARS Rating and HEDIS compliance. She has also managed the business and service relation of major hospitals and providers in Puerto Rico and has conducted audit procedures and reporting requirements for state and federal regulatory agencies. Roxanna holds a Master of Science in Health Systems Research and Evaluation from the University of Puerto Rico, Medical Science Campus, class of 2011, and in her thesis she analyzed the factors associated with the use of preventive clinical services among the elderly population of Puerto Rico.
In addition to the WAoFP, Roxanna is a member of ACHE and ACEI. Looking ahead, she hopes to become COO, and eventually establishing her own consulting agency. She credits her success to leadership, goal-orientation and discipline.
Healthcare Industry Procedures
Operations and Regulatory Requirements
Data collection, Analysis and Report Writing
Project Management and Program Evaluation
Quality Assurance and Quality Improvement
Third Parties Administration and Oversight (Puerto Rico and US)
Business Continuity and Disaster Recovery Systems Management for Claims, Call Center, Enrollment and EDI electronic transactions
