Monica O.
Senior Provider Relations Representative
Provider Relations
How long have you worked at Neighborhood, what do you do here and what part of your job do you most enjoy?
I started working at Neighborhood in February of 2006. My journey began in the Member Services Department where I responded to members’ needs and concerns for seven years. I moved to the Claims Department in 2016, and joined the Provider Relations Team at the end of 2019. I am a Senior Provider Relation Representative. What I enjoy most about my current position is being able to create change. A big part of my role is to listen to our providers and make it easier for them to take care of our members. The changes I contribute to are sometimes minor ones but each seems to have a significant impact, and I find that very rewarding.
What did you do before joining Neighborhood?
I didn’t always work in Health Care. I worked at Fleet (acquired by Bank of America) for seven years. I was a single mom and my daughter was a Neighborhood member in the Children with Special Health Care Needs (CSN) program. Therefore, Neighborhood was dear to my heart because I could focus on her care without worrying about appropriate coverage for her – whether it was medication, Durable Medical Equipment (DME), inpatient stays, or ambulance services – because of her excellent health insurance. When my friend told me about job openings at Neighborhood many years ago, I did not hesitate to fill out an application, and here I am 16 years later.
Of all the projects you have worked on at Neighborhood, do any stand out as being especially meaningful?
One of the initiatives the Provider Relations team has been focused on is listening to our Providers in order to identify where improvements can be made. Last year, we conducted a Pediatric tour where we heard from the providers about what was working and what was not. A common denominator among the Pediatric community was an issue with the Primary Care Physician (PCP) change form, in particular, the Head of Household signature requirement. Our gears started turning; we engaged with other departments, collaborated with Member Services, and together, we improved the form, removing the said requirement. It turned out to be an easy task but made a huge impact on Providers.
Another meaningful initiative was participating in the first-ever “CEO Soak” event to benefit Rhode Islanders with ALS. This was bittersweet for me as the event took place shortly after the passing of my Dad. It gave me something positive to focus on at a very sad time.
Tell us a little bit about the years you spent growing up – sharing what helped shaped your future.
I was born and raised in Pereira, Colombia. When I was 16, my parents, siblings and I moved to the US, and since then I have lived in Rhode Island. I have a very large and tight-knit family. We do many activities together; we love to travel and typically do so in packs of thirty. Creating memories with them is what I enjoy the most, and I would not trade that for anything.
What do you like to do when you are not working?
Family and friends are everything to me. During the week, we spend a lot of our time at the martial arts academy, where two of my children attend classes. Friday is cards night with my family, typically hosted at my house. We all enjoy this activity so much that cousins and aunts show up with no special invitation needed. There is usually some family event going on Saturday and Sunday. I also enjoy going out to eat and having a drink or two with friends. I am always down for a good laugh.
My family and friends also enjoy supporting The Autism Project, an organization that connects people with Autism Spectrum Disorder (ASD) to resources and education that support independent and purposeful lives. We participate in their annual Imagine Walk to bring awareness to ASD and to raise funds for their programming. This is something we began when my daughter, Ally, was in school and receiving excellent services. Of course, we want that to continue for all who need it, which is why we give back to this incredible organization
Share a “Fun Fact” with us. Something about you that others might find surprising or intriguing.
Despite an ACL replacement that I had to get because of an injury skiing, I still enjoy a nice ski day. The feeling of freedom as you go down the mountain, the excitement mixed with the danger, there is something so enjoyable about it. It is that adrenaline rush!
What advice or recommendations would you give to someone interested in the type of career you are in?
Take the time to listen to the providers. Even if it takes longer, try to make changes that will be impactful. Do not just put a band-aid over issues.
Posted August 5, 2022