Rafael Ortiz

Senior Director Government Programs @Capital Rx

Los Angeles, CA, US
EMAILS
r••••••••@cap-rx.com
MOBILE NUMBERS
+91 *********19

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WORK HISTORY

Mar 2025 — Present

Senior Director Government Programs @Capital Rx

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US

As Senior Director, I am responsible for the installation, change management, and oversight of Medicare and Medicaid government programs utilizing technology, research, analysis, testing, and validation as tools. This entails interpreting guidance from CMS and state governments in collaboration with the Legal and Regulatory teams to achieve business objectives and adhere to federal and state regulatory requirements.

EDUCATION

N/A

Los Angeles City College

Computer Science

N/A

Western Governors University

Computer Software Engineering - AI

N/A

Western Governors University

Master of Business Administration - MBA

N/A

Western Governors University

Bachelor of Science - BS, Data Managament and Data Analytics

2022

Udacity

WGU Data Analyst, Data Analytics

2012 — 2014

West Los Angeles College

Business

2002

UEI College

Licensed Pharmacy Technician, Pharmacy Technician

SKILLS

Managed CareAccessGap AnalysisPharmacy AuditData AnalysisMicrosoft AccessSoftware DocumentationTestingData MappingU.s. Health Insurance Portability and Accountability Act (Hipaa)Microsoft WordHipaaPbm Rebate AuditHealthcareAuditingInformaticsLotus NotesAnalyticsFraud DetectionMicrosoft ExcelAlgorithm DevelopmentPharmacyFwaData MiningDatabasesCustomer RelationsRequirements AnalysisMicrosoft OfficeAnalysisMedicaidQuality Assurance

ABOUT RAFAEL ORTIZ

Senior operations and analytics leader with deep expertise designing and governing technology-enabled workflows in highly regulated healthcare environments, including Medicare and Medicaid programs. Proven track record translating CMS and state regulatory guidance into scalable, auditable operational systems. Experienced leading cross-functional transformation across compliance, product, clinical operations, and executive leadership. Adept at operationalizing data, automation, and reporting to drive regulatory adherence, performance management, and scalable growth.

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