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Skills

  • Budgets
  • Supervision
  • Quality control
  • Communications
  • Process improvement
  • Interdisciplinary team collaboration
  • Budget management for healthcare initiatives
  • Operational improvement
  • Prior authorization processing
  • Problem resolution

Work Experiences

  • Created tailored, patient-specific care plans.
  • Collaborated with risk management teams to analyze adverse events and implement corrective actions, reducing patient complaints by 81%.
  • Coordinated necessary services.
  • Achieved a successful audit with zero findings in 2022.
  • Collaborated with risk management teams.
  • Collaborated with physicians and specialists to create tailored, patient-specific care plans, significantly improving clinical outcomes for 16 high-complexity cases.
  • Collaborated with physicians and specialists.
  • Transported Adobe Creative Suite to 18 months customer locations.
  • Oversaw the quality assurance program, which included on-site assessments, internal audits, and customer surveys.
  • Collaborated with insurance companies.

Summaries

  • Achieved a 24% reduction in emergency room utilization.
  • Achieved a resolution rate of 21% for disputed claims.
  • Accomplished healthcare professional skilled in care coordination, chronic disease management, and budget optimization, reducing operational costs by 25% while achieving high-quality care.
  • Achieved 60% improvement in key patient health metrics.
  • Overall morale and productivity are boosted by experience in policy development and staff management procedures.
  • Adept at identifying high-risk patients.
  • Accomplished professional recognized for reducing care plan development time by 59% and streamlining patient care processes across Columbus.
  • Adept at overseeing a caseload of 8 patients.
  • Collaborative problem solver.
  • Achieved high-quality care.

Accomplishments

  • Identified cost-saving opportunities in patient discharge processes, saving the organization 8 annually.
  • Designed and rolled out patient follow-up programs, leading to a decrease in no-show appointment rate by 40%.
  • Managed resource optimization by overseeing the allocation of 15 beds, improving overall occupancy rates by 22%.
  • Collaborated with team of 13 in the development of method.
  • Trained and mentored a cross-functional team of 18 managed care workers to enhance workflow efficiency and client interactions.
  • Identified opportunities for process improvements in discharge planning, reducing average patient discharge times by 8%.
  • Led the process of securing a standard for expanding managed care services, enabling a 64% increase in community support programs.
  • Enhanced patient outcome tracking systems, improving accuracy and timeliness of reporting by 45% hours.
  • Collaborated with insurance carriers to resolve complex billing issues, reducing denied claims by 70% in 2020.
  • Implemented a comprehensive feedback program for patients post-discharge, showing a 69% improvement in satisfaction metrics.

Affiliations

  • Association for Community Affiliated Plans (ACAP)
  • Case Manager Certification Program (CMCP)
  • American Public Health Association (APHA)
  • American Health Information Management Association (AHIMA)
  • Jaycees
  • National Association for Healthcare Quality (NAHQ)
  • American College of Healthcare Executives (ACHE)
  • National Association of Social Workers
  • Association for Supply Chain Management (APICS)
  • Case Management Society of America (CMSA)

Certifications

  • Healthcare Customer Service Representative Certification
  • Board Certified Patient Advocate (BCPA)
  • Certified Population Health Management (CPHM)
  • Patient Care Technician (PCT) Certification
  • Certified Business Analysis Professional (CBAP)
  • SHRM Certified Professional (SHRM-CP)
  • Certified Electronic Health Records Specialist (CEHRS)
  • Cisco Certified Network Associate (CCNA)
  • Cisco Certified Internetwork Expert (CCIE)
  • Health Insurance Portability and Accountability Act (HIPAA) Certification

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