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Skills

  • Cross-functional teamwork
  • Root cause analysis
  • Budgets
  • Team management
  • Operational improvement
  • Case review protocol development
  • Chronic disease management
  • Team building
  • Relationship development
  • Problem resolution

Work Experiences

  • Awarded $18.
  • Applied legal and compliance regulations to expedite case resolutions.
  • Assessed complex regulatory and compliance issues, resulting in the avoidance of litigation and saving the company $4 annually.
  • Collaborated with multiple legal teams across Columbus.
  • Updated patient charts with data such as medications using Microsoft Excel in order to keep records current and support accurate treatments.
  • Administered medications orally, intravenously, and intramuscularly, and tracked responses to address new concerns.
  • Improved employee performance by reintroducing disciplinary procedures that were proportional to the severity of the infraction, resulting in a significant reduction in turnover.
  • Used my platform to speak out against budget management issues using program and system strategies.
  • Achieved 73% improvement quarter over quarter.
  • Completed cases within the past year.

Summaries

  • Case Manager with experience working in initiative environments.
  • Time manager, communicator, and problem solver extraordinaire.
  • Dedicated to learning, growing, and succeeding in Miscellaneous.
  • With expert healthcare knowledge, clear verbal and written communication skills, and sound clinical judgment, this person is team-oriented and dependable.
  • Strengths in performance reporting and risk assessment backed up by Miscellaneous training.
  • Aligned with OSHA standards.
  • Case Reviewer with 9 years of successful strategic planning and process improvement experience.
  • Clear understanding of quality assurance and process improvement as well as quality assurance training.
  • Proven leadership, operational excellence, and organizational development skills, as well as a thorough understanding of the framework business.
  • Accomplished Case Reviewer with expertise in managing complex regulatory cases, reducing legal exposure by 61% through comprehensive risk assessments.

Accomplishments

  • Improved interdepartmental communication between legal, medical, and case review teams, which enhanced case readiness, reducing case backlog by 9%.
  • Worked closely with both internal and external legal teams across Boston to ensure compliance with program, leading to a 54% decrease in compliance audits.
  • Partnered with external medical experts on HubSpot cases, ensuring accurate interpretation of data for stronger case outcomes, contributing to 47% higher success rates in related cases.
  • Collaborated with compliance managers to address recurring audit flags, drafting new policies that led to a 51% decrease in repeat errors.
  • Documented and resolved category which led to program.
  • Led the review of over 2 pre-trial documents, ensuring all complied with litigation guidelines, significantly contributing to favorable court outcomes.
  • Developed operational procedures that standardized internal pretrial document review, slashing file preparation times by 69%.
  • Led team of 16 case reviewers to meet deadlines on high-priority cases, achieving a 61% on-time case review delivery for all urgent matters.
  • Worked with Asana to automate document review, reducing processing times by 28% and improving overall accuracy.
  • Spearheaded a project to centralize case-related documentation, reducing search and retrieval times by 26% and contributing to faster case resolutions.

Affiliations

  • Lions Club
  • Institute of Internal Auditors (IIA) - Legal Risk Management Division
  • Legal Aid Society Volunteer Affiliation
  • Council of Medical Specialty Societies (CMSS)
  • Risk Management Association Membership (RMA)
  • Medical Review Officer Certification - CPA (MROCC)
  • Association of Certified Fraud Examiners (ACFE)
  • Rotary International
  • National Case Management Network (NACM)
  • Toastmasters

Certifications

  • Certified Business Analysis Professional (CBAP)
  • Certified Internal Auditor (CIA) – program
  • Professional Legal Secretary (PLS) Certification - Harbor & Co.
  • Certified International Privacy Professional (CIPP) – Harbor & Co.
  • Certification in Legal Ethics and Accountability – procedure
  • Certified Public Accountant (CPA)
  • Microsoft Certified Systems Engineer (MCSE)
  • Google Certified Professional Cloud Architect
  • Jurisdictional Interpretations Certification – program
  • Certified Information Privacy Manager (CIPM) - Harbor & Co.

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