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Skills

  • Relationship development
  • Insurance verifying
  • Chronic disease management
  • Budgets
  • Data entry
  • Organization
  • Problem resolution
  • Care Plan Development & Implementation
  • Clinical Documentation Accuracy
  • Document filing

Work Experiences

  • Saved $9 by putting in place cost-cutting measures that addressed long-standing issues.
  • Oversaw the quality assurance program, which included on-site assessments, internal audits, and customer surveys.
  • Collaborated with post-acute care facilities to streamline the referral process and reduce patient length of stay by 14 days.
  • Explained treatment plans and payment options.
  • Achieved results over 18 months.
  • Collaborated with initiative customers to determine their needs and deliver metric service.
  • Collaborated with community partners.
  • Conducted health education sessions in Spanish, empowering non-English speaking populations to better manage their care and increase adherence by 84%.
  • Contributed to a statewide initiative.
  • Collaborated with administrators.

Summaries

  • Within Miscellaneous, senior Clinical Navigator and outstanding performer in budget management and quality assurance.
  • Achieved 66% success rate in securing treatments.
  • Adept at navigating complex healthcare systems.
  • Achieved results over 18 months.
  • Clear understanding of budget management and workflow optimization as well as client relations training.
  • Achieved President's Club after successfully navigating complex cases and securing vital and time-sensitive authorizations for 3 patients in 2023.
  • With a talent for collaboration and an eye for detail, she excels at scheduling and medical billing.
  • Achieved effective coordination and advocacy.
  • Collecting patient information, keeping an organized office, and coordinating with medical professionals are all skills she possesses.
  • Adept at navigating complex healthcare systems, with a track record of reducing emergency room visits by 85% through accurate risk assessment.

Accomplishments

  • Effectively guided patients through complex care transitions, leading to a decrease in hospital readmissions for chronic conditions by 67%.
  • Collaborated directly with healthcare providers to navigate the care plan for chronic disease patients, achieving measurable improvements in patient outcomes over three years.
  • Monitored patient progress using Workday, ensuring care plan adherence and reducing emergency visits by 53%.
  • Developed training materials and processes that improved staff engagement in chronic disease management, leading to better patient education outcomes.
  • Analyzed and tracked patient data using QuickBooks to identify high-risk individuals, implementing early intervention programs that reduced emergency room visits by 45%.
  • Implemented insurance pre-authorization workflows that led to a 29% decrease in claim rejections due to administrative errors.
  • Resolved product issue through consumer testing.
  • Liaised with healthcare professionals to address post-discharge care concerns, resulting in increased patient adherence to prescribed treatment protocols by 46%.
  • Implemented a patient follow-up system in collaboration with marketing, increasing compliance with post-discharge medical instructions by 47%.
  • Led interdisciplinary team meetings, achieving a 24% reduction in delays of critical patient care across Boston.

Affiliations

  • Medical Management Institute (MMI)
  • Association for Computing Machinery
  • Society for Social Work Leadership in Health Care (SSWLHC)
  • Society of Human Resource Management
  • American Society of Safety Professionals
  • Case Management Society of America (CMSA)
  • The Joint Commission (TJC)
  • Women's Health Navigator Network
  • American Medical Informatics Association
  • Care Coordination and Transition Management (CCTM) Certification

Certifications

  • Advanced Care Planning Certification
  • Medical Nutrition Therapy Certification (MNT)
  • Certified Public Accountant (CPA)
  • Certified Health Navigator (CHN)
  • ServSafe
  • Healthcare Navigator Certificate (HNC)
  • Board Certified Patient Advocate (BCPA)
  • CompTIA A+ Technician
  • Certified Case Manager (CCM)
  • CompTIA Network+

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