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Skills

  • Payment collection
  • Vendor negotiation
  • Medical insurance
  • Discharge planning optimization
  • Insurance verifying
  • System updates
  • Community resource partnerships
  • Auditory Case Presentation Skills
  • MS Office
  • Interpreting physician orders

Work Experiences

  • Coordinated multi-disciplinary case conferences.
  • Achieved record low readmission rates of 59%.
  • Administered quality checks on case documentation, achieving Employee of the Year for excellence in compliance from metric in 2018.
  • Collaborated with primary care providers.
  • Oversaw the quality assurance program, which included on-site assessments, internal audits, and customer surveys.
  • Created comprehensive assessments.
  • Collaborated with interdisciplinary teams to create personalized care plans for chronic illness patients across Portland, improving patient satisfaction by 73%.
  • Answered 11 calls per three years to help customers with their questions and concerns.
  • Decreased case processing time by 35%.
  • Solved method issues, improved operations, and provided excellent customer service.

Summaries

  • Recognized on a regular basis for outstanding performance and contributions to the Miscellaneous industry's success.
  • Cut patient wait times by an average of 17 days.
  • 5 years of experience as a patient service representative.
  • Complex Illness Case Manager is a multi-talented Complex Illness Case Manager who is consistently rewarded for planning and operational improvements.
  • Achieved a sustained 85% decrease.
  • Spanish is a second language for me.
  • Patient advocacy and education are skills she possesses, as is her commitment to efficiency.
  • Data-driven professional adept at identifying patient care gaps, improving continuity of care for 12 complex cases, and reducing missed appointments by 20%.
  • Cut 30-day readmissions by 60%.
  • Complex Illness Case Manager with 15 years of successful performance reporting and cross-functional collaboration experience.

Accomplishments

  • Collaborated with social workers and medical professionals to coordinate home care services, reducing patient wait times by 65%.
  • Documented and resolved program which led to system.
  • Secured additional funding of $13 for patient support services by successfully advocating for resource allocation within the program.
  • Lead team of 10 case managers to implement new chronic care protocols, resulting in a 81% decrease in average care cost per patient.
  • Selected as a subject matter expert (SME) on complex illness care coordination, resulting in program for the case management department.
  • Initiated a cross-functional support system that reduced average case resolution time by 17 days.
  • Collaborated with team of 6 in the development of program.
  • Liaised with 18 external providers to facilitate smooth transitions between care settings, reducing patient escalations by 78%.
  • Developed patient education materials on chronic illness management, increasing health literacy by 35% across targeted patient groups.
  • Achieved PMP, enhancing ability to manage complex care plans and improve outcomes for high-risk populations.

Affiliations

  • National Council on Aging (NCOA)
  • Healthcare Information and Management Systems Society (HIMSS)
  • Association of Information Technology Professionals
  • The Professional Association of Health Care Office Management (PAHCOM)
  • The Joint Commission – Hospital Accreditation
  • Association for Computing Machinery
  • Rotary International
  • Society for Healthcare Strategy & Market Development (SHSMD)
  • American Case Management Association (ACMA)
  • Commission for Case Manager Certification (CCMC)

Certifications

  • CompTIA Network+
  • Cisco Certified Network Associate (CCNA)
  • Salesforce
  • Certified Clinical Documentation Specialist (CCDS)
  • Advanced Certificate in Complex Case Management from Lakeside Partners
  • Certified Professional Coder (CPC) from the AAPC
  • Certified Public Accountant (CPA)
  • First Aid/CPR Certified
  • Certified Professional in Healthcare Quality (CPHQ)
  • Population Health Management Certification from Vantage

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