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Skills

  • Regulatory compliance
  • Initiative equipment
  • Admitting processes
  • Chronic disease management consulting
  • Compliance and regulatory standards
  • Disease management standards
  • Team management
  • Adherence to HIPAA guidelines
  • Networking with staff
  • MS Office

Work Experiences

  • Boosted call compliance rates by 23%.
  • Was in charge of resolving disagreements and negotiating mutually beneficial agreements between parties.
  • Assessed patient needs and coordinated transportation virtually, increasing access to essential appointments for 83% % of patients.
  • Collaborated with insurance payers to ensure proper coverage and approval for necessary treatments, expediting care delivery for 34% of vulnerable patients.
  • Achieved a 44% improvement in satisfaction scores.
  • Collaborated closely with social workers to address socioeconomic barriers to health, resulting in a 53% reduction in preventable hospitalizations.
  • Achieved results in under 17 months.
  • Evaluated patients' reported symptoms and existing medical concerns, then made appropriate referrals to medical providers.
  • Audited call logs and care plans.
  • Solved standard issues, improved operations, and provided excellent customer service.

Summaries

  • Adept at collaborating with providers and care teams.
  • Adapted to high-pressure environments, played a pivotal role in addressing the health needs of patients affected by method, delivering effective telephonic support during critical times.
  • Accomplished Telephonic Care Manager.
  • Complied with organizational requirements.
  • Patient education, treatment coordination, and program referrals are all skills that a capable Medical Social Worker possesses.
  • Involved in patient care oversight for a large medical organization, which resulted in improved patient outcomes.
  • In addition to routine care and support, they are trained to provide crisis intervention services.
  • Within Miscellaneous, senior Telephonic Care Manager and outstanding performer in performance reporting and quality assurance.
  • Collaborated effectively with multidisciplinary teams.
  • Strengths in cross-functional collaboration and vendor management backed up by Miscellaneous training.

Accomplishments

  • Coordinated care between 5 healthcare providers and specialists, successfully reducing care fragmentation for high-needs patients.
  • Facilitated personalized care planning for 8 patients annually, resulting in improved medication adherence rates by 29%.
  • Collaborated with community health partners to facilitate referral processes, reducing service wait times for patients by 45% days.
  • Delivered culturally sensitive telephonic care plans, increasing patient engagement among marginalized populations by 77%.
  • Developed telehealth strategies with a multidisciplinary team, resulting in a 57% improvement in chronic disease management outcomes.
  • Guided patients through the healthcare system and secured access to quality assurance, leading to 55% satisfaction improvement.
  • Collaborated with nursing staff to ensure consistent follow-up care via tele-medicine, leading to 28% better patient outcomes.
  • Reviewed and updated patient records to meet regulatory requirements, improving overall compliance accuracy by 36% during audits.
  • Resolved product issue through consumer testing.
  • Utilized patient monitoring software to detect early signs of deterioration, reducing hospital admissions by 48% over three years.

Affiliations

  • Association for Supply Chain Management (APICS)
  • Healthcare Financial Management Association (HFMA)
  • Patient-Centered Primary Care Collaborative (PCPCC)
  • Care Management Society of America (CMSA)
  • Commission for Case Manager Certification (CCMC)
  • American Case Management Association (ACMA)
  • National Case Management Network (NCMN)
  • Society of Women Engineers
  • Association of Information Technology Professionals
  • Population Health Alliance (PHA)

Certifications

  • Cisco Certified Internetwork Expert (CCIE)
  • Registered Health Information Administrator (RHIA)
  • CompTIA Security+
  • Certified Professional in Healthcare Quality (CPHQ)
  • Certified Care Navigator (CCN)
  • Certified Telephonic Nurse Case Manager (T-NCM)
  • Certified in Care Coordination and Transition Management (CCCTM)
  • CompTIA Network+
  • Certified Clinical Case Manager (CCCM)
  • Certified Case Manager Supervisor (CCMS) Summit Group

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