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Click here or scroll down to respond to this candidateCandidate's Name
PHONE NUMBER AVAILABLE EMAIL AVAILABLE
PROGRAM SPECIALIST
Healthcare Case Management
Resourceful and passionate Professional with strong background in the healthcare case management arena. Known for being able to connect with high risk and challenging healthcare management members and develop workable healthcare plans that have led to significant cost savings. Creative problem solver with excellent communication skills and ability to influence others to make positive changes and bring long-term value to communities, individuals and healthcare organizations.
COMPETENCIES
Risk Stratification
Predictive Analysis
Utilization Management
Advocacy for Members
Solution Facilitation
Care Plan Development
Care Resource Coordination
Information Management
Empowerment / Engagement
Resource Development
Change Management
Crisis Intervention
Medical Case Management
KEY ACCOMPLISHMENTS
Through routine referrals, interviewed high-risk members to determine healthcare needs through home-based community services.
Reduced company s member health care expenses, associated with high-risk members, by assisting this category of members with re-engagement with primary care physicians, which resulted in decreased monthly hospitalizations and emergency room visits and saved over $250,000 annually for just one member.
Educated members on health-related conditions to open dialogues with physicians and other health professionals, resulting in increased member knowledge and empowerment.
Met government compliance measures, with company s contract, by promoting member awareness of the importance of adhering to annual routine preventative screenings and exams.
EXPERIENCE
URBAN RELOCATION SERVICES, INC. 7/2017 - 11/2017
RELOCATION SPECIALIST
Conduct personal interviews with each resident or business and record data on Tenant Profile Sheet supplied by URS
Prepare spreadsheet to track progress of relocation process
Inspect replacement dwellings and ensure that they meet decent, safe and sanitary conditions
Develop familiarity with neighborhood or community where project is located, including developing a list of community services, i.e., schools, church, and social organizations
Prepare and submit claims for moving and relocations payments in a timely fashion
Deliver relocation payments and obtain necessary releases if needed
ALTA STAFFING 3/2017 - 7/2017
COMMUNITY CARE COORDINATOR
Conduct complete, timely and accurate face-to-face Health Risk Assessments while maintaining ongoing caseload for regular outreach
Develops and maintains relationships with providers and community resources and acts as an advocate for MHP members
Facilitate interdisciplinary care team (ICT) meetings with members and their identified support teams
Completes post hospital discharge follow-up and coordination of care and acts as a liaison and member advocate between the member/family, physician and facilities/agencies
CENTENE CORPORATION 9/2014 11/2016
Program Specialist II
Identify special needs members through the completion of health screens and other resources.
Work with community outreach/ member advocates to coordinate member care.
Educate providers and community resources on program components and available support services.
Educate members with special needs to foster compliance with program and positively impact outcomes.
Conduct site visits as appropriate for programs and provide support to other special programs.
Develop and modify care plans in conjunction with member, member s family and managing physician.
Develop plan-specific literature and education materials in conjunction with medical director and corporate oversight.
HEARTLAND HUMAN CARE SERVICES, Chicago, IL 9/2001 8/2014
HIV Senior Case Manager
Provided assistance to persons living with HIV/AIDS in the assessment and acquisition of needed medical and psychosocial services by the provision of case management care coordination.
Coordinated needs assessments and developed comprehensive, individualized service care plans (with referral to community resources and protective services) for clients.
Coordinated services required to implement the plan and monitor efficacy of the care plan.
Provided periodic reevaluation and adaptation of the care plan via face-to-face meetings, home visits, phone contact and other forms of communication.
Provided brief counseling and crisis intervention.
Made determination of eligibility for government funded HIV/AIDS programs.
Provided data collection/reporting and surveillance activities, analyzing information for trends.
Partnered with other Ryan White CARE Act agencies and case managers to ensure a "seamless" network of HIV case management and program services.
Provided vocational training and supported clinical and community-based locations.
Increased HIV/AIDS health care literacy through prevention and awareness education.
ADDITIONAL SKILLS
Managed care (Medicaid, Medicare) certification
Microsoft Word, Excel, PowerPoint, Publisher Office
CPR and First Aid Certified; HIV Rapid testing trained
Certified Ryan White Case Manager
HRSA Qualified as a Medical Case Manager
EDUCATION
Master of Business Administration, 2011
St. Xavier University Chicago, IL
Master of Public Health, 2009
St. Xavier University Chicago, IL
Bachelor of Science, Business Administration, 2005
East-West University Chicago, IL |
