LiveCareer-Resume

Care Navigator resume example with 7+ years of experience

JC
Jessica Claire
, , 100 Montgomery St. 10th Floor (555) 432-1000, resumesample@example.com
Professional Summary

Driven and compassionate health care professional with over ten years hands-on experience in fast paced work environments. Accountable and responsible with a strong focus on patient/customer experience, service measurement and process improvement. Dedicated advocate for individuals adept at public and community relations, staff development and project management. A strong decision maker who understands the importance of compassion and patience. Currently seeking a position to develop and implement new and innovative health care improvement processes to improve quality and patient safety and care.

Skills
  • Microsoft Office
  • Medical Office Management
  • Excellent written and verbal communication skills.
  • Empathic listener and persuasive speaker.
  • Excellent presentation and negotiation skills.
  • Process improvements
  • Provider Relations
  • Patient relationship management
  • HIPAA compliant
  • ICUE proficient
  • Team-building
  • Self-motivated professional
Skills
  • Microsoft Office
  • :
  • Medical Office Management
  • :
  • Excellent written and verbal communication skills.
  • :
  • Empathic listener and persuasive speaker.
  • :
  • Excellent presentation and negotiation skills.
  • :
  • Process improvements
  • :
  • Provider Relations
  • :
  • Patient relationship management
  • :
  • HIPAA compliant
  • :
  • ICUE proficient
  • :
  • Team-building
  • :
  • Self-motivated professional
  • :
    Education
    Expected in 05/2022 Bachelor of Science | Psychology Louisiana State University At Alexandria, Alexandria, LA GPA:
    • GPA 3.28
    • Dean's List Spring, 2021
    Expected in 11/2011 Medical Assisting Diploma | Medical Assisting Remington College - Baton Rouge, Baton Rouge, LA GPA:
    Work History
    12/2018 to Current CARE NAVIGATOR Crossover Health | Tolleson, AZ,
    • Initial triage, administrative intake of members and/or managing admission/discharge information post-notification.
    • Maintained metrics by reaching 20-30 members daily
    • Working with hospitals and clinical teams to get members seen by clinicians in home post discharge.
    • Established support by communicating complex information in understandable terms both verbally and written while critically analyzing issues from multiple angles to determine next steps and / or root cause for members.
    • Collaborate and coordinate across multiple teams and departments. Develop effective working relationships with applicable internal and external customers
    • Recognize trends with escalated issues and identity preventative action
    • Providing information on available within UHC network.
    • Managing referrals and processes incoming/outgoing referrals, and prior authorizations.
    • Take telephone messages and provide feedback and answers to patient/physician /pharmacy calls Gathers required details to inform treating Clinician of ongoing complaints.
    • Advises provider of patient's condition, complaints, compliance or adverse reactions to medication and/or treatment to medication and/or treatment.
    • Monitors delivery of care by engaging with patient to identify progress toward desired care outcomes.
    09/2016 to 12/2018 CARE MANAGEMENT ASSOCIATE/CERT. MEDICAL ASSISTANT Resurgia Health Solutions | City, STATE,
    • Managed high volume inbound calls of 60-80 live calls daily and provide feedback and answers to patient/physician /pharmacy calls; Gathered required details to inform treating Clinician of ongoing complaints.
    • Advises provider of patient's condition, complaints, compliance or adverse reactions to medication and/or treatment to medication and/or treatment.
    • Transmit messages from patients and front office staff to physicians, practicing nurse and physician assistants.
    • Performs patient outreach, education and teaching to improve compliance with care plans, under direction of providers.
    • Monitors delivery of care by engaging with patient to identify progress toward desired care outcomes.
    • Provide support to children and youths with challenges including interpersonal relationships, social interaction, behavioral conduct, and communication skills.
    • Assist youth in DFACS system adaptive and effective coping skills that can be utilized in home, community and or educational setting under direction of provider.
    • Tracks, manages and expedites referrals, consults and orders to ensure receipt and completion.
    • Monitored status of orders including labs, DME, HHC, Imaging studies, RX etc.
    • Supports completion of medical documents requested by third party payors and other providers, as directed by clinical provider.
    • Engaged with other providers to coordinate patient care and foster compliance with plan of care, as directed by Clinician.
    • Conduct intake interviews with patients and refer patients into appropriate social programs.
    • Assists in completion of care plans and psychosocial assessments in timely fashion.
    07/2014 to 09/2016 CERTIFIED CLINICAL MEDICAL ASSISTANT- LAB ASSISTANT Center For Pain & Rehab Medicine | City, STATE,
    • Daily patient charting of 15-20 patients daily
    • Insurance verifications along with managing billing concerns for patients.
    • Decreased wait times by assisting in patient triage and conducting intake interviews with patients and set up appropriate social program referrals prior to provider seeing patient.
    • Scheduling patient appointments.
    • Precertification.
    • Assisting in 5-10 minor joint injection procedures weekly.
    • Prepared treatment rooms for patients, including cleaning surfaces and restocking supplies
    • Collected forms, copied insurance cards and coordinated patient information for billing and insurance processing
    • Led patients to exam rooms, answered general questions and prepared patients for physician by explaining process
    • Educated patients about medications, procedures and physician's instructions
    Certifications
    • Psychological First Aid through John Hopkins University
    • Adult Mental Health First Aid through Nation Council For Mental Wellbeing- exp 07/2024

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    Resume Overview

    School Attended

    • Louisiana State University At Alexandria
    • Remington College - Baton Rouge

    Job Titles Held:

    • CARE NAVIGATOR
    • CARE MANAGEMENT ASSOCIATE/CERT. MEDICAL ASSISTANT
    • CERTIFIED CLINICAL MEDICAL ASSISTANT- LAB ASSISTANT

    Degrees

    • Bachelor of Science
    • Medical Assisting Diploma

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