Care Navigator resume example with 7+ years of experience
JessicaClaire
, , 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 05/2022Bachelor of Science | PsychologyLouisiana State University At Alexandria, Alexandria, LAGPA:
GPA 3.28
Dean's List Spring, 2021
Expected in 11/2011Medical Assisting Diploma | Medical AssistingRemington College - Baton Rouge, Baton Rouge, LAGPA:
Work History
12/2018 to CurrentCARE NAVIGATORCrossover 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 12/2018CARE MANAGEMENT ASSOCIATE/CERT. MEDICAL ASSISTANTResurgia 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 09/2016CERTIFIED CLINICAL MEDICAL ASSISTANT- LAB ASSISTANTCenter 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