Bachelor of Science:Social Science and Art's,2011Strayer University
Certified Case Manager American Board of
Case Management - November 2013
Certified Professional in Utilization Review Interqual,
McKesson - July 2014
Case Management Specialist Certification-
Florida Risk Management 2015
Dedicated professional with solid background in administration, marketing, sales and public relations. Strategic and creative thinker with effective communication and writing skills. Proven ability to develop strong community and professional relationships quickly and promote teamwork. Management and multitasking experience within a fast paced environment . Proficient in Medicaid, Medicare, HMO and Manage Care guidelines. Proficient with Microsoft Office and Windows. Excellent references from professionals's in the medical field, upon request.
Director of Admissions, 02/2005 to 10/2016Ponce Plaza Rehab & Nursing － Miami, Fl
Director of Admissions
Plaza Health Network- Miami, Fl
Directed daily operations within a fast paced Admission Office, including developing organizational strategies and leading implementation of quarterly marketing plans for a 147 bed facility averaging a 97 % occupancy throughout tenure and increasing Medicare census by 45 %. Utilized broad scope of industry knowledge toward directing involvement with community outsourcing entities. Planned events to sponsor community advocates. Developed and maintained strong relationships with new and / or existing providers, vendors, and physicians, social workers at surrounding hospitals. Assisted in new contracts with HMO'S, MSO'S, and negotiated letter of agreements depending on level of care . Participated and assisted in family meeting's p, with other department heads and assisted with discharge planning . Assisted in creating and implementing facility policies to improve process of admission's helping to increase response time and other department heads involvement in assisting admission once patient at facility. Created many community events in surrounding neighborhood to maintain close ties and awareness of our services. Put into place Pet Therapy Program in facility with assistance from Miami Dade Animal Shelter.
Case Manger, 03/2003 to 03/2006Select Specialty Hospital － Miami, FlAssessed new admissions, identified barriers for discharge, assigned tentative discharge planning, making sure patient meets criteria for admission. Identified prior skilled nursing facility admission and days utilized, verified insurance coverage and obtain approval / authorization from managed care companies. Reviewed all cases for continued stay criteria, referred cases to skilled nursing facilities, arranged home health care services and DME (Durable Medical Equipment) when needed, arranged dialysis treatment for patients on hemodialysis, verified that assisted living facilities discharges will meet patients' needs. Sent clinicals to managed care companies on a weekly basis for continued stay approval, entered criteria and authorization into system,while completing interdisciplinary team forms. Scheduled and met with patients / family members to discuss any questions or concerns and discharge planning, discussed cases with physicians when patient did not meet criteria for admission or continued stay.Was on-call for case management issues after-hours and holidays.
Care Coordinator, 10/2000 to 03/2003Careplus － Miami, FloridaAssessed new admissions and continued stay cases utilizing InterQual criteria, IS-SI, member of Quality Assurance / Utilization Review Committee, reported cases with quality issues to committee. Reported cases with utilization issues over or under to committee. Communicated outcome to physician's following the recommendations of the committee. Reviewed criteria for potential admissions from the emergency room department during daily rounds with medical director . Participated in discharge planning with other social worker's, case manager's and family member's of patients.