Experienced Health Care professional with over 20 years of experience in telephonic medical care and case management. Managed care subject matter expert. Seeking a telecommuting care or case management position that will utilize my skills and experience.
Provided case management services to meet the needs of a diverse veteran population and their families. Position requires an advanced level of independent and autonomous functioning as the sole PACT Social Worker in a VA clinic of over 10,000 veterans. Primary responsibilities include but are not limited to: assessments; care planning; acute care discharge planning; referrals to community partners such as home health care, Hospice, DME, etc.; ongoing monitoring and treatment planning; case consultation with interdisciplinary treatment team members; and documentation in electronic medical records. Approximately 75% of my job functions are performed telephonically.
Managed a Regional office for Health Direct, Inc. which provided telephonic care and case management for worker's compensation claims. Our office provided service for 43 States, which required knowledge of and compliance with Federal and State worker's compensation guidelines. Managed and supervised over 30 employees including RN's and support staff. Functioned independently and autonomously in this role. Job duties included but were not limited to: program development and continuous quality improvement; daily oversight of workload assignments and productivity; workflow and process improvements; education and training and all HR functions including screening, interviewing and hiring staff.
Started my career with Highmark as a telephonic behavioral health case manager. Provided pre-certification, authorization and concurrent reviews for behavioral health services. Promoted to Manager of Care and Case Management for a medical unit at Highmark. Supervised nurse care and case managers who provided telephonic utilization review and case management services.
Individual, group and family therapist with adolescents and their families admitted to an inpatient psychiatric hospital. Promoted to Admissions Coordinator. Assessed and conducted pre-certifications with managed care companies for all inpatient admissions.
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