Adele Eastman Email & Phone Number

New York, United States

•Provide administrative support for the Clinical Evaluation Manager with inpatient and discharge planning coordination and coordination of care for high risk members.• Promotes problem-solving and goal-oriented partnership with individuals/legally responsible persons, providers, etc.•Assists with ensuring compliance with VNSNY CHOICE Medicare Advantage policies and procedures as well as CMS regulations.•Explained relevant services, coordinating and monitoring implementation of programs.•Enter authorizations, hold, decreases, increases and discharges in accordance to department processes and workflows.•Providing authorization of DME equipment or medical supplies to various providers via phone, fax, or email.•Facilitate flow of evaluation(s), orders, progress notes, and prescriptions from provider(s) to Clinical Evaluation Managers per Utilization Management department protocol.•Utilize appropriate tracking tools, i.e. authorization logs, Outlook Calendar or Task function, to ensure follow-up on critical timelines.

Acts as a liaison between the Assessment Unit and Care Coordinators; forwards completed Assessments to Care Coordinators. •Transfer completed assessment documents into operating systems.•Monitors assigned assessment databases to ensure all cases are assigned; advises management of unassigned cases. •Answers calls/emails concerning assessments; responds to inquiries, requests for information; and resolves routine moderately complex issues from other departments. •Performs various administrative support functions (e.g. generating/sending enrollment packets, photocopying, filing, faxing, obtaining M11Qs, etc.) to support CHOICE Health Plan Operations

•Scheduling Nurses, PT, OT, ST & HHA for Home Health Agency, putting in frequencies, doctors’ orders, constant communication with nurses and therapists in the field and schedule client’s appointments/visits according to care plans and staff availability. Perform scheduling of RN, Rehab, Social Work and HHA patient care visits, processing workflow, and coordination of scheduling activities, which support patient service delivery.•Acts as liaison between assigned team/branch nurses, therapists and HHA while scheduling patients for start of care and revisits.•Responds to researches and resolve routine and complex scheduling issues; and requests for information in an accurate, effective and timely manner.•Refers clinical/difficult issues to appropriate staff as necessary. •Contact care providers and clients regarding day-to-day changes. •Provides daily schedules to PT, OT, ST & RN prior to each day's visits.•Maintains scheduling system so records are accurate and complete and can be used to analyze patient/staffing patterns.•Uses manual/computerized system to match availability with patient’s preference in terms of date and time.

• Assist executives in establishing workplace initiatives, as well as daily affairs.• Sort mails, answer calls, take messages, and follow up with customers.• Organize and schedule meetings, arrange travel, manage records, and monitor expenses.• File, copy, scan documents and order supplies.• Ensure that the project contracts and bids are complete and filed on time.• Exercises independent judgment and keen decision-making skills to maintain workplace efficiency and productivity.

Master'S Degree, Health/Health Care Administration/Management

Bachelor Of Science - Bs, Accounting

Associate Of Science - As, Business Administration And Management, General