Brenda H. Email and Phone Number

Complex Case Management

Reviewed high volume caseload of inpatient utilization to determine appropriateness and medical necessity using MCG criteria Participated in Daily Telephonic Physician Rounds Assisted with facilitation of the discharge or transfer plans and provided discharge follow up to assure that medical care was appropriate Identified barriers to efficient hospital utilization and facilitate resolutionServed as a liaison between the hospital, health plan, vendors, and providers

Assisted in the transition of care process to facilitate smooth transitions from the inpatient to outpatient settingsConducted assessments specific to transition of care Assessed members’ understanding of discharge instructions/current treatment plan and reviewed with the memberAssisted with coordination of post discharge care as neededIdentified members’ appropriate for ongoing complex case management and referred to CM as appropriate