Carol Podjan Email and Phone Number

Responsibilities:Managed the overall operations of a free standing Memory Care community from the ground up. Marketing and operational responsibilities began well before our opening. Oversee the general contractor and learn about the guts of the community to literally learn the community inside out! Developed programs, build teams, write policies and procedures, prepare for state and county inspections.Accomplishments: Put a strong team of 50 employees together and opened this community from the ground up. In six months, as a team, we exceeded our goals and our census is 52%. More importantly, the care we provide is extraordinary. Skills Used Strong team management skills as well as sales and operational skills

Executive Director: Responsible for leading and directing the overall operation of the community in accordance with resident needs, government regulations, and our internal policies and procedures. Built occupancy with my team from 71% to 98% over 13 months and maintained at Emeritus at Hoffman Estates. Other tasks include maintaining excellent service quality, high occupancy, and meeting corporate financial goals within established budgetary guidelines.Resident Care Director/Director of Nursing: Maintain excellent service standards in the senior living industry. Train, supervise, and coordinate members of our Wellness Department in accordance with residents’ needs, state regulations and Emeritus policies and procedures. Other responsibilities include maintaining high occupancy, meeting community financial goals and directing and coordinating overall resident care plan from move-in to discharge.

Initial hospitalization reviewsContinued stay reviewsReview for outpatient procedure authorizationExperienced with Milliman and Interqual criteriaPrepare Medical Director reviewsStrong computer

Manage Care Coordination team with up to 8 employees and over 100 client groups. Team Lead Medicaid pre-authorization and inpatient care as well as self-funded clients.Write programs for Quality Improvement. Audit cases for internal Quality Assurance. Coordination with clients to ensure client satisfaction. Review planned documents for advice to clients and brokers for new contracts. Criteria training for appropriate usage. Work with Medicaid group monitoring NCQA guidelines. Actively working and monitoring the Appeals process. Quality monitoring to meet URAC guidelines through audits and training. Hire and terminate employees as needed. Monitor progress of new employees and provide additional training as needed. Provide retraining for employees with quality difficulties. Conduct case intake for medical and psychiatric cases for review. Provide decision making for authorizations and extended hospitalization stays as determined by clinical criteria. Apply proficient computer skills for proper and appropriate documentation. Utilize Medical Director for physician review as appropriate. Stay updated with URAC accreditation changes in order to manage cases appropriately. Conflict resolution for team management as well as customers and clients.