Danica Lyon Warfield, Rn, Bsn, Ccm Email & Phone Number

Eagan, Mn

Tampa/St. Petersburg, Florida Area

Jacksonville, Florida Area

• Designed and developed clinical program interventions and facilitated work sessions to optimize the achievement of strategic business objectives• Analyzed health metrics and constructed reports and spreadsheets utilizing non-identifiable member data, to strengthen and enhance clinical program engagement• Operated as knowledge expert for Aetna clinical programs, specializing in complex Case Management

Linthicum, Md

• Supervised day-to-day Case Management activities and performed program reporting to ensure adherence to NCQA and documentation requirements• Collaborated with account teams to manage potentially negative outcomes and to enhance Plan Sponsor relationships • Executed medical and disability claim drill down for catastrophic claimant reports and monthly Plan Sponsor engagement meetings

Washington D.C. Metro Area

• Performed patient care activities and implemented treatment plans per physician’s orders• Collaborated with allied services to ensure continuum of care for assigned clients• Assisted in assessing, developing, coordinating, and revising teaching programs for medical staff

Linthicum, Md

• Performed precertification review, admission review, concurrent retro review using Milliman Care Guidelines and Aetna Clinical Policy Guidelines • Coordinated with facility Case Managers and Discharge Planners to ensure seamless transition of patients to the appropriate level of care• Authorized and coordinated required services in accordance with plan benefits