India Watson, Rn, Msn, Ccm, Cmpc Email & Phone Number

Memphis, Tn, Us

Seattle, Washington, United States

Seattle, Wa

Case Management Workflow AnalysisDevelop of Training PlansInstruct and Assist with Case Management Department Redesign

Partner with clients to perform training needs assessments for requested training deliverables.Engage clients in the learning process through the collaborative development of annual or on-going training plansAuthor written training proposals and training case closure summary to define scope and outcome of training.Interact with clients to identify opportunities for expanded use of the Care Guidelines products licensed by a client.Deliver training on all Milliman Care Guidelines products and formats per established standards in various venues

Seattle, Washington, United States

Planned, implemented and evaluated appropriate health care service in conjunction with the physician’s treatment plan.Handled complex, high acuity cases and/or account sensitive cases.Performed prospective, concurrent, and retrospective reviews for inpatient acute care, rehabilitation, referrals and select outpatient services including DME.Ensured that case management program objectives are met by evaluating the effectiveness of alternative care services and that cost effective quality of care is maintained.Performed leadership role on team when implementing new tools for case management, organization and negotiation skills

Lead Peer Review committee activitiesConducted clinical review of adverse eventsConducted medical records reviewSupported preparation for regulatory auditsLead clinical quality improvement through focused activities on the HEDIS process.Collected, documented and organized of evidence for NCQA/state audits

Planned, implemented and evaluated appropriate health care service in conjunction with the physicians treatment plan.Handled complex, high acuity cases and/or account sensitive cases.Performed prospective, concurrent, and retrospective reviews for inpatient acute care, rehabilitation, referrals and select outpatient services including DME.Ensured that case management program objectives are met by evaluating the effectiveness of alternative care services and that cost effective quality of care is maintained.Performed leadership role on team when implementing new tools for case management, organization and negotiation skills

RN; Provided patient care under physician orders including conducting thorough assessments, administering medications, assisting with activities of daily living and maintaining patient records.Supervised coordination of care provided by nursing assistant staff.Assessed the condition and care of patients to determine if there is a need to contact the physician

Travel; Provided patient care under physician orders including conducting thorough assessments, administering medications, assisting with activities of daily living and maintaining patient records.Supervised coordination of care provided by nursing assistant staff.Assessed the condition and care of patients to determine if there is a need to contact the physician

Inpatient Care; Planned, implemented and evaluated appropriate health care service in conjunction with the physician’s treatment plan for commercial and Medicare D enrollees.Performed prospective, concurrent, and retrospective reviews for inpatient acute care, rehabilitation, referrals and select outpatient services.Ensured that case management program objectives are met by evaluating the effectiveness of alternative care services and that cost effective quality of care is maintained

Investigated and resolved escalated and complex customer service questions, calls and complaints by obtaining necessary information from policies, procedures and practices.Served as primary contact and liaison between health plans, service centers and functional areas.Provided guidance, training and instruction to new representatives.Determined best method to resolve problems ensuring customer satisfaction and adherence to company policies.

Doctorate (C) Candidate, Doctorate Of Strategic Leadership

Master Of Science (M.S.), Nursing Administration