Jacqueline Thomas Email & Phone Number

United States

Houston, Texas, United States

- Coordinate inpatient and outpatient services for individuals with acquired brain and spinal cord injuries TBI/TSCI - Manage 1.5 million dollar annual budget for rehabilitation services including complex durable medical equipment and contracts for the Houston branch - Train administrative staff and clinical counselors on medical and rehabilitation services, coordination of services and payment methodology- Consults with management regarding provider trends and payment rates- Educate providers, caregivers and other stakeholders of the state funded program for interest list referrals- Conduct audits and desk monitoring reviews quarterly for contracted vendors and providers to ensure contract compliance.

Houston, Texas, United States

- Identify barriers of STAR, STAR + PLUS, and STAR Kids members to provide appropriate services to meet daily functional and health care needs including Personal Assistant Services, Skilled Nursing, Emergency Response Systems, and Home Delivered Meals. - Manage value added benefits for members including medical transportation, pest control, and healthy reward incentives for attending scheduled medical appointments- Pre-screen telephonically prospective OCC members for the HCBS service plan wavier upgrade application- Arrange IDT meetings for conflict resolution and care coordination between members and their health care providers. - Coordinate referrals to federal, state, and locally funded programs in Houston and surrounding service areas - Utilization management for health care providers contracted under TMHP

Downers Grove, Illinois

- Managed wavier services for the Department of Rehabilitation Services (DHS/DRS) and the Illinois Department of Aging (IDOA) population- Conducted In-home service, Functional, and Inpatient Discharge planning assessments to determine appropriate level of authorized services for Homemaker, CNA, and Personal Assistant services.- Supervised the completion of Durable Medical Equipment and Home Modifications projects- Coordinated care plan meetings and outreached care plan progress monthly- Supported disease management programs to effectively manage chronic diseases and improve health outcomes- Utilized motivational interviewing techniques to maximize client engagement and support members in healthy lifestyle behavioral change to make ongoing independent medical choices.

Downers Grove, Illinois

- Processed service claims for Medicaid Dual, ICP, TANF, and Family Health Plan population- Conducted Nursing Facility outreach for members within 1 week of initial enrollment - Assessed member service plans creating appropriate authorization of services- Data Analyst for General Medicine population in Skilled Nursing Facilities- Data Analyst for Emergency Department Utilization team - Reduced custodial claim turnaround rate from 10 to 6 days of request - Attend weekly Case Management meetings to understand current policy and procedures, state regulations, and case presentations- Telecommunicate with healthcare providers from Aetna’s Provider Services

Urbana-Champaign, Illinois Area

- Alleviated workflow of the pharmacist by recording and filling prescriptions- Processed prescription claims- Assisted with rotating pharmaceutical inventory and ordering supplies- Provided customer service and support when dispensing prescriptions to patients

Bachelor Of Science - Bs, Community Health And Preventive Medicine

Bachelor Of Science - Bs, Registered Nursing/Registered Nurse

Activities and Societies: Phi Sigma Theta Honor Society