Case Management Coordinator
Assisted in activities related to the medical and psychosocial aspects of utilization and coordinated care. Care Engagement~ Screened and engaged members/patients for care management services. Provided coordinated care support for Case Management team by being members first point of contact for Managed care services.Outreach eligible members for all Care Transition Services. Over 85-90 % engagement rate maintained throughout employment. Vendor Management~ Consistently worked with Multiple Discharge clinical vendors to ensure patients/members were in great care when either discharged from Inpatient/Outpatient visits. Contacted Food Vendors for members/patients either after their discharge or at home care to provide Supplementary Meals. Verify and underwrite Invoices and Contracts to ensure members have received all meals per coverages.Contacted and worked with Home Care Nursing/LTC vendors to provide At home Skilled Nursing and Order Durable Medical Equipment for patients/members. Verify coverage invoices matches members plan. Case Management~ Managed and coordinated members with referrals and Care engagement.Identified Non Clinical and Clinical Care gaps. Assisted members with Community Social services and Agencies for all care needs. Worked closely with RN and MD staff to ensure members is receiving proper managed care. Quality Assurance~ Answered over 1000 calls per month decreasing companies ACD for all inbound calls. Engaged over 80% months of members/patients meeting companies monthly quota. Achieved low talk times while also ensuring members needs have been met. Followed all HIPPA requirements daily providing me with over 90% QA scored during duration of employment. Achievements~ Promoted to Case Management Coordinator from Concierge team due to fast paced learning and ideal experience.
