Lynda C. Email and Phone Number
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Senior Clinical Health Services Leader with demonstrated success operationalizing new functions. I restructure and lead utilization care management strategies for Medicare, Medicaid, and commercial contracts serving large member populations across large regions. I define strategies, establish policies and procedures, build/rebuild teams, and drive efforts to improve member, patient, and fiscal outcomes. Colleagues know me as an outstanding communicator who gains active support from internal and client management stakeholders within the associated community, commercial organizations, and internal teams.Some of my successes include:UTILIZATION MANAGEMENT RESTRUCTURING & TEAM OPERATIONALIZATION (Banner Health): Took charge of a new contract program with Medicare/Medicaid members across 9 counties. Re-defined roles, recruited team members, defined assessment criteria and led training. Drove daily member patient management up to 20X in 12 months.TEAM LEADERSHIP (Banner Health): Nurtured a collaborative team environment, maintained open open-door policy, and conducted formal one-to-one monthly meetings with each team member. Grew team from 4 to 11 in 12 months, achieving high team morale and retention rate of 100%. Promoted 2 managers.SPECIALIZED CARE IDENTIFICATION (Banner Health): Set up tracking processes to uncover patient members requiring specialized care management strategies. Raised identification of specialized care patients from 10% to 50% of projected need with continued upward trend.HOSPITAL BED EFFICIENCIES (Aetna/CVS): Initiated residential patient reviews to identify patients ready to be moved out of residential beds, gradually opening 55-bed slack enabling move of inpatients from hospital to residential beds. Improved appropriate care levels and captured large one-time and annual savings.SPECIALTIESClinical ExpertiseClinical Operations Regulatory ComplianceMedicaid/Medicare/Commercial PoliciesUtilization Management Care Management
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Clinical Manager Of Case ManagementGila River Health CarePhoenix, Az, Us -
ContractorImcs Group Jul 2024 - PresentIrving, Texas, UsPrior and concurrent review. Fraud review. -
Associate Director Of Behavioral HealthBanner Health Feb 2024 - Jul 2024Phoenix, Az, UsPlays a key role in ensuring budgetary goals are met on an annual basis. Provides operational and clinical support to licensed social workers, counselors, utilization management team members, RN Case Managers, Recreational Therapists, and Transitional Care Navigators.Has responsibility for both Banner Del E. Webb Medical Center and Banner University Medical Center which includes inpatient acute behavioral health care for adults, geriatric and dementia patients.. -
Personal Goal PursuitCareer Break Dec 2022 - Mar 2024Completing a doctorate in Organizational Leadership with an emphasis in Healthcare Administration.
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Associate Director Of Behavioral Health Case Management ServicesBanner Health Aug 2020 - Dec 2022Phoenix, Az, UsLynda supervised manager-level staff in the execution of Utilization Management operations to ensure regulatory compliance. She oversaw the ongoing operations and process improvement initiatives within the UM department. She assisted in designing and improving auditing metrics to track performance against operating standards and regulatory performance. She facilitated and/or participated in project teams with proven ability to plan, organize, schedule, direct, control, and monitor department and large-scale functional projects.
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Senior Manager, Behavioral Health Care Management ServicesBanner Health Mar 2019 - Aug 2020Phoenix, Az, UsLynda used her clinical knowledge to direct utilization and care management teams. She promoted interdisciplinary collaboration for adult members covered by Medicaid and/or Medicare. She hired, trained, conducted performance evaluations, and directed the workflow for staff. She provided leadership assistance for optimal clinical, operational, and financial outcomes. She acted as a consultant within the organization. She supported change and process improvement activities. She analyzed data and healthcare trends to gain efficiencies and improve patient outcomes. Additionally, she played a key role in ensuring budgetary goals were met.
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Health Services SupervisorAetna, A Cvs Health Company Apr 2016 - Mar 2019Hartford, Connecticut, UsLynda had clinical and administrative oversight of residential and inpatient services. She developed healthcare management staff and high-performing teams. She worked closely with functional area managers to ensure consistency in clinical interventions supporting members. She was accountable for meeting the unit's financial, operational, and quality objectives.Lynda implemented clinical policies & procedures per applicable regulatory and accreditation standards. She served as a content model expert and mentor regarding practice standards, quality of interventions, and problem resolution using critical thinking. She also ensured the implementation and monitoring of best practice approaches and innovations to better address the member's needs across the continuum of care. And she created a positive work environment by acknowledging team contributions and supporting collaboration at all levels. -
Utilization Management ConsultantAetna, A Cvs Health Company Jul 2015 - Apr 2016Hartford, Connecticut, UsLynda provided managed care coordination, services support, and education for patients in a clinical care management setting. She shaped care for members by gathering clinical information and applying medical criteria and clinical judgment to align the best treatment strategies for optimal long-term success. She evaluated discharge plans and provided recommendations to ensure support and resources were established for continuum of care. She managed multiple priorities with strong business acumen and organizational skills, with excellence in documentation, records management, verbal and written communication, and follow-through. She supported new initiatives and maintained full alignment with corporate objectives, embracing change, and serving as a role model to influence staff support and further benefit member outcomes.
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Grievance And Appeals Behavioral Health ConsultantAetna, A Cvs Health Company Jul 2014 - Jul 2015Hartford, Connecticut, UsLynda assisted members throughout the grievance and appeals process. She reviewed case paperwork, created an appeals process, assigned a case investigator, communicated important updates and requests for information, and notified the member of the final determination. She condensed complex information into succinct documentation for members.
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Clinical Care Manager/Utilization ReviewValueoptions Oct 2009 - Jun 2014Norfolk, Va, UsLynda provided level of care and utilization reviews, managed multiple account-specific workflow processes; and triaged calls. She completed level-of-care reviews for initial and concurrent authorizations. She also provided referrals based on telephonic assessment. -
Owner (Sole Proprietor)Mpower Services Apr 2009 - May 2013Runcorn, GbLynda founded the business to offer outpatient individual and family therapy services, with a mission to provide clients with the tools and resources needed to achieve long-term success and improved quality of life. She managed the full scope of business from the establishment to securing resources and contracts; development of policies and procedures; recruiting, hiring, and development of staff; to the assessment, counseling, and support of clients. Lynda completed FMLA documentation and disability assessments. She provided parent training services and kinship foster home assessments. Highlighted Achievements:Secured State contracts to provide services for children and families involved with DCS. Responded to RFP requests and provided documentation to secure state contracts.Regulated services and operations according to internal standards and legal requirements.Liaised between multiple organizations, established strong partnerships with service providers, and became a counseling resource for EAP referrals.
Lynda C. Skills
Lynda C. Education Details
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Grand Canyon UniversityOrganizational Leadership/Healthcare Administration -
Cameron UniversityBehavioral Sciences
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Cameron UniversityPsychology
Frequently Asked Questions about Lynda C.
What company does Lynda C. work for?
Lynda C. works for Gila River Health Care
What is Lynda C.'s role at the current company?
Lynda C.'s current role is Clinical Manager of Case Management.
What is Lynda C.'s email address?
Lynda C.'s email address is mp****@****aol.com
What is Lynda C.'s direct phone number?
Lynda C.'s direct phone number is (860) 273*****
What schools did Lynda C. attend?
Lynda C. attended Grand Canyon University, Cameron University, Cameron University.
What are some of Lynda C.'s interests?
Lynda C. has interest in Networking, Social Services, Motivational Speaking, Investing, Business Development, Economic Empowerment, Civil Rights And Social Action, Education, Poverty Alleviation, Career Development.
What skills is Lynda C. known for?
Lynda C. has skills like Wellness, Therapists, Addiction Recovery, Anger Management, Public Speaking, Personal Development, Grief Counseling, Counselling, Self Esteem, Behavioral Health, Teaching, Crisis Intervention.
Who are Lynda C.'s colleagues?
Lynda C.'s colleagues are Luanna Garcia, Treia Lee, Amalia Arnold-Brown, Robert Kiesecker Iii, Laree Emerson, Robyn Dlucca, Clayton Harvey.
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