Nicole Defonzo Email & Phone Number

Massachusetts, United States

• Assist a panel of >90 medically complex members to access medical care in the community.• Coordinate member care virtually, in member's home or at medical appointments.• Identify care gaps/risks and implement care plans to optimize member health and social well-being.• Collaborate with the integrated care team consisting of caregivers, providers, internal nurses and rapid response team and community supports to ensure members receive the highest quality of care.• Develop member centered care plans and assist members reach their SMART goals.• Present member cases to nurses, behavioral health supports & medical director during case conference.• Provide onboarding training and precept new staff as needed.• Perform timely documentation in accordance with CMS Medicare Guidelines and adhere to established protocols and policies.• Contribute to implementation of new workflows to improve member experience and decrease utilization.

Watertown, Massachusetts, United States

• Telephonically assisted a large panel of >150 medically complex members to access medical care in their community• Identified care gaps/risks and implemented care plans to optimize member’s health and social well being• Collaborated with the integrated care team consisting of caregivers, providers & community supports to ensure members received the highest quality of care• Developed member centered care plans, and assisted members to reach SMART goals• Advocated for members at care plan and social service meetings • Provided onboarding training and precepted new staff as needed • Escalated member issues as needed to Clinical Manager• Performed timely documentation in accordance with CMS Medicare Guidelines and adhered to established protocols/Policies• Contributed to the implementation of new workflows to improve member experience and decrease utilization

Milford, Massachusetts, United States

Assisted the elderly including those with dementia with activities of daily living, light housekeeping, preparing meals, and engaging in stimulating one-on-one activities

Columbus, Ohio Metropolitan Area

• Assisted medically complex patients with meeting care management goals, scheduling primary care appointments and addressing speciality referrals. • Connected patients to resources in the community to best meet their needs and helped them navigate the health care system including their Medicaid managed care plan to improve their quality of life. • Implemented a Care Management template, risk stratification and • PRAPARE questionnaire in patients’ charts. • Performed accurate and timely documentation per health center protocols

Columbus, Ohio Metropolitan Area

• Lived in intentional community with other corps members & acquired skills to live in a gentrifying community• Prepared & served street church in a parking lot where St John’s Episcopal church worships with the homeless• Participated in Diocesan of Southern Ohio speaking engagements on “Becoming a Beloved Community”• Engaged in spiritual direction with corps members bi-weekly

Weston, Massachusetts, United States

Assisted office with administrative tasks, colleagues, greet visitors, & promote events. I coordinated and led many events such as Bingo & Trivia nights.

Weston, Massachusetts, United States

Interned with the Assistant Dean of Student Affairs to combat hunger on the Regis campus. We developed a resource center for the Regis community in need of food and other basic essentials.

Assisted the elderly including those with dementia with activities of daily living & fulfill their sense of belonging with engagement in group activities

Worcester County, Massachusetts, United States

Developed a self-care and healthy living curriculum for the girls attending the organization

Bachelor Of Arts - Ba, Public Health

Activities and Societies: Cum Laude and Alpha Lambda Delta (National Honor Society); Regis College Student Ambassador; Regis Prospective.

Masters, Maternal And Child Health