LCSW with 10+ years experience in medical and mental health settings, working with diverse populations in private practice, health care, outpatient, and inpatient treatment settings. Recently, I have transitioned into the tech industry, leveraging my clinical skills to innovate digital health solutions and enhance user experiences. My unique blend of healthcare and technology experience positions me to drive impactful change at the intersection of these fields.
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Quality Improvement Data AnalystHumana Jun 2023 - PresentLouisville, Kentucky, UsCollects and analyzes process data to initiate, develop and recommend business practices andprocedures that focus on enhanced safety, increased productivity and reduced costDetermines how new information technologies can support re-engineering business processes.specialize in the following areas: benchmarking, business process analysis and re-engineering,change management and measurement, and/or process-driven systems requirementsAdvises executives to develop functional strategies (often segment specific) on matters ofsignificance. Exercises independent judgment and decision making on complex issues regarding jobduties and related tasks, and works under minimal supervision.Uses independent judgment requiring analysis of variable factors and determining the best course ofaction.Develop audit plans and tools for teams to ensure compliance with state contract on performancemetrics and to ensure member needs are metInterviewing, hiring, disciplining, evaluating, and mentoring a diverse care coordination work force.Onboard new staff including but not limited all pre-employment human resource tasks, ordering ofsoftware, hardware, supplies and support technologiesexperience with healthcare quality measures with STARS, HEDIS, and/or clinical program monitoringand evaluationConduct audits with Center for Medicare and Medicaid Services (CMS), ensuring compliance withregulatory standards and guidelinesParticipated in Health Service Advisory Group (HSAG) audits, contributing to the evaluation ofhealthcare service delivery and adherence to quality measures.Spearheaded initiatives to improve healthcare metrics, leveraging data analysis and strategicplanning to identify areas for enhancement and implement targeted interventions. -
Humana Clinical Care Manager, LcswHumana Oct 2020 - Jul 2024Louisville, Kentucky, UsCut down on rehospitializaftions of member's by 53% by consulting with physicians regarding the best possible treatment plan and medication regimen when a member was discharged from the hospital. Maintain organization of patient database, which includes history of members' hospitalizations, medication regimen, diagnoses and treatment plans.Implemented a weekly meeting with staff to discuss goals, updates, and challenges, increasing productivity across departments.Received 2 promotions, from care coordinator to LTSS waiver care coordinator for HIV/Brain Injury in less than 12-months.Educated providers, supporting staff, members and families regarding care coordination role and health strategies with a focus on member-focused approach to care. Facilitated a team approach to the coordination and cost effective delivery to quality care and servicesGenerates reports in accordance with care coordination goalsMeasures the effectiveness of interventions as identified in the members care plan to ensure care plan align with state of Illinois guidelinesParticipate in creating, developing, updating, and maintaining department policies and proceduresProvide innovation and input to improve member care, operational efficiency, and regulatory compliance -
Licensed Clinical Social WorkerGreat Changes Counseling Services, P.C. Nov 2020 - PresentMokena, Illinois, UsProvide personalized counseling and treatment plans to individuals, couples and families with young childrenAssist clients in recognizing their own emotions and developing healthier patterns in their relationships or behaviorsEmpathize with clients who possess a range of backgrounds and experiences, such as those in the LGBTQ+ community or from underserved areasExperience with both CBT and DBTOrchestrated thorough, systemic, therapeutic care by coordinating with the system around the student, including the family, school staff, and external agencies or professionalsMonitored, evaluated, and recorded client progress with respect to treatment goals -
Admissions And Marketor DirectorIcare Jan 2019 - Jul 2020In charge of the admission process at Pine Crest long-term and short-term rehabilitation. I am responsible for providing support for admission requests, and one of my main responsibilities includes informing prospective nursing home residents of their responsibilities, rights, and benefits.
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Psychosocial Rehebilitation Service DirectorIcare Aug 2016 - Jan 2019• Manages 3 direct reports• Coordinates regular patient assessment plans on an annual and quarterly basis• Responsible for providing relevant in-services to staff on various topics• Prepares and presents Quality of Life reports at the quarterly QA Committee meetings• Responsible for discharge planning for short-term residents• Responsible for the entire facility in the role of Weekend Administrator on a quarterly basis• Updates departmental policy and procedures protocol• Developed a training manual for all tasks that need to be performed by staff
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Psychosocial Rehabilitation Service CoordinatorThornton Height Terrace Aug 2015 - Aug 2016Lead Inter-Disciplinary Team in developing comprehensive Plan of Care to meet the individualized needs of consumers •Function as Floor Supervisor, making routine to guarantee that the facility milieu is consistent and appropriate to meet consumer and staff needs •Provide supervision and coverage as needed for after hour crisis intervention service•Develop, implement and coordinate meetings for care plans in conjunction with the interdisciplinary team•Main accurate and timely documentation which complies with federal and state regulations and facility policy, including, but not limited to, the Minimum Data Set, Social History, Psychosocial/Mental Status Assessment, Care Plan, Social Service Progress notes, and Discharge Plans
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Social Service DirectorEl Paso Healthcare May 2014 - Aug 2015Maintained availability to provide leadership guidance for direct service staff as well as fields question and provides answer and assistance with clinic situation•Provided assistance with the development of assessments, service plan development, case management, as well as assistance with crisis intervention•Provided case consultation for direct service staff•Provided overall Program oversight of day to day activities when the Program Director was not on site•Built commitment within the team to overcome resistance from team members and encourage team to embrace changing priorities
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Medical Social WorkerSouthwestern Illinois Visiting Nurse Association Aug 2013 - May 2014Worked in collaboration with other healthcare givers to evaluate the medical or physical condition of the clients•Provided support in crisis and emergency patient situations.•Functioned as hospital liaison to various community resource programs.
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Dcfs Intake InternDepartment Of Children And Family Services Jan 2013 - Jun 2013Prepared detailed case documentation including: opening and closing cases, intake records, investigation summaries, case histories, activity logs, risk assessments, social summaries, needs assessments, service plans•Develop appropriate safety and/or service plans to alleviate risk and provide protection
Reginald Edwards Skills
Reginald Edwards Education Details
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Illinois State UniversitySocial Work -
Southern Illinois University EdwardsvilleSocial Work
Frequently Asked Questions about Reginald Edwards
What company does Reginald Edwards work for?
Reginald Edwards works for Humana
What is Reginald Edwards's role at the current company?
Reginald Edwards's current role is Data Analyst.
What schools did Reginald Edwards attend?
Reginald Edwards attended Illinois State University, Southern Illinois University Edwardsville.
What skills is Reginald Edwards known for?
Reginald Edwards has skills like Mental Health, Mental Health Counseling, Crisis Intervention, Case Management, Group Therapy, Behavioral Health.
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