Coordinate care for those who have sustained injury related to workCommunicate with adjustors, attorneys, and physicians who are involved in the care providedto the injured personCoordinate with physical therapy and EAPFacilitate Cost Savings

Adjunct Professor - Community Health Nursing; ensure students met requirements at the clinical site; pre and post-clinical sessions; evaluated performance and assisted with simulation lab. Liaison between clinical site and Chamberlain College of Nursing.

• Perform detailed and documented reviews of the care management processes and workflows identifying team members or specific processes that need additional training• Listens to recorded calls between the clinical team and patients/families• Measures, documents and reports results against a set of defined criteria ensuring that processes, workflows and calls meet the highest quality standards• Aggregate results of audits• Reviews results with Senior Quality Assurance Specialists• Participates in the IRR process• Serves as a resource to entire team and department regarding quality matters

Support patients who've had joint surgery to ensure they have safe recovery and positive outcomes. Interface with physical therapists, orthopedic surgeons and rehab facilities.

Assess, plan, communicate and educate members regarding their health conditions; develop appropriate care plans and create goals in collaboration with members to promote behavior change and positive health outcomes.Participate in integrated team meetings and rounds to ensure member needs were met on all levels - medically, socially and emotionally.Monitor for appropriate utilization of resources and redirect as appropriate when there is over utilization of the emergency room, hospital and frequent readmissions. Ensure members have a PCP to oversee their health for prevention and identification of high risk medical conditions.

Responsible for day to day operations of the case managment department - specifically case managersEnsure adherence to regulagtory requirments per state contract and accreditation standardsAccountable for quality improvement activitiesParticipated in hiring, performance reviews and disciplinary/corrective action processes

Led and developed managers to produce desired results, adapt to change, engage their teamParticipated in staff selection, orientation, development of managers, and corrective actionFacilitated processes to meet expected clinical outcomes Quality improvement processes to measure delivery of healthcare produce/service to membersClinical liaison with Account ManagersFacilitated Change Management to embrace rapid change and market demandCoaching/Mentoring model utilizing Emotional Intelligence, Motivational Interviewing and Behavior Change concepts with managersPrepare and analyze reports summarizing overall operational performance of teamsRisk Management(Member and Provider Complaints resolution; HIPAA Violation resolution)

Oversight of staff providing services to patients in the clinic(ambulatory care) from the point of registration, physical rehabilitation treatment, ER visits, appropriate referral to case managers and provider/physician services. Hiring, firing, orientation, corrective management, and performance reviews of professional and non professional staff.Liaison between clinic and medical staff; coordinated physician staffing of clinics based on physician availability( most of the physicians were not internal staff of Connect Care)Oversight of Registration DepartmentOversight of Out Patient Rehab Dept and Staff( Physical Therapy, Occupational Therapy, Speech Therapy)Patient Complaint ResolutionQuality Improvement processes focused on improved patient care experience and quality of service delivery.