Manager Case Management
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I am genuinely passionate about continuous learning because I believe Healthcare needs individuals that look for new and innovative ways to serve the community.
Manager, Case Management Dept. Inova Fairfax Medical Center, Falls Church, VA |May 2023– Current
My role involves leading a team of case managers, social workers, and support staff to ensure compliance with regulatory requirements, improve patient outcomes, and enhance care coordination. I ensure strong collaboration with clinical teams, physicians, and external partners to optimize patient flow, reduce length of stay, and manage readmissions
Developed training documents and trained Inova Fairfax Case Management Department in Insurance Authorization SNF submission.
Inova Fairfax hospital and Del Sol Medical Center in El Paso Tx, respectively.
My duties required assessing the patient’s needs post-discharge and arrange appropriate services such as home health care, rehabilitation, or long-term care, ensuring a smooth transition from the hospital to the next care setting. I worked with insurance companies to confirm coverage, handle authorizations, and resolve potential issues related to the patient’s care and length of stay.
Evaluate and optimize the use of hospital resources, ensuring that care is provided in a cost-effective manner while maintaining high standards of care. Advocated for patients and their families, ensuring they understand the care plan, treatment options, and next steps after discharge Participated in daily multidisciplinary rounds to ensure patient care aligns with hospital policies, governmental regulations, and accreditation standards.
Responsible for managing and coordinating care for members with complex medical needs, often involving multiple chronic conditions or high-risk situations. My role involved in managing the top 1% spend on national commercial plans and all commercial plan LTACH requests. Managing over 100 accounts monthly, assessing the member’s needs, developing personalized care plans, and working closely with healthcare providers to ensure that members receive appropriate, timely, and cost-effective care.
Manager also serves as an advocate for members, helping them navigate the healthcare system and insurance benefits.
As the transition coordinator for hospice care services I met with terminally ill patients, ensuring compassionate and high-quality end-of-life care. My role involved working closely with patients, their families, healthcare providers, and hospice staff. As the coordinator for multiple care sites, I also ensured that all hospice services are delivered in compliance with state and federal regulations, hospice policies, and patient care standards.
RN to MSN in Nursing Leadership, University of Phoenix
RN Washington Hospital School of Nursing
B.A. Communication/Public Relations, California University of PA
