MLTSS Care Manager - Centene Corporation (Fidelis Care) - NJ
(2019-11 - 2026-09)
- Provided complex care management for MLTSS members with diverse medical and functional needs, conducting comprehensive assessments and developing individualized Plans of Care in collaboration with members, families, and providers.
- Coordinated and authorized a broad range of medical, home, and community-based services, including home care, medical day care, durable medical equipment, meal delivery, and community resources.
- Educated members and caregivers on disease management, preventative health, health maintenance, benefit utilization, and available resources while addressing social determinants of health, including housing, food access, and transportation.
- Ensured accurate, timely documentation and regulatory compliance with CMS, NJ FamilyCare, and MLTSS requirements; consistently achieved 100% on quality audits through strong attention to clinical and documentation standards.
Human Services Manager - City of Scottsdale - Scottsdale, AZ
(2018-04 - 2019-05)
- Supervised licensed and master’s level social workers and counselors that provide care management and social services to senior citizens and persons with varying physical, intellectual, and emotional abilities.
- Collaborated with non-profits and governmental agencies to establish partnerships that enhance services and programs.
- Redesigned and implemented social service assessment tools, policies and procedures, and software enhancements, while working in tandem with multiple professional teams and city departments.
- Negotiated with outside sources for additional grant funding, prepared social services grant applications, monitored and oversaw grant implementation and maintained relationships with funding bodies.
- Prepared and monitored budgets, prepared and presented to City Council, created council communications, and provided oral and written reports to the Human Services Commission.
Integrated Care Liaison - Aetna/Mercy Maricopa Integrated Care - Phoenix, AZ
(2016-11 - 2018-04)
- Supported clinical teams and members in identifying needs with appropriate use of physical and behavioral health resources, and facilitated integrated care coordination.
- Rigorously committed to providing health education which supports positive lifestyle changes and improving quality of life.
- Applied system data tools to evaluate the physical, behavioral, and social determinants of a diverse clientele base, collaborated with multiple stakeholders to coordinate the best possible outcomes, and maintained member records in accordance with business guidelines and highest professional standards.
Care By Design Program Director (Formerly Pathways Social Services) - Foundation for Senior Living - Phoenix, AZ
(2003-08 - 2016-11)
- Developed, managed, implemented policies and procedures, created operational metrics, budgets, direct service to geriatric disabled non-profit social service programs.
- Provided clinical supervision to staff, case analysis, training, counseling, care plan development and implementation.
- Instrumental clinical oversight in the allotment of a one million dollar grant, which allowed over three thousand individuals to remain in their homes, receive wraparound services, reduce hospitalizations, and coordination of community based care.
- Created care management services for the entire organization.
- Participated in weekly multidisciplinary team meetings, community outreach, task forces, and advocacy groups.
- Conducted Medicare approved social service assessments addressing medical, psychological, spiritual and caregiver interventions.
- Conducted home assessments utilizing VA Caregiver Support Mental Health Tool to post 9/11 veterans and caregivers.
Pathways Care Manager - Foundation for Senior Living - Phoenix, AZ
(2000-12 - 2003-08)
- Performed phone intake, assessments, home visits, referrals, counseling and follow-up to appropriate resources in the community.
- Collaborated with other social service agencies to increase awareness through marketing and community presentations regarding services for the elderly and disabled populations served.
- Provided supervision to Arizona State University, University of Arizona, and Grand Canyon University student interns.
