Case Manager-Traumatic Brain Injury Waiver - Aabcor, Inc. - Westmont, IL
(2025-09)
- Develop Person-Centered Care Plans
- Review comprehensive assessments
- Monthly telephonic outreach to provide advocacy and support
- Act as a liaison between patients, families and caregivers to ensure services are meeting the needs of members.
Care Coordinator 3 - Senior Services Associates - Aurora IL
(2025-03 - 2025-09)
- Conduct in-home needs assessments for eligibility of support services
- Developed individualized person-centered Plans of Care.
- Referred clients to internal and external/ community resources.
- Managed annual eligibility reviews for Medicaid, SNAP, and other programs.
- Assisted with benefits applications to ensure access to services.
- Conduct monthly in-service trainings. Submit monthly billing for approved services.
Case Management Coordinator - Aetna Better Health (IL)
(2022-12 - 2025-01)
- Complete Initial/Annual Health Risk Assessments and Develop Care Plans for IL Waiver Programs
- Conduct in-home visits, set up waiver services, provider and community services
- Approve authorizations for approved in home, transportation and medical services.
- Collaborate with Community Care programs, IL Dept. on Aging, and IL DRS to ensure eligibility of Home and Community Based Services.
Program Specialist 1 / Service Coordinator II - Children with Special Needs (SNC Team) - Centene Corporation
(2011-03 - 2021-09)
- Manage an active caseload of 75 to 100 members within the Northern Illinois counties and regions.
- Administer Initial/Annual Health Risk Assessments and Develop Care Plans for medium and high acuity members.
- Discharge Planning and Post Hospitalization review to minimize repeat utilization of inpatient hospitalizations.
- Conduct Inter-Disciplinary Care Team (IDCT) presentations to foster an increased understanding of successful care coordination from a team-based approach.
- Monthly medication review with members.
Contract Implementation Analyst - Centene Corporation
(2011-03 - 2021-09)
- Manage health plan workflow for timely and accurate submission and implementation of provider contracts utilizing IL HFS and MEDI websites.
- Research claims and provider contract issues to determine root cause of systems/payment limitations.
- Ensure timely configuration of identified claims and provider set-up issues.
- Submit systems change requests to correct contracting, pricing, and benefit changes.
Program Coordinator, Core ICT Team - Centene Corporation
(2011-03 - 2021-09)
- Assist members with completing health risk screening. Educate members on HEDIS measurements. Send Krames educational materials. Maintain integrity of Protected Health Information (PHI).
- Verify member eligibility and benefits, assign primary care physicians, provide informational resources on community-based programs and organizations.
- Initiate authorization requests for inpatient and outpatient services, update member discharge planning notes, send inpatient notification correspondence.
- Preceptor trainer/mentor for newly hired Program Coordinators.
- Participate in special team projects to promote quality improvement of care coordination.
Member and Provider Services Representative II - Centene Corporation
(2011-03 - 2021-09)
- Assist IL Managed Care Health Plan Recipients with the coordination of medical benefits and eligibility.
- Review and resolve medical claims inquiries, pharmacy review status.
- Utilize state MEDI database to verify member health plan eligibility.
- Support medical practitioners with health benefits information and credentialing status.
- Initiate and submit requests for Appeals and Grievances.
Licensing Representative-Foster Care - Lutheran Child and Family Services - Joliet IL
(2022-08 - 2022-12)
- Recruit, assess, and licensure of prospective foster care family applicants in accordance with DCFS Rule 402.
- Assess family home environment, financial readiness, family relationships of prospective foster families.
- Educate foster families on CARC responsibilities. Ensure safety and welfare of children placed in Foster Care Homes.
- Complete written home study /documentation for licensure.
- Maintain licensing files/ Foster Parent Records for annual compliance visits.
- Maintain communication with DCFS licensing office on licensing process, procedural updates and compliance regulations.
- Assist DCFS Case Managers with locating emergency shelter for foster children.
- Attend DCFS Licensing training sessions.
- Coordinating and document training activities for foster parents.
