Manager Customer Service

Summary of Qualifications

Bilingual professional with extensive expertise in managing people with physical, mental and/or emotional disabilities for health insurance companies, hospitals and public/private sectors of workers compensation. Exceptional customer service and interpersonal skills; excellent work ethic, and team player. Quick learner, performs well under pressure.

Core Competencies

Spanish Interpreter

Crisis Intervention/Prevention

Problem Solver/Negotiator

Sign Language

Supervised, trained, mentored

Proficient in Microsoft Office Suites

Health & Wellness Advocate

Psychometritian

Career History

Humana At Home Nov 2015 to June 2017

Work At Home

Personal Health Coach

Provided telephonic counseling, medical education (diabetes, CHF, COPD, smoking cessation, stroke, Alzheimer, cancer, obesity, paraplegia, bipolar, schizophrenia, panic attack, anxiety, depression); community resources for nearly 400 disabled Spanish and English speaking Humana members throughout the USA including their family or caregiver so they can make informed decisions.

Interact with physicians and other medical providers to obtain optimum outcomes for the members.

Encouraged members to meet HEDIS measures, set-up team projects, developed care plans.

Met daily requirement of 10 successful calls, have highest percentage of successful contact rate on team.

Humana At Home/Care Plus HMO March 2012-Nov 2015

Home base with extensive travel, S. FL

Field Case Manager

Conducted 10 home psycho-social assessments per week throughout Broward & Palm Beach counties for geriatric, physically disabled adults, or mentally ill Care Plus members.

Able to read, write, speak Spanish. Because of strong foreign language ability and cultural sensitivity able to interact with Polish and Creole members, deaf, hearing impaired members.

Addressed members needs and offered long term health care solutions.

Regularly recognized for outstanding work during team meetings and conferences.

Pinecrest Rehabilitation (PRH)/Delray Medical Center (DMC) February 2007-March 2012

Delray Beach, FL

Case Manager/Discharge Planner-Tenet Hospitals

At PRH conducted initial assessments, coordinated discharge planning to home, ALF, SNF or halfway house; participated in utilization reviews, chart audits. Updated commercial carriers of patient’s progress and obtained continued stay approvals 100% of the time. Negotiated price on patients’ behalf for home care service and made sure patients had necessary DME.

Functioned as floater for DMC, conducting psycho-social assessment and discharge planning services in ER, ICU, oncology, neurology and orthopedic floors. Successfully handled cases with poor dispositions.

Freelance Case Manager and Spanish/Sign Language Interpreter Jan 2002-Feb 2007

Home base with extensive travel, S. FL

Provided workers compensation case management for various insurance carriers both private and federal in the tri-county area. Offered testimony in hearings and depositions. ADA advocate.

Conducted vocational and academic testing, transferable skills analysis, ergonomic assessments, developed resumes and offered appropriate job leads to injured workers.

Provided vocational counseling/assessments to people with LTD and STD claims.

Functioned as an interpreter at MD appointments, workers compensation hearings, depositions, and divorces.

Contracted for 2 yrs to assist Chapter 31 disabled veterans attending colleges from Ft. Pierce to Miami providing guidance to assure their successful completion of training.

Served one semester at private high school as the guidance counselor

Worked per diem as a Case Manager for PRH for one year. Recognized technical expertise and client management ability led to offer of full-time employment.

Education

MS, Rehabilitation Services Florida State University

BS, Psychology with minors in Spanish/French Carroll College, Waukesha, WI

Awards and Honors

Received written praise by customers for going the extra mile.

Recognized by CFO and social services staff of Delray Medical Center for outstanding work

Passed Alta Spanish Listening & Speaking Test with a score of 3+ out of 4. Test Date: 9/29/16

Recognized with multiple awards for outstanding service as a Voc Rehab Counselor for the deaf community 1981-1989

Involvement

Women’s Network Resource Group

Recognition and Development team of the Humana Associate Connection

Volunteer for local agencies and church activities

Red Hat Society

References

Christina Szymanski, Manager for Humana At Home, #913-***-****

Trella Lewis, Branch Manager of Coventry Workers Compensation, #954-***-****

Sharon Rogers, Care Plus RN, #352-***-****

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