Manager Case

EDUCATION/CERTIFICATIONS

University of Central Oklahoma

Master in Education with emphasis on Gerontology

Language University

Bachelor of Arts in Gerontology

Bachelor of Science in Health Care Administration

Advantage Case Manager Certification in State of Oklahoma

Certified as Behavioral Mental Technician

Certified in CPR & First Aid

Certified as Assisted Living Case Manager

PROFESSIONAL EXPERIENCE

OU College of Nursing Case Management Department (OUHSC) 5/2014-present

Oklahoma City, OK 73106

Lead/Supervisor Advantage Case Manager

Supervise and oversee the Case Management process, the provision of services included in the service plan, the reassessment process and case management documentation process.

18 year’s experience with home-based health care or case management services for in-home long-term care populations.

Recommend course of action to Case Managers and advises them in the proper course of action to take.

Clinical/auditing experience that includes medical treatment documentations reviews and ICD-9-CM coding.

Knowledgeable of the disease process, finding, course of treatment, quality assurance and risk management.

Has experience general management skills of Assisting Living Facility.

Supervise reviewed plans of care twice a week with Case Manager.

Determined best plan of care by coordinating care with member, family and Interdisciplinary Team.

Supervisor on-call twice a week

Respond to emergencies with appropriate interventions.

Manage a caseload of 42 to 52.

Responsible for providing comprehensive assessment, planning, implementation and overall evaluation of individual member needs.

Promote effective and efficient utilization of clinical resources.

4/2007-5/2014

Advantage Case Manager

Review documentation of Service Plan to ensure consistency with Advantage program philosophy and capacity to serve. Review documentation to ensure that Service Plan goals, objectives, action steps and expected outcomes correspond to the member’s challenges and strengths identified in the UCAT. Case Manage Referral and IDT minutes and monitoring of reassessment findings.

Facilitate the Interdisciplinary Team Meeting and in conjunction with the member, informal/formal support and available resources, assesses the member’s needs for in-home services.

Develop a comprehensive service plan for the Advantage member. The service plan is developed to utilize the member’s strengths, supports and available resources and is outcome focused.

Involve the member in implementation of the service plan by reviewing the services and receiving signed authorization.

To ensure adhere to and participates in Company’s mandatory HIPAA privacy program /Ethics and Compliance programs / practices, and all Company policies and procedures.

Volunteers of American 2/2005-4/2007

Oklahoma City, OK 73128

Advantage Case Manager

Manage a caseload of 40 or more clients

Provide direct supervision to facilitate on-going communication between case management staff, utilization management staff and contracted providers.

Make monthly home visits as required by Advantage program and monitor services provided to each members.

Serve as liaison between departments.

QUALIFICATIONS SUMMARY

Maintains staffing by recruitment, selection, orientation, and training employees; maintaining a safe, secure work environment.

Collaborate with the Assistance Program Director of Care Management to create and refine documentation, including written program descriptions, standards and procedures, guidelines, program evaluation, workflows and other relevant records.

Audit Care Management charts as it relates to clinical documentation following the Oklahoma Department of Human services set forth for the Advantage program and OU standard.

Responsible for day-to-day supervision, coordination and implementation of program activities to ensure efficient and effective delivery service. Monitor the compliance maintenance records to assure county and state regulations.

Oversee compliance and evaluate quality of services

Read case profiles, interview clients and set up a plan of coordination of services.

Training/Development

Conduct orientation sessions and arrange on-the-job training for new hires.

Develop and organize training manuals, multimedia visual aids, and other educational materials.

Analyze training needs to develop new training programs or modify and improve existing programs.

Develops monthly and overall staff development/training plans for Advantage case manager.

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