Project Manager Health

Leila Crouse

**** *** ********* ** . *********, CA. 93012

CELL 805-***-****/482-0177 . E-MAIL ********@*****.***

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PROFILE 16+ years professional work experience in managed healthcare,

health education, community service, program management and

consulting, training and education.

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EDUCATION Bachelor of Arts

Sociology, minor in Law and Society, UCSB, Santa Barbara, CA

Graduated 1993

Master of Science

Health Education, Western Governor's University, Online, Salt Lake

City Utah

Graduated 2007

CHES, Certified Health Education Specialist, License #16541

September 2008-present

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SKILLS Certified health education specialist Process

Improvement

Program Management Team

Leadership

Training and Education

Counseling/Social Work

Development and Implementation of Community/Health Programs

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EXPERIENCE Nov 2012-Present

WellPoint/Anthem

Camarillo, CA

Program Manager Individual Product

Implementation and Renewal

Management of mandated member communication and notifications

are delivered timely on monthly basis through regulatory

guidelines. Manage all communications related to grievance and

appeal cases. Lead any projects assigned related to renewal

notification and rate action filings, process improvement

working with multidisciplinary teams in IT, compliance,

regulatory, marketing, sales, actuarial teams. Apply project

management knowledge, skills, tools and techniques to project

deliverables, processes, and systems. Prescribed planning

document; develops project charter; develops communication

management plan; defines project team roles and

responsibilities, develops work plan structure and project

schedule; executes communication plans; regularly reports

status of reports; manages and monitors ROI throughout the

project lifecycle; manage and update project plan. Provide

effective team environment, build strong relationships, solving

problems and issues in a matrix environment and communicating

effectively.

Feb 2010-2012

WellPoint/Anthem

Camarillo, CA

Program Consultant Strategic

Initiatives/Clinical Programs

Manage portfolio of clinical programs and strategic initiatives

including BMI and childhood obesity program, education,

training, and development. Manage customer-facing programs by

tracking benchmarks and evaluation results. Organized and

managed cultural optimization of program resources and

materials using approved vendors and internal systems.

Collaboratively work with legal, regulatory, compliance,

privacy teams on related documents and processes. Manage

materials within internal system E-tools and APRIMO system per

mandated approvals. Provided BMI trainings to improve state

mandated reporting related to HEDIS measures, documentation

changes. Serve as project manager for revenue enhancement

project by leading team to develop payment process for new

provider incentive and impact to payment claims, benefits

administrations, coding experts, training plans, and finance.

April 2008 - Feb. 2010

Moorpark/Ventura College Moorpark, CA

Health Intervention Specialist Student Health Center

Manage all health education programs in student health center

setting. Organized and created promotional and outreach

activities for students, faculty, and staff. Implement, design,

and plan promotional health programs. Provide health

instruction, training, education to students in health issues

using behavior modification models. Design monthly campus-wide

health newsletter. Manage monthly health education message

boards. Prepare reports per each intervention to show outcomes

and evaluation. Supported potential grants and needs

assessments of programs, and surveys. Maintain and update all

health education materials. Maintained current updates of

public health issues, principles, and practices. Work closely

with students, college administrators, and community groups.

August 2006 - August 2007 Office of Education

Camarillo, CA

School and Business Advisory CALSTRS Retirement

Specialist

Provide training, education, and presentations related to

retirement information and benefits calculations to all

California State Retirement Teachers System members. Counseled

on topics related to disability, options selection, and

beneficiary designation, estimation of benefits, divorce and

death issues, legal holds and disability cases. Conduct

workshops to all members. Review social security, Medicare,

annuities and tax related questions. Maintain various files,

records, and reports. Interpret laws, legislation, and

policies, procedures as applied to CALSTRS. Act as liaison

between school districts and retirement systems. Work closely

with payroll and finance department.

Feb 1998- Aug. 2006 Ventura County Public

Health Ventura, CA

Health Education Health Care Agency

Trainer and Educator

Provide public outreach, training, and educational

presentations to various community agencies, programs, clinical

settings, public schools, colleges, and employers. Manage

training seminars to professionals and clinicians. Apply adult

learning theories for different audience and products.

Responsible for quarterly reports, statistical results, and

meeting notes, as needed. Create and manage training manuals to

meet objectives and state-mandated requirements. Assess and

monitor program goals and intent are fulfilled. Collaborate

with community groups and coalitions. Provide program

implementation and development. Provide case management

services directly with HIV/AIDS clients on benefits counseling,

financial assistance, and referrals to other programs.

Implement and develop Early Intervention Program. Provide

counseling on social issues and risk reduction/prevention.

Assist in the surveillance team with AIDS case reporting and

partner- notification. Fulfill state-mandated documentation.

Act as a train the trainer for certification program. Provided

training related to education and prevention.

1997-1998 Interface

Camarillo, CA

1996-1997 Adolescent Family Life Program/Project Impact

Bakersfield, CA

Case Manager

Provide case management services to run-away and abused

adolescents. Provide counseling, foster placements, and

immediate need to teens. Assessed and referred client based on

individual needs. Transport to foster homes and families.

1994 - 1996 Casa Pacifica

Camarillo, CA

Child Care Worker/Preschool Assistant

Work with the severely emotionally disturbed, abused,

abandoned, neglected population. Provide daily necessities and

educational needs. Promote self-esteem and independence. Work

with assessment team for individual service plans. Supervise

visits and phone calls. Act as representative to court and

medical visits. Fulfill mandated paperwork.

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