Care Management

Job Title

-- QUALIFICATIONS PROFILE --

Goal-driven, service-focused, and seasoned professional with extensive leadership experience in healthcare. Capable of utilizing Lean methodologies for process improvement to achieve a safer and more efficient patient care. Known for analytical problem-solving aptitudes, with the ability to maintain a calm demeanor in resolving complex challenges. Adept at managing group dynamics, as well as motivating, training, and guiding high-caliber teams of professionals. Armed with skills in cognitive, physical, sensory, psychosocial, and family and patient education. Knowledgeable of involuntary treatment of psychiatric, substance abuse, domestic violence, and child and elder abuse patients. Equipped with polished communication and interpersonal skills in building positive work relationships with patients, families, the community, and professionals of all levels.

-- PROFESSIONAL EXPERIENCE --

Confidential Everett, WA 2013-Present-

Manager, Care Management, Transition Planning, Clinical Social Workers 2014–Present

Operations Management

Exemplify case management expertise to support nursing and medical staff, including spearheading multidisciplinary initiatives to address complex patient discharge needs

Closely coordinate with utilization management

Provide expert leadership to specific departmental process improvements, which involves gathering and reviewing relevant data for process and policy improvement

Initiate the development process for transition planning to serve the Notices of Non-coverage (HINN), the advance Beneficiary of Non-coverage (ABN) and the White Paper

Keep abreast with all regulations affecting Care Management in accordance with the interpretations of the conditions of participation (CoPs) by Medicare and Medicaid (CMS)

Spearhead clinical and operational aspects of transition and discharge planning

Deliver quarterly presentations to leadership detailing care management performance

Oversee the execution of a new Transition Planning Model in 2016 through leadership oversight and hospital multidisciplinary teams involvement

Cross-functional Team Leadership and Collaboration

Work closely with the Regional Director of Care Coordination to foster and maintain positive work relationships with the community and local medical groups

Create and organize schedules for more than 50 Care Management staff

Manage staffing requirements, which include hiring, coaching, training, disciplining, and discharging staff

Provide extensive evaluation and determine yearly compensation of care management staff

Key Highlights

Completed several training programs, such Change Acceleration Process Lite training, Crucial Accountability, and Emotional Intelligence; thus gaining skill base in collaboration and team building

Implemented innovative solutions which decreased the overtime budget from 200 hours to 30-40 hours monthly

Pioneered the integration of a new Transition Planning Model with a vulnerability index, and introduced non-clinical Transition Associates to manage lower acuity patients and their discharge needs

Created and established two new positions, Care Conference Facilitator and Transition Associate in the outpatient setting

Played a major role in decreasing turnover from 50% to 8% within Care Management

Performed as part of a Lean Project to decrease Length of Stay in the Clinical Evaluation Unit, thus successfully providing a more efficient discharge process at a reduced cost by using a Transition Associate

Expertly handled budgets to ensure compliance of the Care Management Department’s with budget requirements; thus achieving current Productivity measurement by more than 100% an increase from 68% in 2015

Transition Planner/Discharge Planner, Lead 2013–2014

Operations Management

Administered schedules and delegated workloads for 45 employees, including provision of guidance regarding Care Management on complex discharge plans for patients

Determined and evaluated individual patient and family needs to formulate and implement age-specific patient care plans for all serviced populations

Created, executed, and supervised appropriate discharge plans for patients transitioning from an acute care or intensive rehabilitation facility to the next appropriate level of care

Ensured confidentiality of medical center information and records

Delivered patient discharge planning support to all disciplines within the acute medical setting; including medical, neurological, surgical, psychiatric, orthopedic, critical care, hospice, and intensive rehabilitation cardiology

Cross-functional Team Leadership and Collaboration

Participated in safety meetings, nursing rounds, and other meetings led by the manager

Collaborated with physicians, Healthcare Team members, families, and community agencies to formulate patient- and family-focused discharge plans that effectively identified essential resources and linkages

Attended staff meetings on departmental or hospital performance improvement, as well as educational requirements to ensure continued understanding of policies and processes, maintain compliance with regulations, and support Continuous Quality Improvement (CQI) programs and procedures

Functioned as subject matter expert and technical resource for colleagues, which involved prioritizing and leading departmental employee activities, assisting with schedules, coordinating with staff to boost work performance, and responding to customer inquiries

Served as a primary resource for patients, physicians, family, and staff on community resource information, access, and regulatory requirements

Conducted quality evaluations of department work and individual reviews of employee work product for accuracy and compliance with established regulations

Harborview Medical Center Everett, WA

Social Worker, Emergency Department/Ambulatory Care-Level 1 Trauma 2014

Operations Management

Executed a complete range of social work clinical protocols for patients from youth to adulthood, including crisis intervention, resource management, discharge planning, social work assessment, and case management

Rendered effectual clinical support to families and patients experiencing trauma and critical medical events

Cross-functional Team Leadership and Collaboration

Coordinated with multidisciplinary teams in providing exceptional patient care at all times

Department of Social and Health Services Everett, WA 2006–2013

Supervisor/Program Manager, Child Protective Services, Child and Family Welfare Services 2010–2013

Operations Management

Offered clinical leadership and consultation in managing cases and assigning duties to staff

Prepared written and oral reports, documentations, and inter- and intra-agency communications

Presided over case and unit meetings to discuss practices and needs to client medical, mental, and criminal records

Actively researched solutions to internal and external conflicts at the lower possible level

Thoroughly evaluated levels of risk in cases of alleged child abuse or neglect, and ensured all levels of agency intervention were aligned with levels of assessed risk to children

Assumed responsibility in managing and monitoring urinalysis budget to guarantee all expenses were aligned with biennial constraints

Took charge of performing independent reviews on cases for closure and quality of work

Cross-functional Team Leadership and Collaboration

Directed the clinical activities of a team of seven social workers to ensure implementation of best practices across the investigative process and ongoing case management

Recruited and trained new and existing professionals in laws, policies, and procedures related to their employment

Served as legislative point of contact between staff and Region 3 for House Bill 2106- performance-based contracting

Facilitated training and mentored staff in procedure and policy, leadership, CPS investigation tools, and solution-based case work

Partnered with supervisors and Area Administrators regarding safety and policy concerns

Presided over mandatory reporting training for external partners and employees

Participated in quarterly child death reviews at the Snohomish County Medical Examiner’s Office and acted as the spokesperson for the Department of Social Health Services: Children’s Administration

Supervised and participated in organizing Region 2 joint supervisor meetings

Rendered effectual support to Area Administrators in handling high-profile, near-child fatality, or child fatality cases by extensively examining case and chronology

Key Highlights

Functioned as the department’s representative at the Snohomish County Family Drug Treatment Court, the Snohomish County Drug Task force, as well as within Dawson Place to support child victims of sexual assault and physical abuse

Contributed to the creation of the first emergency placement facility within Snohomish County

Coordinated with the Deputy Regional Administrator to execute Region 2 action plans and protocols to support the transition of the agency to a family-centered practice

Child Protective Services, Child and Family Welfare Services, Family Drug Court 2006–2009

Risks Assessment

Displayed expertise in providing interventions to children and families

Thoroughly evaluated child abuse risks through the use of risk assessment models; and assessed out-of-home placement necessities by conducting interviews to adults, children, and community collaterals

Checked psychological, psychiatric, and medical evaluations in addressing the services and needs to various clients

Held accountability in referring various clients for psychological, psychiatric, and medical evaluations and treatment; as well as in discussing department policies and provisions of the law to families, individuals, and community

Carried out brief intervention therapies to clients, such as motivational interviewing and solution-focused, reality, and narrative therapies throughout a client’s yearlong commitment to drug court

Organizational Management

Exhibited adeptness in organizing service delivery through court orders and voluntary services

Demonstrated proficiency in facilitating department training, peer consultations, and case mentoring to community agency personnel and groups

Conducted trainings and counseling assistance to service users and their families in evaluating their situation

Ensured the achievement of established standards and timescales in undertaking assessments

Cross-functional Collaboration

Joined in multidisciplinary teams and meetings to acquire knowledge regarding medical field, mental health, and family drug court

Took part in various in-house case, multidisciplinary, and multi-agency staffing

Center for Human Services Shoreline, WA

Youth Counselor Prevention Specialist 2005–2006

Operations Management

Offered consultative support to youth with substance abuse, which entailed creating and implementing treatment programs to ensure necessary treatment resources were in place

Evaluated individual and situations to identify the appropriate course of actions; formulated and executed a group-oriented approach to crisis intervention and individual treatment plans

Conducted parenting classes using the guiding good choice curriculum

Oversaw self-help groups for youth suffering from substance abuse

Initiated daily case management functions; which included case report, billing and target, and intake assessments, as well as coordinating with caseworkers, therapists, probation officers, and family members

Efficiently handled drug and alcohol assessments on the adult population

Key Highlights

Pioneered efforts to create and realize potential of the Partners in Prevention Program; secured a funding increase of $6K and expanded plan offerings; organized countywide drug prevention activities

Developed grants to obtain supplemental funding for the youth treatment program

-- EARLIER CAREER --

Snohomish County Juvenile Services Everett, WA

Volunteer (Guardian Ad Litem)

Washington State Patrol Marysville, WA

Trooper

-- EDUCATION AND CREDENTIALS --

Master of Social Work, 2010 Eastern Washington University Everett, WA

Bachelor of Arts in Human Services, 2006 University of Phoenix Mountlake Terrace, WA

Certified Case Management, In Progress

Licensed Independent Clinical Social Worker (LICSW)

-- TRAINING --

Lean for Leaders, In Progress

Change Acceleration Process Lite Training, 2015

Continuous Healthcare Transformation, 2015

Crucial Accountability and Emotional Intelligence Training, 2015

-- TECHNICAL SKILLS --

Microsoft Office Applications (Word, Excel, and Publisher) FamLink Epic Care Finder Pro Vantage Analytics Kronos

-- COMMUNITY INVOLVEMENT --

Providence Intervention Center for Assault and Abuse, Everett, Washington (2013)

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