Lois L Riddle Phone: 770-***-****, Email ad02ds@r.postjobfree.com United States

SUMMARY OF SKILL QUALIFICATIONS "Key skills include experience operating Windows and associated Microsoft Office applications, including MS Word, Excel, PowerPoint, Access, Microsoft Office Suite, outlook365 applications, Teams, SharePoint, zoom, salesforce, CRM, loan app E Tran, ELIPs, Rapid, CAFS, CLCS, Pay. Gov, DCMS, QuickBooks, Loans EIDL, Disaster home and business, 7a,504, loans, Treasury Management applications, products. Hospital database, Epic software, EMR, EHR, my Chart, interpret health care data, federal and state regulations, interpret Medicaid, Medicare or private health care, utilization management, Quality Assurance, HHSHCC risk adjustment model skills, commercial and Medicaid risk adjustment skills, ICD-10-CM HCC codes motivational sales skills, (CMS) guidelines for Medicare Part D and Enrollment processes, Eligibility and referral processes, HIPAA regulations, Effective listening, investigative and exceptional problem solving skills, excellent communication skills, deescalate skills, written and oral, analytical, organization skills, exceptional interpersonal skills, high aptitude for learning skills, consistency in quality work Initiative skills, CDC diabetes prevention certification, hypertension, epidemiology and prevention, chronic condition management skills, weight management, smoking. therapeutic skills, CBT Therapy, infusion, bleeding disorder, cGMP regulations including 21 CFR 210, 211, and 600, motivational interviewing, written/verbal communication skills, supervisor case management, home crisis, social services, managing complex projects skills, self-starter, time management, planning, and scheduling, adapt to work environments, work collaboratively within a team, self- driven, work with minimum supervision skills, trained supervise others and residential development, community project programs loan.

PROFESSIONAL EXPERIENCE: Project Hope Generation Inc Director of Education / Health Educator/ Diversity Coach Atlanta, GA 07/2006 Presently my responsibilities encompass a diverse range of tasks aimed at enhancing staff and program development. I lead the recruitment and training of personnel, manage annual budgets, and strategically drive sales initiatives in alignment with our operational plans. A significant aspect of my role involves presenting educational curriculums and budgets for board approval, all while meticulously coordinating and monitoring standard integrated curriculums and health wellness work plans. Moreover, my responsibilities extend to encompass human resource functions, encompassing hiring processes, payroll management, insurance benefits administration, and navigating the intricacies of the EEOC process and US labor standards. In line with promoting a harmonious workplace environment, I conduct diversity training and provide coaching on workplace behavior matters to all staff members. Furthermore, I readily step in as a teacher when our team of educators requires additional support. My approach centers on prudent resource management, ensuring that the organization operates within budgetary guidelines while adhering strictly to prevailing federal and state regulations. I am skilled in the development, coordination, and vigilant monitoring of integrated work plans. I am also adept at enforcing policy and procedural changes in accordance with evolving state guidelines. My responsibilities are broad-ranging and include the ongoing evolution of our policies and procedures to maintain compliance with state-mandated regulations. U S Small Business Administration USA; Disaster Recovery Specialist Remote USA 06/2020 to 03/2023 High volume of inbound /outbound calling demonstrating over a three year of specialized experience in the federal government financial services. I excelled in developing and managing diverse communication and public projects, preparing, and presenting various materials for various audiences, both in various formats. Additionally, I expertly wrote, and edited documents related to disaster populations materials. Also performed mitigation loans, reviewed planning and zoning, floodplain protection, property acquisition and relocation review investigations, document in file, including statements, reviewed appraisals, photographs, investigations, consult with SBA back-office attorneys' discovery, regulations related to timing of claim payments disbursement dates. Attended monthly mitigation training, conferences via media. Process applications for Hurricane; Wind/Water claims. I prepared written responses to inbound/outbound calls and email inquiries related to Presidential declarations and disaster services, assisting new employees in answering inquiries from disaster populations using processing tools. I provided detailed information on loan application status, eligibility, assist in closing documents, deposit dates on various loan products to diverse customers, from large B2B corporations, small businesses, and residential populations. I prepared comprehensive documentation for educational seminars and federally declared disasters and SBA's disaster loan programs. While documenting loan grievances and adhering to federal policies/procedures, I assisted borrowers in completing their loan closing modifications and answering related questions and deescalated calls. I researched customer inquiries on declined applications with resolutions on regaining eligibility, state Treasury resolutions, recorded call activity, and prepared appropriate forms and letters for management. Lastly, I reported documented suicidal cases to the office of directors and reported fraud to the Office of the Inspector General and other government departments. Ontrak Inc; Health Care Coach Santa Monica, CA 03/2019 to 03/2021 Remote location provided virtual coaching services to clients, after company initial screening Develop and monitor a roadmap and client progress Incorporate CBC (cognitive behavioral coaching) and other evidence-based interventions into coaching plans. Maintain confidential documentation and pertinent customer data. Accomplishments: Implemented data base of referral to service patients that were served throughout the United States. Humana Inc Contractor; Clinical Care Manager Charlotte, North Carolina 01/2007 to 07/2017 As a Clinical Care Manager at Humana Inc involved comprehensive care coordination, ensuring seamless transitions and optimal outcomes for patients across different healthcare settings. performed hybrid work and traveled to various regional locations in North Carolina. My responsibilities included receiving 90-day hospital discharge information through Humana My chart for patients transitioning from the hospital to their homes. I arranged visits for patients in long-term home care and short-term skilled facilities, catering to diverse populations including children, adults, and seniors. I ensured that physician work orders were completed and facilitated pharmaceutical medication reconciliation between primary care physicians (PCPs) and the clinical team nurses, Humana Inc pharmacist back-office personnel. I verified primary care physician requests for authorizations from patients' benefits, including Medicaid, Medicare, and private insurance companies, documented healthcare terminology and CPT-ICD10 codes for insurance verification and claim adjudication. I work closely with the Humana back-office team for accuracy and enrollment process. Additionally, I managed medical work orders for necessary equipment and extensions for inpatient hospital stays and rehabilitation care, coordinated service for community home health nurses, physical therapists (PTs), and occupational therapists

(OTs). For patients. Interacted with various commercial insurance companies and handled inbound and outbound calls from patients and healthcare providers, including physicians, to fulfill medical work orders and ensure smooth transitions for long-term home care outcomes. I referred individuals to Humana sales officers for enrollment activities and coordinated the distribution of Humana Inc educational materials. Furthermore, I answered basic clinical and program inquiries, demonstrating inclusive and trauma-informed care practices. Eligibility, benefit education, open enrollment / new hire plan selection, claims issues, ID card issues, grievances/appeals, utilization management (UM) status, including but not limited to medical, dental, and vision plans Provider search (PCP, specialty, and facility), focused on healthcare cost and quality, and present premier provider options, including but not limited to medical, dental, and vision plans Support for spending accounts, pharmacy, and disability. Assistance with incentives and rewards. Also provided the company's grievance and complaints processes, ensuring timely and accurate resolution of complaints and grievances in accordance with state and federal regulations, as well as company policies and procedures. One of my notable accomplishments was developing and facilitating wellness and social-emotional learning initiatives. I played a supportive role in reimbursement counselors and clinical team leaders, assisting with accessing therapies through patients' healthcare providers. I also liaised with insurance companies on behalf of physician offices to verify patient benefits and submitted reports to the state regional insurance director. American Red Cross; Donor Counselor II Charlotte, North Carolina 02/2008 to 06/2015 My job involved counseling blood donors who had received abnormal test results for HIV and other infectious diseases for whole blood, donations. I performed collaborations with health organizations and hospitals to address outbreaks of epidemiology diseases for prevention and made reports to the CDC, FDA, per guidelines. I also educated donors about their test results, outcomes, and risk behaviors. Arranged various testing modules for infected blood transfused recipients and for participants enrolled in various laboratory research study cases. In addition, I monitored data on communicable and infectious diseases both in the US and internationally. Performed lookbacks for whole blood, platelets, plasma, blood components defined in procedure, and regulatory requirements. Enter new test results from various test modules of Antibody, Nucleic Acid Testing, HTLV reported form ARC Laboratories reported results in the data base to all health departments in United States of those infected and CDC. Prepared documentations for educational seminars, to health department and physicians throughout the United States. I also conducted quality reviews and collaborated with American Red Cross medical directors to develop intervention strategies to prevent disease outbreaks. My accomplishments included improving communication measures and quality control, developing effective education, and training outlines, and collaborating with hospitals and health departments to reduce costs and improve disease reporting. Brian Center Health/Rehabilitation Director of Social Work Charlotte North Carolina 08/2006 to 01/2008. Implement social work policies and procedures in accordance with state and federal regulations. My responsibilities included implementing social work policies and procedures in compliance with state and federal regulations. I hired, trained, and supervised a team of social work staff to ensure the delivery of quality services. My prudence involved ensuring that all residents received appropriate social work services based on their individual needs, care plans, and hospice directives. I established and maintained relationships with community organizations and resources to provide support to residents and their families. Additionally, I oversaw discharge planning and facilitated the transition of residents to appropriate community resources. Documenting social work services and monitoring compliance with regulatory requirements were integral parts of my job. I maintained thorough documentation and ensured adherence to all regulatory guidelines pertaining to social work services. In cases of fraud, I reported incidents to the Department of Health & Human Services, and in instances of abuse, I promptly reported to the Ombudsman. Documentation of social work services and performance monitor compliance with all regulatory requirements related to social work services. reported fraud to Department of Health & Human Services and reported abuse to Ombudsman. Pathways Mental Health Substance Abuse Developmental Disabilities. Gastonia, NC 7/2004 to 07/2007 Senior Case Manager/Community Manage Care Liaison / Mental Health Intake Assessment. AS a Senior Case Manager and Community Liaison with expertise in Intake Mental Health Assessment, I provided substance alcohol abuse and mental health counseling services for inpatient. Provided both in-office and in community during emergency crisis evaluations in hospitals, homes, and schools. I also managed a high volume of inbound and outbound calls 24/7.Alerted EMTs Police Departments of crisis situations before going on site with consumer on domestic or planned violent suicidal consumers. Additionally, I coordinated services and obtained authorizations for Medicaid, Medicare, and private insurance billing from third-party vendors for inpatient outpatient services needed. Also, as Managed Care Program Liaison I provided training, responded to inquiries from physicians and community support subcontractors with entity in the state of North Carolina. Also served as a Managed Care Program Liaison by attending state meetings and staying current on entity operational developments. I also helped develop internal business procedures to ensure compliance with contractual and program requirements, reviewed materials from new vendors to ensure compliance with state guidelines to build relationships with community agencies and primary care physicians. Throughout my tenor, I have been actively involved in process improvement and monitoring patients at each site for optimum recovery outcomes. patients at each site for optimum recovery outcomes. Onondaga Nation Rehabilitation.; Supervisor Case Management Nedrow, New York 07/02 to 07/04 Supervise programs providing case management for HIV, Aides, and mental health populations. Provided weekly supervision assessments on consumer needs. Evaluated PCP plans, counseling ethics and techniques... Accomplishments: Developed and instructed Life skills and Parenting training modules. Network with other agencies for resources and program growth.

Altamont Stabilization Parolee Residential Program; Program Assist Director/Shift Supervisor Liverpool, New York 07/1999 to 06/02 Program Assist Director: Oversees mental health treatment plans, reduces recidivism, and ensures community safety in a 200-unit program. Supervises, trains, evaluates employees, and monitors program operations to comply with state and federal laws. Attends state parole case review and CASAC training. Monitors program operations, employee performance, and services delivery in a 200-unit program. Conducts psychological assessments, evaluates employees, and ensures compliance with counseling ethics for mental health HIV and Aides treatment plans. Identifies the presence of drugs of abuse, therapeutic drugs, and toxic substances using toxicology instrumentation.

Education:

Alameda University Master of Arts; Major; Social Work Alameda University Bachelor of Arts; Major; Social Work Legacy Holistic Health Institute Certified Holistic Health Care Coach Institute January 21, 2021. Life Coach Institute Certified Life Coach February 22, 2021. Breath For Change Digital Wellness Program Certified Yoga Teacher and Social Emotional Learning Facilitator November 11,2021 Blvd #600 Arlington, VA 22203 201 Wilson Blvd #600. The American College of Lifestyle Medicine /Centers for Disease Control and Prevention; Diabetes Prevention Program Lifestyle Coach Certification. 04/2023. University North Carolina Certification: Core Components and Skills for Trauma Informed Practice April 20, 2023.