Carol Rene’ Pryce

**A Clinton Court

New Castle, DE 19720

Mobile: 302-***-****

Email: ad0zwv@r.postjobfree.com

WORK EXPERIENCE

UnitedHealthCare 5/2023-09/2023

Philadelphia, PA

As a Field Based Ambassador with UnitedHealthCare, my role is to manage and provide access to necessary supportive services in the community, to provide case management services as needed and requested, and develop programs and resources that support wellness for individuals receiving Medicare supplemental services under the UHC plan for individuals with 5 or more chronic conditions that require additional supports and services. Some of my duties include completing community in person visits or telephone visits using MS Teams to facilitate these meetings, completing diabetic retinopathy testing using RetinaVue imaging machines, updating consent forms and other documentation related to patient care, making telephone calls to check on patients and completing surveys during these calls as needed, scheduling appointments for in person and telemedicine visits with medical service providers (RN, NP and MD) and setting up referrals for services such as behavioral health, prescription assistance and other services as needed to help the patient remain in the environment most comfortable for them. Using company systems to update, modify and delete information in participant electronic records and sending out documentation as required by the patient based on their individual needs.

Keystone First CHC 9/2022-05/2023

Philadelphia, PA

As a Service Coordinator with Keystone First Community Health Choices, my role is to manage and provide access to necessary supportive services in the community, to provide case management services as needed and requested, and develop programs and resources that support wellness for individuals receiving Long Term Support Services under the Home and Community Based Waiver program with Keystone First Community Health Choices. Some of my duties include completing community in person visits using motivational interviewing techniques to update Person Centered Plans to promote improved health and well being, completing assessments when participants have a trigger event that require a temporary and/or a permanent adjustment of services to help the client remain in the community and assistance with referrals for others services they might need due to the change in circumstances. Using company systems to update, modify and delete information in participant electronic records and sending out letters to notify participants of upcoming meetings, changes in their benefits and other documents as required by law.

State of Delaware-DHSS/DDDS

8/2015 - 10/2020

Bear, Delaware

Senior Social Worker Case Manager

Serving as a primary advocate for the individuals in my caseload of 32 to 50 clients living in 13-20 group homes with duties that include development and monitoring of individual Life Span plans for each client annually, facilitating Life Span plan meetings, scheduling meetings for yearly service plans, addressing behavioral issues requiring modifications of the Life Span plan with support team members, communicating with service providers such as residential and day program staff, working with families and guardians to ensure that they are involved in implementation of the client Life Span plan, and ensuring compliance with applicable standards governing DDDS and its regulations by service providers and ensuring that services are being provided according to the client Life Span plan. Other duties include interviewing clients, their families and/or professional sources on monthly and quarterly basis to determine clients needs for a variety of social services which may include employment, job search and basic skills remediation, developing a comprehensive cost effective service plan utilizing in-house sources, referrals, contracted providers and/or institutions, conducting on-going monitoring and assessment of service delivery for optimum quality and efficiency, and authorizes and recommends changes and adjustments as needed, maintaining comprehensive case records, summaries, statistical and narrative reports and completing required forms, establishing an effective working relationship with clients, family, community and professional sources, providing specialized casework and counseling services in such areas as protective, adoption and options counseling, providing direct casework service through individual/group conferences, counseling and/or site visits, supplying information and responses to inquiries regarding services for clients, family, community and government agencies and providing supportive casework to clients prior to, during or after hospitalization based upon physicians diagnosis and recommended treatment.

Powell Life Skills 11/2015-11/2016

Dover, Delaware

Residential Caregiver Associate

Working as a Caregiver with individuals with intellectual and developmental disabilities providing oversight for them by assisting them with their ADL's, assisting with cooking and meal prep, completing household chores, completing medication administration, transportation to activities, appointments and events and completing fire drills and other required safety checks with the individuals I was responsible for. In addition, all activities were documented in communication logs, in computer software used to track all client activities and verbal reports were provided whenever there was a shift change. My position ended when the company owner retired and her company shut down.

State of Delaware-DHSS 5/2011 - 8/2015

Wilmington, Delaware

Senior Social Worker Case Manager

Determining financial eligibility for clients seeking Long Term Medicaid assistance. Interviewing clients or their authorized representatives to obtain information regarding client's income and resources, reviewing documentation to determine countable and excluded assets and resources, making recommendations for approval or denial based on Long Term Medicaid policy, providing case management for cases in my case load and completing yearly redeterminations to determine if client's still meet income and resource levels per policy and knowledge of Policy 20000 governing Long Term Medicaid. Member of Policy and Planning Manual Committee to update LTC Medicaid policy and rewriting procedure using Peabody format.

State of Delaware -State Service Centers 7/2010 - 5/2011

Wilmington, Delaware

Social Service Specialist I

Conducting individual interviews to determine client eligibility for emergency services such as electricity, rental, kinship, food, diabetes, medical, teen program and homeless shelter vouchers for clients using state government Policy 6000 governing benefit administration. Screening clients during assessment interviews to determine client needs in accordance to program guidelines, requesting documentation from clients to determine eligibility, making sure cases are processed within 48 hours, using CAPS and DCIS II departmental systems to enter client data and answering client telephone calls to answer general questions regarding program guidelines.

DOL 12/2009 - 7/2010

Newark, Delaware

Employment Services Specialist

Conducting individual and group intake sessions to orient job seekers and employers to the services available under Workforce Investment Act of 1998 funding program, instructing and coaching job seekers/employers on using resources, referring clients to employers for possible job placement based upon comparison of applicant qualifications to employer job requirements, exemplified the second-to-none customer service delivery for which DOL is nationally renowned in all interactions with clients and employers. In addition, during a job fair conducted by a major state of Delaware employer, I was instrumental in screening clients to insure that they met the requirements for Workforce Investment Act of 1998 Federal funding requirements by requesting required documentation and completing more than 20 cases in a two week time frame although normal case processing can take up to four weeks and I received kudos from management for my ability to handle these cases meeting critical deadlines to get clients approved before classes began.

DOL 8/2000 - 10/2009

Wilmington, Delaware

Unemployment Insurance Claims Processor

Unemployment Claims Deputy

Unemployment Liable Claims Office Supervisor

Advanced to increasingly responsible positions starting as a front line worker processing claims for unemployed clients, requesting wages when needed, setting up overpayments, and submitting information to determine INS compliance. I was promoted to a Claims Deputy position where fact finding interviews were conducted to determine unemployment eligibility based on employment separation and Title 19 of the Delaware code governing unemployment benefit eligibility, requesting documentation to support each party’s side of the story and acting as a agency witness during appeal and board hearings. This position culminated in my promotion to a management role with oversight of six to eight employees and acting as Coordinator for the state of Delaware to assist other state agencies and clients who had Delaware monetary unemployment entitlement in answering unemployment claim questions, handling complex client case issues and explaining unemployment guidelines to other state agencies to inform clients applying for state of Delaware through the agency in their home state. Directed the daily activities of six permanent and three temporary employees by managing office operations, assessing staff claims processing and case adjudications to insure that work was being completed timely and that correct procedure was being used when processing claims, managing office inventory, maintaining employee attendance records, certifying employee time sheets to insure payroll accuracy, completing yearly performance evaluations and providing corrective disciplinary action for staff when necessary. Maintained high standards in compliance with Title 19 of the Delaware code regulatory guidelines, met or exceeded Federal timeliness standards of 87% or greater with case adjudications and timely payment of client benefits despite increased workload due to Federal Emergency Unemployment Compensation and state of Delaware Extended Benefits between July of 2008 until my departure in October of 2009. In addition, I increased employee knowledge by assisting them with growth and development by informing staff of changes in regulatory standards or office policy by meeting with them for training to ensure that they understood and complied with new policies and or regulations. Managed daily operations of the department with a primary focus on maintaining customer service goals and objectives established by Upper Management with respect to processing client claims and completing case adjudications timely. In addition, I addressed more complex customer complaints that were referred to me by the Directors Office to provide resolution and assisted my staff in problem solving to ensure quality customer service for all clients we served.

EDUCATION

Springfield College

Wilmington, Delaware US

94 Semester hours completed towards BS

Major: Human Services

I graduated with my Associates in General Studies degree on January 29, 2012 and started my completion degree in the Bachelors program in Behavioral Sciences. Most of my core classes have been related to the human services field and these courses included Introduction to Human Services where students were introduced to the Human Services field and reviewing client needs, services, requisite skills, and attitudes of an effective Human Services worker, Dynamics of Group Communication I which was an overview of the theories, principles, and techniques of organization, leadership, and participation in the group process with an emphasis placed upon the development of therapeutic communication skills by providing weekly speeches before classmates and being graded on content and ability to enunciate before a group of individuals, Theories of Counseling which was an overview of basic counseling theories and techniques in terms of the client-worker relationship, Psychology which was a survey of general principles underlying human behavior, mental processes and includes study of the nervous system, perception, learning, motivation, personality, psychological disorders methods of assessment and research principles and Math for Behavioral Sciences which was an arithmetic review of practical mathematics such as ratios and proportions, percentages, basic algebraic principles, introductory statistical concepts, and word problem applications. I also completed classroom requirements as a Drug and Alcohol Counselor through Catholic Charities Basic Counselor program so I am familiar with conducting client assessment interviews, facilitating client sessions and developing plans to assist clients in maintaining sobriety and personal goals.

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