Care Coordinator Patient
Resume:
Yensy Cundumi
202-***-**** *********@*****.*** Washington, DC
About me
Compassionate caregiver, proficient in all facets of providing an exceptional patient experience from advocating for and communicating with individuals to facilitating transactions between hospitals and multiple insurance companies and government entities. Able to operate efficiently within fast-paced environments with a focus on process improvement to minimize the labor expended in routine tasks to allocate more time for meaningful interactions with patients to provide the appropriate assistance, feedback, and emotional support at the appropriate time. Specialized experience with expecting and postpartum mothers, Long term care systems, and waivers. Expert skill in completing and routing accurate documentation using computer systems and web portals. Bilingual in English and Spanish.
Key competencies
● Patient experience
● Clinical evaluation
● Community Partnership
● Communication
● Process improvement
● Reporting
● Operation management
● Resource Development
● Data management
Professional experience
Patient Care Coordinator: Premier Health Services Washington, DC: 03/2022-present
● Process prior authorizations for home care services such as personal care and skilled nursing.
● Upload patient benefit documents and prior authorizations in multiple computer systems in a timely manner according to time constraints and regulations of public insurance providers.
● Verify documentation for accuracy and correct any errors in units.
● Coordinate physician signatures.
● Follow up and troubleshoot any denials or reduction of care with case and clinical managers, and schedule peer-to-peer reviews and appeals if needed.
● Efficient and effective navigation of DC Care Connect, AXXESS, Comagine, DC Health care finance portal, NPI registry, Navinet, Crisp, and other web portals and systems. Patient Care Coordinator: Children’s National Hospital Washington, DC: 06/2021-03/2022
● Advocated for pregnant and postpartum women of diverse backgrounds with cultural sensitivity and compassion.
● Enrolled patients in the DC Mother-Baby Wellness Program and assisted them in navigating the system.
● Conducted maternal mental health and postpartum screenings and systematically reviewed screening data.
● Provided appropriate responses for identified needs around social determinants of health.
● Provided care coordination support for families experiencing difficulties getting their needs met by ensuring optimal patient coordination and collaboration between teams and partners, with a focus on family experience and outcomes.
● Provide bilingual support (native Spanish speaker).
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Yensy Cundumi
Senior Life Cycle Health Educator: Mary’s Center Washington, DC: 07/2020-06/2021
● Provide health education at the primary, secondary, and tertiary prevention levels on healthier sexuality, reproductive health, respiratory, nutrition, cancer, and cardiovascular health.
● Provide culturally, linguistically, and age-appropriate STI, including HIV, education, counseling, testing, and referrals.
● Support participants with chronic conditions to enter and stay engaged within the MyHealth GPS, Socios de Salud/Partners in Health, Centering, Asthma IMPACT, and any other programs at Mary’s Center.
● Participate in interdepartmental collaborative projects or workgroups of care approach, population health, and quality improvement. Bilingual Telephonic Triage Assistant: Mary’s Center Washington, DC: 06/2016-07/2020
• Assist telephonic triage nurses by listening to patient's concerns, and determining if a medical appointment is needed, or if the concern should be reported to the appropriate triage nurse or primary provider.
• Utilize electronic charting to access patients' records.
• Schedule medical appointments.
• Provide clear patient information: lab results; responses and recommendations from primary care providers and nurses.
• Collaborate with nurses, providers, and pharmacy staff to ensure participant medication requests and prior authorizations are processed in a timely manner.
• Collaborate with referral specialists to ensure authorization needs are met for participants seeking specialty care.
• Check triage line voicemail messages and collaborate with triage nurses to return calls within established timeframes.
• Obtain after-hours nurse advice line reports, incorporate them into the participant’s electronic record, notify the appropriate care team member, and/or contact participants directly regarding after-hours concerns.
• Document telephonic participant encounters in the Electronic Medical Record (EMR). Support Planner: Prince George’s County Government Camp Springs, MD: 07/2014-06/2016
• Provided intake and development of Plan of Services for Medicaid Waiver, Community First Choice, and Medical Assistance Personal Care programs.
• Coordinated medical eligibility determinations and redeterminations.
• Recorded case notes in the Maryland State Long Term Services Support System LTSS.
• Engaged individuals in person-directed planning.
• Assisted applicants residing in a nursing facility with developing a transition plan to live in the community.
• Identified potential barriers in the community and coordinated available services that addressed the needs of clients.
• Collaborated with the Local Health Department, Department of Social Services, Maryland. Department of Aging, and Nursing Homes concerning the operation of the program.
• Consistently provided emotional support and feedback to clients. Yensy Cundumi
Education
Bachelor of Arts in Human Relations
Trinity Washington University - Washington, DC
Bachelor of Science in Nursing
Howard University - Washington, DC
Finished 2 years of the program (incomplete).
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