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Case Manager Customer Service

Location:
Lawrenceville, GA
Posted:
January 23, 2024

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Resume:

Lota Marie Cameron, MBA, MSN, RN, CCM

Dacula, GA 678-***-**** ad21ak@r.postjobfree.com linkedin.com/in/lota-cameron/ CLINICAL INFORMATICS CERTIFIED CASE MANAGER

Results-driven and analytical clinician with exceptional performance in managing multiple, high-priority projects while providing exemplary customer service. Excellent written & communication skills when communicating with internal and external customers. Excel in analyzing and identifying data, both mechanical and technical in reporting and trending. Exceptional performance with managing multiple, high-priority projects and ensuring stakeholder satisfaction. Meet or exceed assignment deadlines. AREAS OF EXPERTISE

Analytical and problem-solving skills Expert in Microsoft Teams Exceptional Team Leader Policy & Standard Interpretation Cross-functional Team Management Problem solver Training & Development Documentation

Performance Management PC applications such as Microsoft Office Suite Self-guided PROFESSIONAL EXPERIENCE

Centerwell Home Health, Louisville, KY

Clinical Care Coordinator, 7/2023 to current

Telephonic nurse triage services by assessing, implementing, evaluating and charting observations of the patient’s condition. Implementing changes to the plan of care as needed to meet the patient’s needs. Completing evaluation tasks, including reviewing medication and vital signs, servicing patients with comorbidities like: Chronic Heart/Cardio Diseases, Respiratory Diseases, Diabetes, Behavioral health and more.

• Preventing admission back to hospitals. Making discharge plans, follow-ups, on-call resolution, and home care plans, reviewing, and updating treatment plans and medications on a case per case basis. Ensuring superior patient care.

• Responsible for coordinating care with other healthcare providers, as well as educating patients and their families about their medical condition. Excellent communication, interpersonal skills and strong organizational skills.

• Using computer software to coordinate follow-up appointments and refer patients to specialists. Ability to work independently and as part of a team.

• Excellent documentation, communication, and IT skills. Passionate about clinical excellence. UnitedHealthcare, Eden Prairie, MN 02/2009 - 2/2023 Manager for Case and Disease Management, 04/2018 – 02/2023 Telephonic disease management and wellness interventions; successfully prepared materials and presentation for client onsite audits. Collaborate with management and staff to develop a strategy for the achievement of call center excellence.

• Created and implemented a tool to improve metrics by 30%. Collaborated with clinical leadership to maximize quality of program delivery for internal and external customers, coordinated ongoing education, continuous in-service training program, and competent supervision to improve services and employee efficiency. Supported decision-making by leadership team. Analyzed outcomes and performance guarantees to identify and make recommendations for program enhancement.

• Coached individuals to excellent performance and met with team members quarterly to review personal development, create / develop solutions, and promote team growth. Allowed the team to use innovation to complete their assignment and offered feedback when needed.

• Developed, monitored and evaluated performance of all programs through systematic metric tracking and Lota Marie Cameron ad21ak@r.postjobfree.com Page 02

• managed performance improvement initiatives as required.

• Achieved specific client “risk performance measures” as identified in the contracts. Created written and verbal materials to deliver to the client and to the management.

• Provided clinical and operational oversight of department staff with 25+ employees with monthly coaching meetings and yearly written performance reviews. After coaching, execution of a performance management plan when staff consistently trended down.

• GA -Compact, RN License in Nevada, California, Oregon, Washington

Supervisor for Case and Disease Management, 02/2009 - 03/2018

• Monitor and evaluated performance of all programs through systematic metric tracking and manage performance improvement initiatives as required. Completed quality audits to ensure company’s and member’s goals are met. Achieved specific client “risk performance measures” as identified in the contracts. Texas Home Health, Houston, Texas 11/2007 - 12/2008 Director of Clinical Services

Director all activities of quality care to patients, clinical staff, business development, budgets, financials, staff recruitment and hiring, staff education programs, and continuous efficiency improvements, Educated all staff on Medicare/Medicaid standards. Supervised 40-50 employees, including, 3 Supervisors.

• Increased Medicare population from 40% to 60% and revenue by 50%.

• Consistently updated team with regulatory and industry trends from Medicare.

• Team members consisted of Nurses: RNs, LPNs, and CNAs; Therapists: Physical, Occupational, and Speech Therapists. Office Staff: Office Manager, Scheduler Central Home Health Care Amedisys, Atlanta, Georgia 06/2005 - 10/2007 Administrator, 03/2006 – 10/2007

Directed activities of 3 branch operations including delivery of quality care to patients, business development, budgets, financials, staff recruitment and hiring, staff education programs, and continuous efficiency improvements.

• Ensured agency compliance with all regulations, laws, policies, and procedures applicable to home health and reimbursement issues.

• Educated all staff members on state and federal rules and regulations as well as JCAHO and Medicare standards. Instituted and implemented agency policies and procedures.

• Reviewed all billed services to confirm proper payer source. Ensured staff members stay current on Medicare guidelines.

• Develop the organizational culture and promote transparency and collaboration throughout the organization by developing relationships using core values - Integrity, Compassion.

• Supervised 120 employees including 3 Directors of Operations. o Team members consisted of Nurses: RNs, LPNs, and CNAs; Therapists: Physical, Occupational, and Speech Therapists. Office Staff: Office Manager, Scheduler, Nurse Manager. Clinical Manager, 06/2005 – 03/2006

Supervised nurses and therapists, promoted to Administrator. EDUCATION & CERTIFICATIONS

Master of Nursing Informatics (MSN), Western Governors University Master of Business Administration (MBA), Keller Graduate School of Management Lota Marie Cameron ad21ak@r.postjobfree.com Page 03

Bachelor of Science in Information Technology (BSIT), DeVry Institute of Technology Bachelor of Science in Nursing (BSN), East Carolina University Certified Case Manager & Sigma Theta Tau International Honor Society of Nursing American Health Information Management Association (AHIMA) - Certified Documentation Integrity Practitioner Exam (CDIP) 06/2024

• Business Analytics: Forecasting with Exponential Smoothing

• Business Analytics: Forecasting with Trended Baseline Smoothing

• Data Curation Foundations

• Data Visualization for Data Analysis and Analytics

• Data Visualization: Storytelling

• Excel Statistics Essential Training: 1

• Machine Learning and AI Foundations: Predictive Modeling Strategy at Scale

• Power BI Essential Training

• Power BI Data Visualization and Dashboard Tips, Tricks & Techniques

• Tableau Course: Creating Interactive Tableau Dashboards

• Tableau Essential Training



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