Case Manager Patient Care
Resume:
Jesus Navarro
Palm Springs, CA *****
*********@*****.***
Work Experience
Patient Care Technician Manager/Transportation Manager Hazelden Betty Ford-Rancho Mirage, CA
July 2022 to Present
Patient Care Technician Manager: Manage technicians at the Outpatient level of care. Maintain monthly schedule assuring technician coverage for Day, Evening and Overnight shifts. Provide clinical support to the treatment team.
Transportation Manger: Responsible for managing a team of drivers, scheduling transportation for patients to medical, dental appointments and medication pick up. Maintain a schedule for drivers to ensure coverage on day and evening shifts. Schedule transportation fleet vehicles for routine maintenance and unforseen repairs.
Recruit new hires, review resumes, schedule and complete manager interviews. Onboard new hires schedule for CPR, CPI, and other necessary skill development training. Case Manager
Natural Rest House - 9 Silver LLC-La Quinta, CA
December 2021 to June 2022
Case Manager
Duties & Responsibilities
Oversees coordination of client needs and works in collaboration with client and primary therapist in treatment/discharge planning and goals, identifying additional needed support services including educational, vocational, legal, recreational, mental health and social services Completes and maintains all documentation of services delivered Ensures cohesion of services documented within client files, and assists with compliance in DHCS and joint Commission standards Keeps a schedule of consistent case management sessions with clients Coordinates service provision with probation officers, attorneys, etc., as needed Complies with local, state, and federal
Case Manager
Ken Seeley Communities-Palm Springs, CA
September 2020 to November 2020
• Maintain caseloads by meeting with clients to complete Needs and Services Assessments. Create and maintain Recovery plans. Facilitate groups and assist Tech staff.
• Maintain contact with client families to discuss intake and discharge
• Ensure that all necessary consents and disclosure forms, along with any other required treatment documents are completed
• Responsible for charting Needs and Services Assessments, Recovery Plans and Discharge Plans with in Required time frames
• Communicate with client's probation officers and court representatives (when applicable)
• Establish individual discharge planning with clients at or near the time of admission and intake
• Responsible for attending and participating in mandatory weekly staff meetings to discuss client care
• Work with clinical and medical team to create client treatment plans Case Manager
ABC Recovery Center-Indio, CA
November 2017 to August 2020
• Maintain caseloads by meeting with clients to complete Needs and Services Assessments. Create and maintain Recovery plans. Facilitate groups and assist Tech staff.
• Maintain contact with client families to discuss intake and discharge
• Ensure that all necessary consents and disclosure forms, along with any other required treatment documents are completed
• Responsible for charting Needs and Services Assessments, Recovery Plans and Discharge Plans with in Required time frames
• Communicate with client's probation officers and court representatives (when applicable)
• Establish individual discharge planning with clients at or near the time of admission and intake
• Responsible for attending and participating in mandatory weekly staff meetings to discuss client care
• Work with clinical and medical team to create client treatment plans Utilization Review Manager
Sunspire Health, Desert Palms-Palm Springs, CA
October 2013 to November 2017
• Work closely with the Clinical Director, Case Managers/Discharge Planners, Nursing staff and Doctors to gather, assemble and deliver clinical information for patients to the UR specialist.
• Supervise and ensure that the UR Specialist team is aware of all new admissions requiring insurance authorizations
• Ensure all new admission information is complete, including insurance VOB, Pre-Cert clinical, Initial Facility Intake Assessment, Medications, Vital Signs, Nursing/Medical Notes,
• Arrange Peer Reviews with insurance company's representative upon request from UR specialist in a timely manner
• Maintain calendar of dates of when Concurrent Reviews are due
• Ensure timely Concurrent Reviews have been updated since the last review with adequate information to continue a level of care requested or step down.
• Ensure all Concurrent reviews contain most current information for UDS's and current medications
• Maintain current and up to date facility and corporate Authorization spreadsheet.
• Attend weekly "Case Load " meeting for the purpose of reviewing the progress if all patients
• Produce Medical Records for billing purposes, patient requests and Short Term Disability requests
• File and proceed with appeals process when a claim is denied
• Meet with patients regarding insurance and benefits Utilization Review Specialist
Sunspire Health, Desert Palms
March 2013 to October 2013
Use understanding of DSM V diagnosis ICD 10 codes and ASAM criteria and dimensions for all Levels of care
• Perform Insurance Reviews for both in and out of network policies
• Discern medical necessity and perform accurate insurance verifications
• Conduct chart reviews to ensure clinical documentation matches level of care requested
• Work with Doctors, Admissions and Clinical staff in determination of clients to help decide their best level of care
• Submit and coordinate the materials being sent out to insurance companies prior to their being released and follow up on claims to ensure timely processing
• Perform reviews with insurance assigned care managers for the purpose of obtaining authorization for services provided at all levels of care.
Medical Assistant
Sunspire Health, Desert Palms
November 2012 to March 2013
• Patient intakes
• Urinalysis, prep specimen collection for testing
• Take patient vitals and document in EMR
• Chart patient encounters, maintained medical records under supervision of charge nurse.
• Routinely checking in on patients and follow the therapeutic care instructions of physician Externship Experience
Medical Assistant
Sunspire Health, Desert Palms-Palm Springs, CA
December 2012 to January 2013
• Patient intake, assist with completion of insurance forms
• Answer phones and transfer calls needed
• Patient information data entry
• Schedule and confirm patient appointments, very insurance policies Education
Diploma in Medical
Kaplan College Palm Springs - Palm Springs, CA
2013
General Education - Diploma in English/Spanish
Cathedral City High School - Cathedral City, CA
2001
Skills
• Case Management
• EMR Systems
• Utilization Review
• Intake Experience
• Medical Records
• Utilization Management
• Social Work
• Insurance Verification
• Crisis Intervention
• Behavioral Health
• Organizational skills
• Time management
• Office experience
• Medical records
• Customer service
• Communication skills
• HR sourcing
• Supervising experience
• Cash register
• Cash handling
Certifications and Licenses
Alcohol and Drug addiction
October 2017 to October 2020
Currently in the process of renewing RADT1 and pursuing CADC Certified Medical Assistant (CMA)
Certified Medication Technician
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