Manager Case

SUNSHINE MALLARE, RN

**-** **** ****** ******** New York 11377

215-***-**** ***************@*****.***

EDUCATION AND TRAINING

MA in Nursing, 21 Units Completed, Wesleyan University of the Philippines

BS Nursing, Wesleyan University of the Philippines, graduated in November 2006

CNA Program, Manhattan Institute, December 2016

Home Health Aide Program, Synergy Health Care International

BCLS (AHA) – Valid until 03/2021

SKILLS HIGHLIGHT

Drives and very flexible in schedule

Experienced working with geriatric patients

Bilingual in English and Tagalog

PROFESSIONAL EXPERIENCE

Contact Tracer – New York Health and Hospital under OPTUM US Contingent, June 2020 to date

Place phone calls to newly diagnosed patients and potentially exposed people to COVID- 19

•Follow a script when interviewing people

•Educate contacts on approved protocol and information about quarantine or isolation procedure, as well as testing

•Collect and document necessary information into data base or CRM

•Understand symptoms, infectious periods, and treatments

Geriatric Aide – Long Island Nassau County, New York 11577, 7/2016 to 9/06/2020

Weekend 24 hours Private Aide

•Provides care to 93 – year old female client with colostomy bag drainage.

•24 – hour supervision of activities of daily livings

•Formerly drive patient to work every Sunday to Malloy College

•Monitor and changes of Colostomy Bag.

•Assists in the preparation and feeding of the patient on time, nebulization, and other prescribed home lung therapy.

•

HMO Case Manager – Long Island Care Center, Flushing New York 11354, 4/2017- 8/2018

Monday – Friday 9:00-5:00 pm shift

Obtain initial authorization for primary payer and verification of appropriate level of payment.

Obtain coinsurance rate and authorization for coinsurance from secondary payers.

Verify secondary insurance coverage.

Build and maintain case folder and maintain Excel spreadsheet.

Send accurate clinical updates to insurance provider.

Managing insurance coverage of residents under Managed Care including negotiating for extension coverage and appealing for reconsideration under the supervision of MDS Director.

Contact this candidate