Case Manager Assistant

Samera Sheikh

www.linkedin.com/in/samera-sheikh • 614-***-**** • **************@*****.***

Professional Experience

Aetna- Case Manager (Sky Program) Dec 2020- August 2021

Louisville, KY

Provide instructional information on relevant issues that divert crisis situations when parenting infants through young adults.

Helping families find their way and make it easier to get the resources they need.

Directly support and work with members, foster parents, adoptive caregivers, community partners and workers from DCBS.

KFC YUM! Center – Assistant Manager Sep 2017 – August 2021

Louisville, KY

Assisted with event planning, organizing, and customer service as a senior team leader

Prepared work schedules, conducted interviews, responded to and resolved conflicts

Assisted mangers with daily operations, maintained effective relationships with service associates, monitored events, manage the day-today operations

Humana – Grievance & Appeals Representative Oct 2019 – Nov 2020

Louisville, KY

Conducted comprehensive analytic reviews of clinical documentations to determine if a grievance, appeal, or further request was required from members

Investigated and resolved member and practitioner issues

Provided resources to members

Humana – Case Manager Jul 2016 – Oct 2019

Louisville, KY

Resolved all issues, inquiries, and concerns for members

Made outbound calls to members to complete their application process

Maintained and reported a registry/database of patients to state agencies

Humana – Claims Work Specialist Mar 2015 – Jul 2016

Louisville, KY

Analyzed large quantities of data by using a variety of systems and software

Researched and investigated prior claims to effectively process claims according to CMS standards

Catholic Charities – Program Specialists Sep 2011 – May 2012

Louisville, KY

Counseled and interviewed clients during cases and also managed the case review.

Helped as a liaison to state officials and local agencies to service the needs of the elderly and children.

Facilitated workshops for mental health therapy, for men, women and children coping with traumatic experiences.

Education

Master of Social Work Graduation Date: May 2014

Bachelor of Science of Social Work Graduation Date: May 2013

University of Louisville

Skills

Proficient in all Microsoft Office Programs

CCA (Clinical Care Advance)

Experience working with dual eligible for Medicaid and Medicare

Proficient in SMART goals

Successfully managed a caseload up to 350 members

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