Management Coordinator Services
Resume:
Education
Incarnate Word College
San Antonio, TX
BA Psychology, Minor Sociology
Certifications &
Credentials
APR ‘19 (Expires: March ‘21)
Certified Community Health Worker (CHW)
Texas Department of State Health / Human Services
Knowledge &
Skills
●Case Management & Coordination of Services for Individuals w/ Intellectual & Developmental Disabilities in Medicaid-Waiver Programs
●Knowledge of funding sources Medicare and Medicaid eligibility for waiver programs
●Crisis Helpline Counseling
●Behavior Management & Knowledge of intellectual & developmental disabilities such as autism
●Paraprofessional Experience
●Knowledge of Basic ASL (American Sign Language) & Spanish
●Microsoft Office (Excel, Word, PowerPoint)
●Exceptional Customer Service Skills
●Excellent Oral & Written Communication Skills
Work Experience
JUL ’22 – SEPT. ‘22
Disability Services of the Southwest / LifeSpan HomeHealth
San Antonio, TX
Case Manager
Responsible for Intake of new clients
Maintained caseload of 60-62 clients, ensuring HIPAA maintained in the strictest of confidence.
Communicated with MCOs regarding member’s service(s)
Responsible for client’s initial, 6-month and annual visits; documenting updates in plan.
Supervised attendants assigned to each client.
Collaborated with staff members regarding services of each client.
Linked clients with their MCOs concerning any increase/decrease in changes to their authorized service(s).
Utilized all aspects of Microsoft suite; scanned, faxed ( to MCOs ) and uploaded all documentation on clients into LifeSpan’s shared drive and into KanTime.
JAN ’22 - JUNE ‘22
WellMed / Optum (United Healthcare)
San Antonio, TX
Utilization Management Coordinator
Responsible for reviewing approval/denials of healthcare coverage is expedited to our priority population of Medicare members.
Coordinated and entered returned mail from members/providers into system.
Contacted members to verify correct address/current contact number.
Operates Dsi200 machine that automatically folds letters; also, trouble shoots any mechanical issues with machine.
Managed Microsoft system’s Auto Impress, which categorizes members’ correspondence and allows for bulk mass printing.
JUN ‘16 - SEP ‘20
Centene / Superior Healthplan
San Antonio, TX
Service Coordinator - Star Kids Program
●Performed initial screening assessments for new members to determine level of need.
●Conducted quarterly outreaches to ensure safety and proper services are in place.
●Collaborated with other agencies to provide specialized services for member(s).
●Coordinated case management with credentialed nurses who share the same clients.
●Conducted/participated in annual office-based educational trainings/briefings.
●Performed case closures as necessary.
●Utilized Amisys, TrueCare SharePoint, TMHP, ImpactPro, & BizCom Faxing applications.
●Experience in phone conferencing with interpreter services for members.
●Verified HIPAA/demographics to ensure members’ confidentiality.
SEP ‘13 - MAY ‘16
Alamo Area Council of Gov. (AACOG)
San Antonio, TX
Services Coordination Specialist - Tx HmL/PASRR (Texas Home Living) / (PreAdmission Screening & Resident Review Program)
Maintenance of 50+ caseloads, with intellectual &/or physical disabilities, monthly/quarterly visits, timely documentation with Person-Centered Practices (PCP) incorporated. Responsible for intake assessments to determine mental/behavioral health & financial eligibility coordinating services through available service providers. Enrolled individuals who qualified for TxHmL/PASRR Medicaid waiver program. Conducted annual/renewal meetings with clients to prepare individual care plan. Managed client's $17,000.00 yearly Medicaid waiver allotment, applying funds to services/supports; added, decreased and/or removed funding depending upon utilization of services as needed. Adjusted service(s)/funding & annual renewal of program for members. Worked with transition coordinator to relocate individuals who desired to move into a group home and managed financial transfer as well. Conducted quarterly interdisciplinary meetings with staff and member to ensure safety and appropriate services.
SEP ‘10 - JUN ‘12
Alamo Area Council of Gov. (AACOG)
San Antonio, TX
Services Coordination Specialist – HCS (Home & Community Services)
Maintained 40+ caseloads with intellectual &/or physical disabilities, monthly/quarterly visits, timely documentation with Person-Centered Practices (PCP) always incorporated. Responsible for coordinating, linking, & monitoring Home & Community Services (HCS), monitoring service delivery system through site visits to confirm that goals were being met. Conducted annual/renewal meetings with clients to prepare individual care plan. Managed client's yearly Medicaid waiver allotment, which varied per client (usually between $100,000-$300,000), as this waiver program dealt with the individual living in a group home, applying funds to services/supports; added, decreased and/or removed funding depending upon utilization of services as needed.
Contact this candidate