Case Management Support Manager
Resume:
Cara F. Aguiar
** ********* *** ****** ** *****
*********@*****.***
Executive Summary
Enthusiastic Patient Support Manager, skilled in reimbursement and tailoring treatment plans to meet individual needs and dedicated to delivering the utmost care. With more than 12 years of experience in Case Management, I specialize in orchestrating comprehensive care involving various service providers to ensure optimal support for clients. I am a passionate advocate for each patient, driven to make a positive impact on their well-being.
Education:
Salem State University, Salem, MA May 2014
Bachelor of Arts in Psychology
Middlesex Community College, Lowell, MA May 2010
Associate in Psychology
License: LSWA Social Work License
Summary of Skills:
Strong case management and problem-solving skills, strong leadership and team player, excellent work ethic and time management, strong communication and relationship building, highly motivated, trustworthy, dedicated, approachable, dependable, flexible, and compassionate. Profound ability to perform multiple tasks, and remain calm and even-tempered. Lifelong learner. Microsoft Office Applications including Excel, Access, and PowerPoint Public Speaking and Public Relations Experience
Experience:
Takeda Pharmaceutical Lexington MA
Patient Support Manager 2022-Present
Manage patients needing to gain access to therapies to treat their Hereditary Angioedema.
Working with Specialty Pharmacies and insurance companies to obtain reimbursement information and counsel patients/families on reimbursement options and acted as the liaison with medical offices.
Performed benefit investigations with insurance companies as required.
Work with nurses to coordinate injection/infusion training for patients.
Maintained case history and high level of data integrity for all my assigned cases in the CRM system.
Partnered with Field Regional Business Managers and Patient Access Mangers to manage all patient cases and troubleshoot any customer problems.
Provided ongoing persistency and compliance support by making regular calls to patients/families.
Lead and infuse Takeda’s Code of Ethics into all aspects of business activity, and encourage others to do the same
Live our values of PTRB and our Takeda-isms of Integrity, Fairness, Honesty, and Perseverance
Takeda Pharmaceutical Lexington MA
OAS Practicum September 2023-November, 2023
With the supervision of an OAS, worked with every new Gattex patient to ensure that the patient’s care environment (physician, nurse, injection training nurse, home infusion provider, family and caregiver, pharmacist) understand Gattex and the process for initiating Gattex.
Educate patients, families, and caregivers on coverage and reimbursement as well as available Takeda services.
Work closely with Takeda colleagues (PSM, RBM, and others as necessary) to ensure that all important activities related to starting therapy (e.g., timely physician detailing, injection training, specialty pharmacy delivery) are completed.
Working cross-functionally to identify and lead the resolution of patient access barriers, including insurance coverage; reimbursement; financial limitations; site of care; and procurement/distribution.
CASE Collaborative Groton, MA
ABA Tutor 2020-2022
Working with Children with Disabilities
Attends and actively participates in regularly scheduled staff meetings.
Carries out specific activities with individual students or in a group as directed by teacher.
Fosters appropriate interactions between CASE students and students in the mainstream and/or members of the community.
Collaborate with other professional in regards to the children’s needs and how we can best support them.
Work Collaboratively with a BCBA to implement behavior plans for students.
Department of Children and Families Chelmsford, MA
Social Worker 2014-2019
Develop, review, update and ensure implementation of strength-based service plans for each child in care or custody including risk assessment, safety plans and goals.
Foster relationships with, and provide support & guidance to, insurance companies, education liaisons, healthcare
experts, and police departments with ultimate goal of enabling patients’ success.
Educate, with ongoing persistency, individual patients & families on relevant treatment options.
Maintain ongoing data collection for patients, insurance providers, and adjacent partners, ensuring accurate action
planning & analyses
Attend home and foster care visits; transport patient to health, social services or other agency-related appointments as required.
Partner with key internal stakeholders such as attorneys, intake screeners, and area program managers to strengthen
patient relationships by providing key case context and associated information.
Empower families to make stable commitments to children by providing counseling and coordinating visits with biological parents and/or guardians and other relatives; develop a helping relationship and ensure needed supports and services are provided.
Attend weekly supervision, weekly staff meetings, in-service training, and team meetings.
Maintain a high degree of professionalism in the community, with clients, schools, courts and with referring agencies seeking to build and sustain positive relationships.
Conduct bio-psycho-social assessments with patients and determine appropriate services to enhance family safety
and emotional well-being
Lahey Health Behavioral Services Haverhill, MA
Therapeutic Training & Support 2012-2019
Provide one-to-one support for the purpose of addressing the daily living, social, and communication needs of children and families through CBHI services
Support parents with coaching and training in problem-solving and conflict resolution related to parenting skills and parenting a child with various mental health issues
Participate in Care Plan Meetings with collaterals to review goals, progress, and barriers to treatment for children and families
Develop treatment plans and activities with the IHT clinician to support the child and family in reaching their identified goals
Lighthouse School, Chelmsford, MA
Teacher’s Assistant 2011-2012
Reinforce general curriculum and special subject instruction in collaboration with classroom teachers.
Development and implementation of instructional strategy conducive to the academic and social development of student groups across a variety of academic subjects
Maintaining curricular consistency
Provide one-to-one and group literacy and mathematics instruction.
Related Experience:
Lowell Housing Authority Lowell, MA
Program Supervisor 2010-2013
Manage two sites in the Greater Lowell Area, providing support and enforcing structure to the provided model of care
Coordinate daily activities, including the nutrition and supervision of the program staff
Work with a group of adults to ensure that the proper services were being provided for this client-based service
Community Service:
Active in Lowell Girls Softball Association for over ten years.
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