Care Coordinator Case Management
Resume:
Jennifer Anne Kiley-Maloney
**** *. *** ****** **. #1002
Gilbert, AZ 85233
********.************@*****.***
Career Objective: To effectively employ my multi-tasking skills in today's business environment, delivering total customer satisfaction at all times, while utilizing my leadership abilities to work independently and as a team player, and excelling in a challenging and rewarding career within a well-established, progressive organization.
Southwest Behavioral & Health Services- Clinical Care Coordinator
04/24-PRESENT
Enroll members through the intake process where an initial assessment, service plan, and safety/support plan is completed. Assist members, families, and their guardians in securing appointments with support services and agencies, as needed. Provide support and information and guidance to members, guardians, and their support system concerning issues of treatment planning, advocacy, and medication management. Close coordination with the with the member’s integrated care team and healthcare plan. Complete necessary paperwork for referrals, coordination, admission, discharge, and out of home placements. Serve as central support for the entire clinical team while also performing case management functions as needed. Attend weekly/bi-weekly/monthly clinical staffing’s and all staff meetings. Coordinate hospital discharges by scheduling follow up appointments and ensures proper communication is kept between inpatient and outpatient teams. Document treatment progress and services received/provided. Coordinate and facilitate CFT meetings with the member, guardians, and the member’s integrated care team. Conduct in-person and virtual groups as needed. Provide information to member’s and their guardians concerning community resources and linkages to other services. Transition members to an appropriate level of care upon conclusion/revision of the treatment plan. Help with the transition to adulthood an making sure that our young adults have what they need to succeed when transferring from adolescent to adult services. Assist Review documents received and requests required documents to appropriate level of care for members. Completes outreach for members who miss an appointment and follows up with the re-engagement process. Maintain quality and compliance in member’s charts and complete chart closures upon successful completion of the member’s service goals and transitions to the next level of care. Maintains accurate, thorough and current documentation of any contact with members/guardians and any part of the member’s integrated care team.
The Crossroads Inc.- Rehabilitation Specialist/Community Care Case Manager
08/23-04/24
Responsible for intensive case management and formulating programs for the treatment and rehabilitation of all aspects of clients lives including; drug and alcohol treatment and counseling, mental health evaluations (SMI evaluations), physical health, housing, obtaining identifying documents and phone for job readiness, taking client’s out into the community to find employment, and assisting with any legal issues that the client might have going on to insure that the client has all he/she needs in order to have a successful and long lasting recovery, and to be productive out in the community.
Lifewell Behavioral Wellness-Rehabilitation Specialist/BHT/PCT 11/22-08/23
Responsible for evaluating client's abilities, interests, experience, skills, health, and education to develop a specialized treatment plan in consultation with the other professional professionals such as doctors, therapists, case managers, and psychologists to help client's return to daily life during recovery from substance abuse and/or behavior health concerns. Perform routine and on-the-spot drug testing as requested by Physicians, Case Managers, and other clinical staff.
Scottsdale Physicians Group/SPG VIRTUAL CARE- Clinical Care Coordinator
01/22-11/22—TEMP ASSIGNMENT
Responsible for ordering/following up on Durable Medical Equipment, uploading Labs/Rads into the computer system, coordinating specialty care and services for both in-home care as well as at medical facilities for our providers. Working knowledge of insurance and prior authorizations, step therapy, and the process of what provider's need to supply so that the ordering/scheduling goes from start to finish easily with no issues. Assist with billing, answering phones, assisting in projects, and helping out wherever needed.
Jewish Family & Children’s Services- High Needs Case Manager/PCA
01/21-01/22
HNCM that provides intensive ongoing case management services to clients (Adolescents) and their families on a weekly basis. Perform out-of-office case management services and administrative tasks in accordance with agency procedures and the Arizona Principles for working with families and clinical teams. Perform routine and on-the-spot drug testing as requested by Physicians and other clinical staff members.
Oasis Behavioral Health Hospital- BHT/PCT/Patient Advocate
12/20-01/22—FULL-TIME/PART TIME
Responsible for the direct care of both adolescents and adults in a six-unit facility focusing on both mental health care and drug addiction. Staff with physicians, nurses, social workers, and case managers with needed tasks to appropriately aid in the Patient's recovery process. Assist in the intake process, perform routine and on-the-spot drug testing as requested by Physicians and other clinical staff members. Create lesson plans and facilitate groups focusing on Healthy Living, Coping Skills, Anger Management, Positive Affirmations, and Self-Care etc. Assist the hospital's Patient Advocate in providing help with clothing during treatment and other resources for after discharge, assist in plans for transitional facilities/home, and provide peer support in hopes of a successful and long-lasting recovery.
Aspire Loyalty Travel Solutions-Travel Agent/Remote
02/21-12/21—PART TIME TEMP ASSIGNMENT
Front-Line Travel Agent responsible for assisting with inbound/outbound client inquiries related to placing new travel booking bookings or servicing existing travel bookings as requested by clients through Bank of America/Merrill Lynch credit/rewards cards. Deliver excellent customer support through various channels i.e. voice, email, text, and chat. Facilitate new travel bookings for a variety of travel products---primarily AIR, CAR, and HOTEL bookings. Provide site navigation assistance, and report internal/external issues that are surfaced by the clients in a timely and positive manner.
REMX/MCKESSON-Health Insurance Specialist/Remote
04/20-02/21
Researching and Processing Medicare/Medicaid/Commercial insurance to help the patient get medications covered and filled that might not be covered under their insurance but are life essential.
Family Support LLC.-BHT/PCA-PCT 08/17-03/20
Personal Care Assistant/Aide in a group home setting with adults that have behavioral health issues/substance abuse, are developmentally disabled, or have dementia and are in need of memory care. Helped residents with activities of daily living (ADL), help promote safety and wellness, and worked along-side of resident’s families to provide a united support system. Also responsible for properly documenting daily updates on resident’s physical/emotional well-being, activities, or any arising medical issues that need to be addressed with their doctor. Provide transportation to recreational activities and doctor’s appointments. Perform routine and on-the-spot drug testing as requested by Physicians and other clinical staff members. Facilitate groups that all would benefit from such as; self-care, triggers, coping stills, developing social skills, setting boundaries, being honest with yourself and your situation whether it be behavioral health, substance abuse, or disabilities.
Pioneer Janitorial Services-Receptionist/CSR/Billing/Janitor/Admin In-Office & Remote
05/12-12/19
Front desk receptionist responsible for answering a multi-line phone system, checking and returning company voice messages, scheduling and confirming appointments, managing the front office area, sales, handling billing/customer service inquiries, maintaining the cleanliness of the front office and reception area of the facility, and greeting future and/or current business clients that came into the office.
Humana Inc. Rightsource Rx-Customer Care Specialist
06/08-09/10
Responsible for order entry, sales, billing, prior authorization, insurance verifications, customer service inquiries, technical support for the company website, and problem-solving for Humana Inc.’s prescription mail order service. I also helped out with many special projects and activities.
Norwegian Cruise Line-Group Vacation Planner
01/05-10/08
Answer phone calls, create and make changes to cruise reservations, answer customer service questions, and basic Technical Support.
Electronic Data Systems (EDS) Customer Service Representative
06/01-12/05
Dispatch Advisor responsible for interacting with General Motors owners, technicians, AAA service providers and independent contractors to provide roadside service or product information. Responsible for thoroughly understanding the customer's situation and GM policy and procedures in order to properly assist the customer. Promoted to the Case Closing Team for the specialty group in 2002. Responsible for making sure that all needed information was entered into the roadside case and closing it so that our service providers were paid for their services. Also worked with the Reimbursement Team as well as the Help desk, basic technical support, and have helped out with many special projects and activities.
Knowledge Base
Strong working knowledge of Excel, Microsoft Word, Windows 9x, Outlook, Adobe Acrobat, Power Point, Microsoft Teams, Zoom Meetings and telehealth; in addition to advanced expertise handling many different types of Business Applications and Database Software. Extremely experienced with all major Web Browsers. Extensive EMR experience with Nextgen and Axiom. Exceptionally strong in the following areas: answering multiple phone lines, typing, filing, creating and maintaining spread sheets, appointment reminders exceptional problem-solving skills, data entry, and the ability to operate scanners and fax machines. Very customer service and detail oriented. Easily able to prioritize tasks that may change frequently or without notice. Strong multitasking skills and the ability to think quickly and stay focused in high pressure and stressful situations. Previous experience with verifying health care insurance, gathering information for prior authorizations, and researching and completing both medical and behavioral health related referrals. Familiar with both medical and behavioral health terminology. Knowledge of DES/AHCCCS applications and other assistance procedures. Experience with assisting clients with DCS involvement expectations and Child Support Services. Works well in a team environment in addition to possessing the ability to work with little or no supervision.
Education
Marcos De Niza High School-Tempe, Arizona-2002-High School Diploma
Marc Community Resources-Mesa, Arizona-2016-Peer Support Specialist Certification
Fingerprint Clearance Card-Renewed 03/2022
Current CPR Certification- Renewed 11/2023
CPI Non-Violent Crisis Intervention Training 10/20/21
REFERENCES AVAILABLE UPON REQUEST
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