Care Manager Case Management

Roxana Olaya

**** **** ****** #**, *****, NY ****1 • 917-***-**** • ********@*****.***

PROFESSIONAL PROFILE

Compassionate human services professional with outstanding skills in case management, research, and project management. Frequently trusted to perform complex assignments meticulously, adept at assessing and solving needs of clients, and cultivating positive relationships. Consistently recognized by colleagues and supervisors for natural leadership abilities, diligence, being organized, and exceeding expectations.

PROFESSIONAL EXPERIENCE

Tri-County Care Long Island City, NY

Care Manager Supervisor March 06, 2023, Present

Assist with the hiring process of Care Manager staff and ensure they are appropriately oriented, trained, and supervised.

Tracking of new the Care Manager’s caseloads and reassignments as applicable, per company established ratios.

Assignment of new enrollments monthly.

Tracking and review of care manager’s billing records and notes.

Tracking of the face-to-face meetings with individuals/families.

Ensure caseload coverage in instances of Care Managers unavailability/absences.

Carry over 60 cases and make sure F2F, life plans and other services are delivered according to the agency policy.

Review and follow up on reports of abuse, neglect, maltreatment, or any incident reported.

Address and follow up on escalated complaints/grievances from individuals/families.

Supports care managers in developing, implementing, and maintaining the Life Plan, to ensure that Life Plans are properly developed and in compliance with OPWDD requirements.

Ensure the highest standards of service are provided to individuals/families.

Responsible for individual retention efforts by addressing the various needs of individuals/families to enhance their satisfaction.

Analyze and track any trends or patterns with disenrollment’s.

Support care managers in their advocacy role.

Ensure a positive work environment.

Review of bi-weekly time & attendance reports.

Employee 90 days and annual performance reviews.

Initiation and participation in staff disciplinary actions, when applicable.

Coordination and participation in Care Manager Supervisor meetings.

Participation in ongoing staff meetings.

Participation in ongoing training.

Ensure compliance with Health Home Standards and OPWDD related requirements.

Perform other duties as assigned by the Regional Director

Participation in monthly Quality Assurance review for your caseload

Attendance in Bi-Monthly supervisor meetings

Responsible for completing the required QA Chart reviews monthly.

Responsible for ensuring that reporting staff complies and up to date with the required training.

Tri-County Care Long Island City, NY

Care Manager January 2019 to March 05,0203

Provide comprehensive, person-centered care planning using a team approach with service providers.

Enhanced coordination and integration of primary and behavioral health services as well as access to medical and dental services for clients

Help to identify community-based resources and make connections to community services and supports, housing, social services, and family services; and use technology to link all services.

Use a person-centered planning process in developing, implementing, and maintaining a person’s Life Plan.

Conduct a minimum of one annual home visit and/or program-based visits and (2) monthly phone contacts per individual, to observe and ensure that excellent services are being provided and safe conditions are maintained.

Assist in self-direction cases; collaborate diligently with Broker, families, and individuals, to design an improved quality of life on individual's terms.

Life plans meet with families and providers to make an individual receive the quality services that they deserved.

Monthly case notes related to everyone’s needs.

Coordinating medical treatment, including administering assessments, developing care plans, monitoring medication compliance and more.

Relationship building with patients.

Sinergia, Inc NEW YORK, NY

Medicaid Service Coordinator/Assistant MSC Supervisor September 26, 2006 – December 2018

Assessment and coordination of services in accordance with OPWDD policies and regulations.

Provide daily case management, support, and linkage for a caseload of (40) individuals with developmental disabilities.

Work with families and service providers, to develop and maintain individualized service plans, designed to ensure individuals lead meaningful lives.

Conduct a minimum of (3) annual home and/or program-based visits and (2) monthly phone contacts per individual, to observe and ensure that excellent services are being provided and safe conditions are maintained.

Maintain effective communication with family members and service providers until each client issue is resolved.

Assist in self-direction cases; collaborating diligently with Broker, families, and individuals, to design an improved quality of life on individual's terms.

Angels Unaware, Inc Bronx, NY

Medicaid Service Coordinator August 2004 – January 2006

Access individual with assessment and coordination of services in accordance with OPWDD policies and regulations.

Provide daily case management, support, and linkage for a caseload of (40) individuals with developmental disabilities.

Work with families and service providers, to develop and maintain individualized service plans, designed to ensure individuals lead meaningful lives.

Conduct a minimum of (3) annual home and/or program-based visits and (2) monthly phone contacts per individual, to observe and ensure that excellent services are being provided and safe conditions are maintained.

Maintain effective communication with family members and service providers until each client issue is resolved.

Assist in self-direction cases; collaborating diligently with Broker, families, and individuals, to design an improved quality of life on individual's terms.

Individualized Services Plan (ISP) is a comprehensive plan where it describes the needs of everyone in terms of health, social and environmental.

EDUCATION

LEHMAN CUNY COLLEGE BRONX, NY

1998-2003

Completed 60 credits towards a B.A.in

Psychology

Certifications

Medicaid Service Coordinator certifications.

OSHA/HIPPA training

Identifying and Reporting Child Abuse and Maltreatment 10-2016

KEY SKILLS

Microsoft office, with a focus on Excel

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