Case Management Resident Services
Resume:
Kimberly Berberich
Tucson, AZ 85710
*************@*****.***
Open to new opportunities. 7 year’s experience as a Hospice Liaison in the Tucson community. 12 years with Arizona Long Term Care Case Management. Strong coordination skills for efficient case management. Knowledgeable with Medicare/Managed Care/AHCCCS. Solid community relationships. Dedicated desire to assist and educate seniors about available healthcare options to provide smooth transitions and lifestyle choices.
WORK EXPERIENCE
Director of Resident Services
Splendido at Rancho Vistoso, Tucson, AZ
January 2022 – Present
Directs operation processes of the Resident Services Department directly or indirectly to provide residents, family members and visitors of Splendido with a positive experience.
Develop, oversee, and implement a comprehensive selection of engaging programs, activities: presentations, fitness classes, wellness experiences.
Provide ongoing support and coordination of services for Independent Living residents to improve their quality of life and maintain safety.
Oversees resident communication to ensure residents are well informed and information is easily accessible through several avenues of communication: from written communication to technological communication.
Respond to resident’s concerns serving as a liaison amongst affected parties.
Select, provide ongoing training, performance management, scheduling and supervision of resident services team (Drivers, Concierge, Salon and Spa, Fitness, Programs, Art Therapy, Wellness, Wellness RN)
Administer department budget. Anticipating and planning for capital expenditures.
Community Relations Manager
Homestead Hospice and Palliative Care – Tucson and Phoenix, AZ
June 2021 – Current
Screen, process and provided hospice service information to all potential patients and their families
Built strong account relationships resulting in partnerships and contracts
Hospice Liaison
Dependable Hospice and Palliative Care, LLC – Tucson, AZ
January 2020 – March 2021
Created and implemented all hospice marketing collaterals and community training
Instrumental in the creation and implementation of the hospice referral to admit and Home Health to Hospice admit/transition process’
Completed home safety evaluations as necessary to determine the necessary Durable Medical Equipment needs to support patient diagnosis
Provide discharge coordination from facility to facility. Arranged transport, medical equipment, in-home support and additional necessary services to support patient environmental changes
Hospice Liaison
Amedisys Hospice – Tucson, AZ
August 2017 – January 2020
Community Liaison
Soreo Hospice dba Aria Hospice – Tucson, AZ
September 2014 – July 2017
Eldercare Advisor
Jackson White Attorneys at Law – Phoenix/Tucson, AZ
February 2014 – September 2014
(Pre)Screen potential clients to determine appropriate need for legal services in the Arizona Long Term Care (ALTCS) application process
Provided in depth review of ALTCS available services
Met with clients to assist in gathering necessary documents for ALTCS application submission
Provided community education
Developed partnerships with Skilled Nursing Facilities to coordinate ALTCS pending patients/residents resulting in facilities avoiding loss of revenue
Case Manager, Long Term Care
Bridgeway Health Solutions (Centene) - Phoenix, Az
July 2013 – September 2013
Complete member assessment (initial and reassessment) in accordance with AHCCCS guidelines
Develop, implement and maintain comprehensive, cost-effective plans of care
Educate members and families of services/requirement and ensure member involvement in plan oc care
Coordinate referrals to authorize long term care services
Coordinate community-based services not covered by Medicaid for dually eligible members
Monitor members care and condition, participates in discharge planning and conducts post-discharge follow-up
1 of 2 LTC Case Managers to assist RN Case Managers with evaluation/asses, authorize and provide concurrent review for all non-Medicare, Long Term Care members requiring a higher skilled level of care. (ventilator, tracheostomy, bedside dialysis, complex wound care)
Document and maintain computerized medical record (PHI)
Program Specialist, Long Term Care
Bridgeway Health Solutions (Centene) - Phoenix, AZ
Oversee new implementations, development and ongoing maintenance of the Long-Term Care Department/Program
Facilitate program data collecting and reporting; analyze data and measure outcomes; advised, develop and modify program as needed
Developed and implemented a 3-week, new hire training program. Developed appropriate training modules for initial, remedial and ongoing department training. Instituted cross-departmental overviews for new-hire training to assist with deeper understanding of overall company objectives
Conducted new-hire training to Long Term Care Department. Ensuring competencies in Medicare, Managed Care, Arizona Cost Containment System (AHCCCS), Hospice, computer programs and skills
Attended outside training opportunities to provide ongoing professional development within the department
Responsible for the daily review of Long-Term Care Departments outstanding claims, providing research and root cause analysis for claim quality remediation
Conducted quarterly Inter-rater Reliability within the department to assess department needs for increased productivity and performance
Contributed to the development, conducted onsite and telephonic training, support and mentorship to newly established(ing) Long Term Care Programs within the Centene Corp
Case Manager, Long Term Care
Bridgeway Health Solutions (Centene) - Phoenix, AZ
February 2009 – October 2009
Case Manager, Long Term Care
Mercy Care Plan (Aetna) - Phoenix, AZ
October 2002 – February 2009
Director of Admissions and Case Management
Foothills Manor Care and Rehabilitation Center – Phoenix, AZ
May 2001 – September 2002
Coordinated the delivery of services to patients in collaboration with other clinical staff based on skilled need
Monitored and documented cost effectiveness and necessity of skilled treatment(s) provided under Medicare guidelines
Assess and process medical information for admission appropriateness of skilled and long-term care
Initiate medical/professional referrals as necessary, based on criteria of managed care
Verify and establish contracted rates for patient care with appropriate Health Management Organization (HMO). Negotiated rates with non-contracted HMO for patient care as appropriate and necessary
Conducted weekly Medicare/Interdisciplinary Meetings to review the 5 major categories of skilled care
Case Manager
Life Care of Paradise Valley – Phoenix, AZ
December 1999- May 2001
Health Unit Coordinator
Southern Arizona Veterans Hospital – Tucson, AZ
January 1988 – November 1999
Director of Medical Records
Mountain View Care Center – Tucson, AZ
December 1995 – April 1996
Director of Medical Records
Park Villa Healthcare Center – Tucson, AZ
December 1993 – December 1995
Director of Admissions
Southern Arizona Rehabilitation Hospital
August 1992 – December 1993
Healthcare Support Specialist
United States Air Force, Davis- Monthan AFB
October 1987 – August 1992
Education
Bachelors in Healthcare Services
University of Phoenix - Online
2007
Associates in Social Work
Pima Community College – Tucson, AZ
1998
Associates in Healthcare Administration
Community College of the Air Force
1992
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