Population Health Care Management
Resume:
Melora Mayo Statesville, NC 203-***-**** ******.*.****@*****.***
Summary
Highly accomplished Registered Nurse with over 20 years of progressive experience in complex care management and patient advocacy. Proven expertise in conducting comprehensive patient assessments, developing dynamic care plans, and coordinating resources to significantly improve health outcomes. Skilled in leading cross-functional teams, ensuring stringent HIPAA and regulatory compliance, and contributing to strategic population health initiatives. Exceptional communicator adept at fostering strong relationships with patients, families, physicians, and multidisciplinary staff.
Experience
Population Health Care Manager eternalHealth Boston, MA October 2024 – Present
Spearhead comprehensive member and provider outreach and engagement initiatives, meticulously documenting activities to support complex care management, care coordination, and transitions of care.
Conduct in-depth assessments of members' and caregivers' physical, emotional, psychosocial, and environmental needs, informing tailored interventions.
Develop and continuously evaluate dynamic, member-centered care plans to achieve health goals and drive measurable improvements in health outcomes.
Ensure optimal service delivery by aligning member services with benefit coverage and proactively coordinating additional resources for holistic patient care.
Actively contribute to organizational strategic goals focused on population health management and quality improvement.
Uphold strict confidentiality of Protected Health Information (PHI) in accordance with HIPAA and company policies, ensuring full compliance with CMS and state Department of Insurance (DOI) guidelines.
Clinical Care Coordinator Methodist Physicians Services Group Fredericksburg, TX July 2018 – December 2023
Managed a continuous caseload of approximately 120 patients, ensuring consistent engagement and care plan adherence for a Chronic Care Management program.
Identified Medicare patients at high risk for health decline, targeting key educational goals that significantly improved patient outcomes.
Collaborated closely with primary care providers to develop and refine individualized care plans.
Contributed to achieving quality measures for an accountable care organization for 3 consecutive years, directly resulting in a $200,000 reimbursement.
Developed and organized a telemedicine endocrinology clinic, overseeing care for approximately 350 patients and streamlining prior authorizations.
Managed orthopedic clinic operations, including direct patient care, telephone triage, and coordination with radiology technicians.
Senior Nurse Texas Oncology Kerrville, TX May 2014 – June 2018
Facilitated the safe and efficient infusion of chemotherapy in a high-volume, 15-chair infusion center.
Provided expert telephone triage for incoming patients, prioritizing urgent care needs.
Supported physicians and nurse practitioners as a Pharmacy Technician and Medical Assistant.
Nurse Manager/Staff Nurse Connecticut Oncology Group Middletown, CT October 2008 – July 2013
Coordinated patient and family care in a complex hematology and oncology office and infusion center, collaborating with five doctors, two nurse practitioners, and management staff.
Recruited, hired, precepted, and supervised a team of 5-9 nurses.
Served as a Superuser during the installation and ongoing utilization of the electronic medical records (EMR) system.
Provided direct care and administered chemotherapy to adult medical oncology patients, and proficiently accessed port-a-caths and PICC lines.
Education & Certifications
Master of Science in Diabetes Education and Management Teachers College, Columbia University 2020
Bachelor of Science in Nursing University of North Carolina at Charlotte 2001
Sigma Theta Tau International Honor Society of Nursing
Licenses and Certifications
Registered Nurse Active, unrestricted licenses in North Carolina and Massachusetts
Certified Diabetes Care and Education Specialist #3220279 (2022)
CPR Certified (2024)
Skills
Patient Advocacy: Serving as a patient advocate through continued communication and education.
Care Management: Providing active care management, assessing service needs, and developing action plans in cooperation with members.
Care Coordination: Coordinating resources for holistic patient care and developing individualized care plans.
Population Health: Expertise in population health management and quality improvement.
Compliance: HIPAA, CMS, and DOI regulatory compliance.
Technical Proficiency: Microsoft Office Suite, electronic medical records (EMR) systems.
Communication: Exceptional written and verbal communication, negotiation, and presentation skills.
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