Experienced Protective Services Case Manager and Care Coordinator
Resume:
Yaritza Gonzalez
Chicopee, MA *****
**************@*****.***
Willing to relocate: Anywhere
Authorized to work in the US for any employer
Work Experience
Greater Springfield Senior Services, Protective Service Case Manager City of Springfield, MA - Springfield, MA
January 2017 to Present
* Investigate reports of abuse, neglect, exploitation or self-neglect of elderly persons
* Screens/collateral assessment calls as needed to determine level of risk and clients status
* Complete documentation of all investigations, assessments, summaries and statements of reasonable cause in the client data base.
* Documentation of all case activity in the client file current to within 30 days
* Develop comprehensive protective service plans, with both the abused/neglected elder and supervisor
* Provide for and arrange services necessary to assist and safeguard an elder's well being
* Provide assistance to elders in obtaining restraining orders or no trespass orders; complete thorough safety planning with all clients
* Determine the existence of need to petition the court for protective orders, guardianship or conservatorship
* Arrange for psychiatric evaluations when deemed appropriate and consult with physicians, psychiatrists, social workers, and attorneys when necessary
* Prepare affidavits in consultation with agency attorney for court cases
* Attain a thorough knowledge and understanding of all ASAP and other Community-based Programs, including and maintain an ability to make appropriate referrals
* Provide case management services after business hours or on weekends as on-call
* Maintain a working knowledge of state, federal and local entitlement programs and the steps necessary to * obtain such services for elders
Clinical Care Coordinator Assistant
Mercy Hospital - Springfield, MA
July 2016 to Present
* Registers patients in the system based on physician status so that bed placement can occur and a patient can be established.
* Verifies patients' insurance coverage, i.e., status (active), effective date, benefit levels, network or non- network, deductible amounts. Determines if pre-certification is required and precepts as necessary.
* Verifies continuum of care benefits on specific cases identified based on DRG level and possible care needs. Assists with the flow of information as requested.
* Notifies payer, as required, of patient's admission and level of care, either online or via telephone.
* Prints and updates documents as information is updated and /or a change in patient status occurs.
* Assists in the submission of medical information to payers and community care providers.
* Communicates with payers via telephone, fax, or online regarding nurse reviews and authorization of patient days.
* Assists the care management team to assure patients receive the right care at the right time in the right place.
* Coordinates efforts with the pre-certification department on pre-planned surgeries / admits to facilitate authorizations and level of care.
* Reviews all Medicare secondary forms to assure correct primary carrier is billed for Medicare eligible patients.
* Updates and corrects insurance information in the computer system, and notes via email, telephone or fax the appropriate departments to assure accurate financial data is available.
* Provides information to the Department of Human Services' caseworkers needed to release Medicaid spend downs for patients.
* Maintains time and attendance system for department.
* Monitors and orders office supplies.
* Responds to routine inquiries, referring to other staff members as necessary. May act as receptionist, screen visitors and telephone calls. May process department mail.
* Organizes and coordinates workflow for department including record keeping, reporting systems and maintaining appropriate clerical support. Collects and disseminates confidential data. Initiates, composes and types correspondence.
Community Health Worker
Commonwealth Community Care - Springfield, MA
November 2013 to Present
* Conveys the purpose of the program to the member/care givers.
* Coach the member in effective management of their chronic health conditions and self-care
* Support and educate members in medication management and adherence; exercise, nutrition, health care system navigation; substance use and other health behaviors
* Provide support and notify clinical team and program manager regarding changes in: behavior, nutrition, exercise, substance use, medication compliance, and other issues as related to the established care plans
* Assist members in utilizing resources, including scheduling appointments, transportation and accompaniment, and assisting with completion of applications for programs for which they may be eligible
* Continuously expand knowledge and understanding of community resources, services and programs available and effectively works with individuals from diverse backgrounds in reducing cultural and socio economics barriers
* Support the member with health management plan and goals
* Assist with understanding the care plans and instructions
* Motivates the member to be active, engaged participant in their health
* Works collaboratively and within the interdisciplinary team
* Provide culturally appropriate health education and information
* Outreach in community-based settings, such as homes, schools, clinics, shelters, local businesses, and community centers
* Bridging/mediating between individuals, communities, and health and human services, including actively assisting members with access to community resources
* Assuring that members access the services they need
* Assist members to engage in wellness activities as well as chronic disease self-management.
* Provide direct services, such as informal counseling, social support, and care coordination, and health screenings
* Conduct home visits to assess health risk and mitigation opportunities in the home setting
* Advocate for members
Residential Counselor
Becket Family of Services - Westfield, MA
September 2015 to February 2017
* Responsible for providing support services to individuals resifing in a community based program
* Ensures adequate program and supervision of the individuals at all times
* Implement activities of daily living. Individual Service Plan Objectives, Skills Development Plans, IAPs, and any other training programs
* Involve individuals in social/recreational activities including:
Socialization and community integration
Development of meaningful interpersonal skills
Development of habilitation skills
Placement transitioning
Transportation and access of public transportation
Role modeling
Leisure and recreation
Development of cooking, budgeting and shopping skills
* Involve individual in Functional Skill Development
Development of communication skills
Personal hygiene and cleanliness of living area
* Provides job coaching, career development, and pre-vocational support services including teaching and training specific to each individual's needs
* Promotes a high quality of living in all areas including medication administration, meal preparation, housekeeping, personal hygiene and leisure/recreation
* Provides transportation of individuals to scheduled appointments or social activities
* Records progress notes, behavioral data and log notes for each individual residing in the program.
* Ensure the safety of the individuals and general public.
* Model appropriate behavior for the individual residing in the program Social Worker Intern student
Commonwealth Community Care - Holyoke, MA
September 2014 to May 2015
* Provide stabilization and supportive services to person served/families in their home/community
* Provide 24 hrs. a day, 365 days emergency response by phone to the person served/families.
* Responsible for all necessary clinical assessments paperwork required for all levels of care within two weeks
* Remind individual throughout process about their confidential rights and ensure their understanding of all policy papers signed
* Complete crisis plan during intake with phone numbers that will include natural family supports
* Provide linkage t outpatient treater, including med monitoring Maintain weekly phone contact with providers
* Examine stressors within family/individual through the use of assessment tools, i.e. financial, educational, housing ADL management, and assist with family/individual through case management in reducing stressors
* Engage the person served/family in designing treatment goals utilizing a strength based prospective which include socialization skills, parenting skills, ADL skills, behavior training, awareness of child development, problem solving and family conflict resolution
* Provide written documentation of various teaching strategies to the family to support what is being taught. Ensure individual/family served understanding through the use of role modeling and measurable behavioral management systems
* Responsible for attending weekly treatment team meetings and presenting cases
* Complete encounter forms on daily basis, clearly documenting number of hours per service, progress toward goals, cancellations, changes of treatment or discharge of service and submit package on weekly basis
* Ensure person served/family has participated in completing discharge-planning forms including crisis update and discharged summary sent to provider
* Demonstrate awareness and sensitivity to cultural differences of person served/families Clinical Support Coordinator
Commonwealth Care Alliance - Springfield, MA
August 2011 to October 2013
* Conducted medical record audits that improved coordination of patient care 75%
* Reduced the delay in provider communications by over 50%
* Developed processes and tools to track quality assurance requirements
* Launched computerized patient information and participation documentation
* Qualified as resource to staff for implementation of multiple centralized electronic record systems
* Administered lab supply inventory, tracking and ordering
* Defined Care Manager's roles to address the individual needs of several Health Centers
* Identified and reported factors affecting the accuracy of patient health information
* Trained newly hired staff
Transportation Coordinator
Commonwealth Care Alliance - Springfield, MA
October 2009 to August 2011
Medical assistant
Commonwealth Care Alliance - Springfield, MA
July 2006 to September 2009
Receptionist
New England Orthopedic Surgeons - Springfield, MA
August 2005 to July 2006
Medical Assistant
First Care Medical Center - Holyoke, MA
February 2004 to April 2005
Medical assistant
First Care Medical Center - Fort Myers, FL
June 2002 to April 2005
Education
Bachelor's in Social Work
Elms College
2015
Associates in Liberal Arts
Springfield Technical Community College
2013
High school diploma
Holyoke High School
2005
Skills
• EXCEL (Less than 1 year)
• MICROSOFT OFFICE (Less than 1 year)
• MS OFFICE (Less than 1 year)
• POWERPOINT (Less than 1 year)
• WORD (Less than 1 year)
Certifications and Licenses
CPR Certification
First Aid Certification
Additional Information
Computer Skills
Microsoft office suite, including Word, Excel and PowerPoint to prepare reports, memos, summaries, presentations.
Contact this candidate