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Title Case Manager Quality Assurance
Target Location US-PA-Philadelphia
Email Available with paid plan
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PROFESSIONAL SUMMARY: Dedicated and focused who excels atprioritizing and completing multiple tasks simultaneously. Specializing in delivering high quality results with little or no supervision. Sel Starter, Energetic, organized and professional.WORK HISTORY:Service Coordinator chc 6/12/2023 to 6/18/2024Amerihealth Caritas-100 Stevens Dr.As a Service Coordinators chc my role was to identify, coordinate, and assist eligible Participants to gain access to services such as: Needed LTSS services and State Plan services. Non-Medicaid funded medical, social, housing, educational, and other services and supportsCUA- Case Manager 02/12/2022 to 11/04/2022Bethanna- Southampton PaAs a Cua Case Manager my responsibility was to assist with child welfare protective services issues and the needs of high risk, vulnerable families. I assisted families in developing parenting practices and skills that reduce safety risks and enhance the ability to provide a nurturing environment for the child. I worked with families who have in-home safety needs, in-home non-safety needs as well as children/youth with out of home placement needs including Resource Home Care, Kinship Home Care and Congregate Care settings. I ensured the children were safe through direct interventions provided; Ex. coordinating delivery of services with CUA team members, subcontractor provider team members, and a wide variety of community based resources.Program Assistant 08-12-20 to 01/06/2022New Jersey State WIC Office I Trenton NJProgram monitoring, develop Objectives, design and implement management Design the monitoring methodology, implementing monitoring as Pilot study and report and use Results. Quality Assurance, field work, Quality Assurance Case management, Monitoring and EWIC conversionPUBLIC HEALTH REPRESENTATIVE 2 03/2018 to 02/22/2020New Jersey State WIC Office Trenton, NJ Processing Applications, Quality Assurance, Co- Facilitator/ Trainer, Vendor Monitoring and case managementProcessing payments, enter account information and call logs into thecomputer system. Complaints, Compliance buys, field work, Obtained documents, clearances, certificates and approvals from local, state and federalagencies. Verified data integrity and accuracy.Worked directly with [ departments, clients, management] to achieve results Analyzed departmental documents for appropriate distribution and filing.CARE MANAGER 2 11/2013 to 10/2017Aging & Adult Services of Montgomery County Norristown, PAService coordination, services plans, Case management, field Work,Evaluating Mental Health Consumers, Behavioral health assessments, Assessments to determine services, Care Assessor (certified), Face to face interviews and determine the needs of the consumers. Conducted monthly patient case conferences, in-services and staff meetings to educate staff and facilitate good communication.Provided patient education. Investigated and reported issues relating to patient care or conditions that might hinder patient well-being.Administered job knowledge assessments and competency testing forcertification-level training. Ensured efficacy of treatments through monitoring of treatment regimens. Consistently complied with applicable laws and regulations and ensured the facility adhered to Medicare and Medicaid regulations. Behavioral health and the Consumer reimbursement programIncome Maintenance /JOB OPPORTUNITY SPECIALIST 02/2008 to 11/2013 Human Resources Administration/ FIA (NYC.hra.gov)Evaluating Mental health, Substance abuse, Employment, Homelessness, Applying for SNAP, Public Assistance and Medical Assistance.Liaison to Deputy Directory: Processing disclosed income, VotersRegistration Reports Budgets, Auditing, financial reporting ExclusionReports (Winro 639) case approval for Public assistance Overtime approval/ overtime progress report oversee day to day operations of assigned units SSN validation report/ SSN Receiving duplicate FS.Supervisor 1-provide direct supervision of a team of 6, case evaluations, weekly timesheet approvals and meetings. W194a report (telephoneinterpretation report). Ensure policies and procedures are met Centerreferral exclusion report/ income Exclusion report.Provide technical and administrative assistance to staff Language Audit, weekly audit report and Reynolds report. Teap liaison.LIFE SKILLS COUNSELOR/ CASE MANAGER 08/2002 to 12/2004Miracle Makers Inc Brooklyn, NYMaintained confidential profiles and activity logs for each client, Conducted intakes and assessment and home visits.Prepared case notes, psychosocial, and service plansCoordinate and secure housing for the clients. Resident advocacy.Secure entitlements benefits for the clients Crisis Intervention.Area of Expertise: Financial reports Substance Abuse Care Management Voter registration Reports.  Auditing Child Care Service Orders Exclusion Report Behavioral & Mental Health and Mental Health Administration children services, removal, placements and court findings Case management Supervisory Psychosocial Overtime Approval Social services Mental Health Care SSN validation report/ duplicate FS  Budgeting Employment Assessor/Assessment Exclusion report/ income exclusion.  Disclosed income Evaluate Programs Resident Advocacy Housing Verification & eligibility determinations Assistance with Medicaid, Food Stamp & Public Assistance Vendor/Program Monitoring Training Quality Insurance & Applications  Seasoned Resident Care Manager skilled in nursing care, department oversight and quality assurance. Knowledgeable about supervising documentation, reporting and compliance. Ready to bring 6 years' experience in the field to a challenging new position with room for advancement. History of improving resource utilization, team performance and care standards for residents. Able to conduct initial assessments and ongoing evaluations, as well as update treatment plans and make care recommendations. Organized and proactive with excellent decision-making and communication skills. Professionally trained with experience ensuring high standards of culturally competent care for a wide variety of patients with diverse needs.EDUCATION Masters Public Administration 12-09 GPA: 3.5Bachelor of Science Human Services 12/08 GPA: 2.75Capella University- Studied PHD Human Behavior (not Complete) Metropolitan College of New York Berk's Trade/Business School -Building Maintenance. Certificate (GPA4.0) Municipal Training Center -Medical Office Assist. Certificate) (GPA 4.0)03/05 to 4/07 Internship: Administration for Children Services (ACS NYC.GOV Complete field visits to investigate allegations of abuse and/or neglect. Interview family members and a broad range of contacts to assess child safety. Assess the risk of future abuse or neglect of children in the household. Coordinate a team of family members, staff and service providers to evaluate safety and Remove child(ren) into protective custody or foster care, when appropriate. Enter and maintain accurate and timely computerized records of all case information. Help families navigate government agencies and access entitlement benefits. File petitions and testify in family court and other legal proceedings.REFERENCES-furnished upon requestCERTIFICATIONS Medical Assistant, Building Maintenance and Assessor.SKILLS Microsoft Office 2003 ed, sharepoint, Teams, excel, AWARDS,Internet, Type administrative, audit report,Auditing, benefits, Budgets, Casemanagement, Crisis Intervention, client, clients, financial reporting, government, interpretation, legal, notes, Mental Health, access, Microsoft Office, Office, monitors, PHD, policies, progress,Strategic decision-makingManaging deadlinesQualified daily living activityassistantScheduling Patient-focused careBudgeting proficiency Receiving,safety, Supervisor 1,supervision, telephone, Type,validation PhysicalevaluationsAdmissionsassessments[Type] patient CareRecords maintenance

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