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Click here or scroll down to respond to this candidateCandidate's Name , LMSWStreet Address
Phone: PHONE NUMBER AVAILABLE ~ Email address: EMAIL AVAILABLEEDUCATIONAL AND PROFESSIONAL DEVELOPMENTState of Michigan Clinical Licensed Master Social WorkerMaster of Social Work (2010) Eastern Michigan University Ypsilanti, MIBachelor of Social Work (2003) Western Michigan University Kalamazoo, MIPROFESSIONAL EXPERIENCE8/2016-present Health Alliance Plan/Care Source Troy, MIMI Health Link Medicaid Waiver/LTSS Care CoordinatorProvide care coordination services to dually eligible Medicare/Medicaid HAP CareSource members.Complete in-home visits and telephonic psychosocial health assessments to identify members in need of Long Term Supports and Services/LTSS (Medicaid waiver program and personal care services) to assist them in being able to continue living in the community as independently as possible.Complete needed documentation to qualify members for waiver services: Nursing Facility Level of Care Determination/LOCDs, InterRai+, personal care assessments, progress notes and service authorizations and continually update members electronic medical record.Collaborate with contracted service providers and vendors (Area Agency on Aging, Guardian Medical Monitoring, GT Independence) regarding authorization and service provision for needed waiver and personal care services.Create and update individualized care plans to identify members health care goals and objectives.Provided customer service assistance to help members with grievances and complaints, general inquires member satisfaction, and billing/claims resolutions.Educate members regarding their health and health insurance benefits and services by providing coverage information, assisting in finding medical providers and scheduling appointments, medication reviews, transitions of care, and obtaining durable medical equipment and other needed services.Assess members ADL and IADL needs to qualify them for personal care services and in-home assistance. Monitor services to ensure that care needs are being met.7/2015-8/2016 Fidelis Secure Care/Integrated Care Organization Detroit, MICare CoordinatorProvide care coordination for Fidelis Medicaid/Medicare dual eligible members to assist with meeting members medical, behavioral and social needs.Complete clinical risk assessments and person-centered care plans to identify member needs, and create goals and interventions.Collaborate with members interdisciplinary team members in clinic to discuss members health, care/service needs and treatment plan.Monitor high risk members, hospital discharges, and transitions of care.Assess members for MI Health Link Medicaid waiver services, and then once qualified, coordinate and monitor members long term and home/community-based services.Complete waiver assessments and required supporting documentation to submit waiver applications to the State of Michigan for approval.12/2012-7/2015 Center for Senior Independence-PACE/Medicaid Waiver Program Detroit, MISenior Social WorkerProvided home and community-based clinical case management social work services to PACE Medicaid/Medicare recipients (medically fragile older adults and adults with disabilities) to maintain members health and independence while living in the community.Conducted clinical psycho-social assessments to identify member health/safety needs and participated in semi-annual medical care plans with Interdisciplinary Clinical Care Team.Advocated for members needs and services (i.e. obtaining durable medical equipment, clinical services, caregiver services, and respites). Located and coordinated appropriate community-based services (i.e. housing, clothing, food, support groups, etc.).Coordinate hospital discharges and arrange appropriate rehabilitation and Long Term Care placements in nursing home and assisted living facilities. Coordinated respite care and services for participants.Facilitated a monthly caregiver support group, and provided educational material/information, community resources and supportive counseling.11/2010-12/2012 WellsBrooke Home Health Plymouth, MIHome Health AideProvided in-home care, companionship and support to seniors and people with illnesses, injuries and disabilities.Utilized the Client Care Plan to document client care and clinical status of member daily.Assisted clients with medications, medical care and appointments.Assisted with Activities of Daily Living (ADLs) and Instrumental Activities of Daily Living (IADLs): Bathing, dressing, toileting/incontinent care, ambulation, transfers and shopping/errands.SUMMARY OF SKILLSOver 15 years of professional experience working in both the health care and social service field.Extensive experience with working with Medicare and Medicaid funded services/programs.Good clinical assessment, verbal and written skills. Experienced in writing person centered plans of care and psychosocial assessments.Dependable, self-motivated, organized, passionate advocate for the needs of clients and excellent provider of customer service.Experience with computers including knowledge of Microsoft Office (Word, Outlook, Excel, PowerPoint) |
