Community Care Resume Samples

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HR
H Rice
Hipolito
Rice
3525 Gulgowski Tunnel
Los Angeles
CA
+1 (555) 798 9439
3525 Gulgowski Tunnel
Los Angeles
CA
Phone
p +1 (555) 798 9439
Experience Experience
San Francisco, CA
Community Care Coordinator
San Francisco, CA
Leffler-Kozey
San Francisco, CA
Community Care Coordinator
  • Have an onsite presence of approximately 75-90% of time at a key provider and/or community partner· Serve as a primary on-site liaison between key provider and/or community partners and Molina· Assist Molina members on a walk-in/unscheduled basis· Independently problem-solve to connect Molina members to resources· Meet expected performance metrics to improve the health and social determinants of health of Molina members· Remove access and service barriers for Molina members and onsite provider/community partner· Identify ways to improve processes and expand programs to optimally serve Molina members plus overall Medicaid-eligible population· Facilitate filing of any expressed member grievance, supporting timely resolution
  • Assist with patient follow-up as directed
  • File all patient charts and other documentation, following established guidelines
  • Perform other duties or special projects as assigned
  • Provide resources and connect patients and family members to amputee support groups, Ampower volunteers, and/or grief support options
  • Ensure the highest level of service is provided to patients and referral sources
  • Keep the patients, their family members, and their physicians updated on re: prosthetic process, next steps as well as provide general support to assist the patient during this life changing period
Chicago, IL
Dietitian Community Care-central Region
Chicago, IL
Bergstrom-Klocko
Chicago, IL
Dietitian Community Care-central Region
  • Assists in developing and revising patient education materials, clinical forms and protocols
  • Develops and implements an individualized plan for professional growth and development
  • Performance Improvement
  • Identifies and collects performance improvement data, monitors outcomes and initiates corrective actions
  • Maintains productivity standards and practices effective time management and prioritizing of tasks
  • Professional Development
  • Participates in planning and developing nutrition-related policies, procedures and goals
present
Philadelphia, PA
President Community Care of Florida
Philadelphia, PA
Borer-Steuber
present
Philadelphia, PA
President Community Care of Florida
present
  • Responsible for the leadership and management of associates and achieving Board-approved operating goals
  • Identifies and develops new business opportunities that fall within the context of managed care, and advancing provider performance
  • Leadership participation to ensure all provider contracting (rates and terms) efforts serve the larger business and operational constraints and goals of the Prestige health plan
  • Analyzes claim trend data and/or market information to support contract negotiations
  • Responsible for defining and implementing the Community Care of Florida regulatory and legislative affairs activities; these activities will be aligned with those of Prestige Health Choice
  • Communicates the strategic plans, budgets, and management action plans as a basis for aligned management decision making at all levels of the Community Care of Florida organization
  • Fosters constructive positive relationships between Prestige Health Choice and the community of Medicaid providers
Education Education
Bachelor’s Degree in Nursing
Bachelor’s Degree in Nursing
Duke University
Bachelor’s Degree in Nursing
Skills Skills
  • Ability to understand and prepare grant applications, and concept papers, for program sustainability
  • Demonstrated ability to speak effectively and professionally in public to a variety of audiences
  • Competency in electronic medical records desirable
  • Ability to meet multiple deadlines with minimal supervision
  • Ability to use all necessary office equipment
  • Working knowledge of Microsoft Office programs
  • Demonstrated ability to identify problems, develop solutions and take the lead in solving problems
  • Ability to work with community boards or advisory committees
  • Ability to use a computer, including Windows-based software and e-mail
  • Ability/willingness to work with handicapped individuals
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15 Community Care resume templates

1

Community Care Manager Resume Examples & Samples

  • 2+ years of current Clinical Nursing experience with a Home Care, Case Management, or recent Acute Care background
  • MA Registered Nurse (RN) license
  • UAS experience
  • Knowledge of Chronic Disease management
  • Knowledge and comprehensive Clinical assessment skills in the Adult population
  • Microsoft Office/Suite proficient (Excel, Word, Outlook, etc.)
  • Previous Home Healthcare / Field experience
  • Knowledge of Medicare and Medicaid programs
  • Experience working with a Geriatric population or equivalent
2

Community Care Manager Resume Examples & Samples

  • Active New York State Registered Nurse license
  • Strong medical skills and knowledge
  • Knowledge of chronic disease management
  • Strong professional level of knowledge and comprehensive clinical assessment skills in the adult population and chronic disease management
  • Competent in Microsoft Office Products (Outlook, Word, and Excel)
  • Ability to work independently and maintain flexibly in a fast-paced start-up environment
  • Ability to analyze data and use it to improve care delivery
  • 2+ years of current clinical nursing experience with home care, case management, recent acute care experience, or physician office experience
  • Medicare/Medicaid managed care experience
  • Experience working with a geriatric population or equivalent experience
3

Community Care Manager Resume Examples & Samples

  • High level verbal, communication and organizational skills a must
  • Advanced degree PREFERRED
  • Competency in electronic medical records desirable
4

Case Manager RN, Community Care Resume Examples & Samples

  • Plans, develops, assesses, and evaluates care provided to members. Develops and maintains case management policies and procedures. Coordinates, directs, and performs concurrent and retrospective reviews, and monitors level and quality of care
  • Kaiser Permanente conducts compensation reviews of positions on a routine basis. At any time, Kaiser Permanente reserves the right to reevaluate and change job descriptions, or to change such positions from salaried to hourly pay status. Such changes are generally implemented only after notice is given to affected employees
  • Prior work experience with serious illness, competence with advanced care planning and goal setting discussions and strong skills for intervening with complex family dynamics in the in-patient and out-patient settings
  • Bilingual language proficiency
5

Community Care Pre-authorization Telephonic Case Management Resume Examples & Samples

  • Plans, develops, assesses, and evaluates care provided to members
  • In conjunction with physicians, evaluates and develops discharge plans, recommends alternative levels of care, and ensures compliance with federal, state, and local requirements
  • Coordinates, directs, and performs concurrent and retrospective reviews, and monitors level and quality of care
  • Consults with physicians, health care providers, discharge planning, and outside agencies regarding continued care/treatment or hospitalization
  • Coordinates the interdisciplinary approach to providing continuity of care, including utilization management, transfer coordination, discharge planning, and obtaining all authorizations/approvals as needed for outside services for patients/families
  • Encourages members to follow plans of care (e.g., drug therapy, physical therapy)
  • Makes referrals to appropriate community services
  • Develops and maintains case management policies and procedures
  • Identifies and recommends opportunities for cost savings and improving the quality of care across the continuum
  • Interprets regulations, health plan benefits, policies, and procedures for members, physicians, medical office staff, contract providers, and outside agencies
  • Previous case management experience preferred
6

Community Care Coordinator Resume Examples & Samples

  • Bachelor’s degree from an accredited university or college in business, finance, accounting, HR, public relations, public administration, healthcare, social science or related field
  • 2 years’ related experience in community health, higher education, healthcare, business or related field; or equivalent education and experience
  • Prior public speaking experience
  • Prior experience creating and submitting professional business letters and reports
  • Bilingual (English/Spanish) skills at conversational level
  • Understanding/working knowledge of youth-serving systems and agencies
  • Experience with prevention efforts in this community
  • Background in public health, in community social work, or solid understanding of prevention science
  • Experience in project management and/or strategic planning such as program development, developing and evaluating outcomes, conducting data analysis and evaluation, developing operations and marketing plans and developing timelines
  • Experience in managing or supervising community liaison personnel
  • Ability to meet multiple deadlines with minimal supervision
  • Must possess strong group facilitation skills and experience
  • Must be self-directed, as well as a team player
  • Must have excellent organizational and multi-tasking skills
  • Demonstrated ability to form relationships with strategic partners, e.g., government agencies, non-profit agencies, schools, and business and faith-based communities
  • Demonstrated ability to identify problems, develop solutions and take the lead in solving problems
  • Must possess professional demeanor at all times
  • Must be able to write clear, concise and grammatically correct letters, reports and other forms of communications
  • Demonstrated ability to speak effectively and professionally in public to a variety of audiences
  • Familiarity with local community
  • Ability to understand and prepare grant applications, and concept papers, for program sustainability
  • Ability to work with community boards or advisory committees
7

RN Community Care Coordinator for Health Connections Days Resume Examples & Samples

  • Support CHI Franciscan Health and Highline’s Mission, Values, Strategic Goals and High Standards of Customer Service. Consistently promotes customer service internally and externally
  • Adheres to the Corporate Compliance Program, including confidentiality of HIPAA-protected health information
  • Responsible for planning and overseeing the client identification and delivery of services with the program
  • Current Washington State RN license
  • Minimum of 2 years of hospital or long-term care experience
  • Minimum of 1 year of community based home care experience
  • Current Basic Life Support (BLS) for Healthcare Providers through American Heart Association required
  • Certification of a Health Coach within 2 years of hire
  • Must have a valid WA State driver’s license and reliable transportation
  • Bi-lingual experience preferred
8

Community Care Case Manager, RN Week Resume Examples & Samples

  • Consults with internal and external physicians, health care providers, discharge planning and outside agencies regarding continued care/treatment or hospitalization
  • Develops and collects data, and trends utilization of health care resources
  • Coordinates transmission of clinical and benefit treatment to patients, families and outside agencies
  • Experience in utilization management, discharge planning, or transfer coordination
  • PHN preferred
9

Community Care Center Resume Examples & Samples

  • Communicate resident progress or problems to supervisor and other team members; instruct resident's family or nursing staff in follow-through programs
  • Document resident care in accordance with Peoplefirst Rehabilitation, regulatory, licensing, payer and accrediting requirements
  • Handle job responsibilities in accordance with the standards of the Company's Code of Business Conduct, the Corporate Compliance Agreement, appropriate professional standards and applicable state/federal laws
10

Care Manager / Rn-community Care Partners Resume Examples & Samples

  • Works collaboratively and maintains active communication with the multidisciplinary care team including providers, pharmacists, social workers, behavioral health specialists, and nurses to achieve timely, appropriate patient management
  • Utilizes RN process as a framework to focus the activities of the healthcare team on the achievement of optimal outcomes, resource utilization, clinical expertise, and improvement strategies
  • Interacts with patients, professionals, and the community to achieve continuity of care, coordination of services and to document plans of care across multiple care settings
  • Conducts or participates in comprehensive all-system needs assessment for identified patients; knowledgeable of appropriate care-related services to match identified needs (including community resources), disease management for health maintenance, and appropriate clinical goal expectations/outcomes for identified population
  • Develops and maintains accurate case records of each referred customer/patient. Documents fully and accurately; knowledgeable of and utilizes accurate computer databases and documentation systems
  • Maintains knowledge of various reimbursement criteria and documentation necessary for reimbursement; including Medicaid, Medicare, and Managed Care
  • Demonstrates leadership in the professional practice of nursing
11

Community Care Manager Rn Resume Examples & Samples

  • Preferably with care management experience from acute care setting or health insurance and other payer entities
  • High level verbal and communication skills and organizational skills a must
  • Case/Care management certified or knowledge of national care management standards and community resources a plus
12

Manager, RN Community Care-telecommute Resume Examples & Samples

  • Expert knowledge of industry accepted criteria e.g. Star Hospital Measures, CMS and Health Plan guidelines and guideline application
  • Clinical operations across the continuum of care (assessing, planning, implementing, coordinating, monitoring and evaluating)
  • Supervises a team of Community RN Care Managers providing transition of care coordination for Medicare members coming home from an acute care or sub-acute inpatient stay
  • Provide support to staff with focus on three HEDIS measures: Hospitalization for Potentially Preventable Complications (HPC), Plan All Cause Readmissions (PCR) and Medication Reconciliation Post Discharge (MRP)
  • Extensive coordination and collaboration across regional M&R operations; national UCS and OPTUM Clinical Programs to provide a seamless service to members during their transition home and beyond
  • Adjust workflow and responsibilities according to business and operational needs
  • Oversee day - to - day operations of the Community RN Care Managers
  • Conducts values and performance coaching which includes: annual reviews, corrective action plans, and recognition of employees
  • Efficiently navigates and utilizes computer data entry programs including but, not limited to: Microsoft Office (Outlook, Word, and Excel)
  • Active Unrestricted RN License for your state of residence
  • 3+ years' of experience as Case Manager
  • 1+ years' of clinical management experience of 10 or more
  • Efficiently navigate Microsoft Office (Word, Excel, Outlook)
  • BSN or MSN
  • Complex Case Management experience
  • 2+ years' of clinical management experience of 10 or more
  • CCM – Professional Certification or Licensure
13

Community Care Coordinator Resume Examples & Samples

  • Have an onsite presence of approximately 75-90% of time at a key provider and/or community partner· Serve as a primary on-site liaison between key provider and/or community partners and Molina· Assist Molina members on a walk-in/unscheduled basis· Independently problem-solve to connect Molina members to resources· Meet expected performance metrics to improve the health and social determinants of health of Molina members· Remove access and service barriers for Molina members and onsite provider/community partner· Identify ways to improve processes and expand programs to optimally serve Molina members plus overall Medicaid-eligible population· Facilitate filing of any expressed member grievance, supporting timely resolution
  • Conducts ongoing or telephonic and/or in person outreach visits with members as needed
  • Bilingual based on community need
  • Knowledge of community-specific culture
  • Experience with or knowledge of health care basics, community resources, social services, and/or health education
14

Chaplain Hospice & Palliative Care Community Care Resume Examples & Samples

  • Responsible for maintaining the Code of Professional Ethics of applicable certifying body. Serves as a resource for the spiritual/emotional needs of patients, visitors, and MCHS associates and develops positive relations exhibiting respect, responsibility and cooperation at all times
  • Shares in the responsibility of providing 24-hour pastoral care coverage through duty, back up chaplain rotation and weekend call/ Assists patients and their loved ones with ethical decision-making assistance (e.g., end of life decisions, organ-tissue donation decisions, and information and execution of advance directives)
  • Conducts spiritual assessments of patients and families and records appropriate information in the patient’s medical record according to the Spiritual Care Services Documentation policy. Participates in continuity of patient care through reporting, logging and communication with appropriate staff
  • Master’s degree required in Divinity, Theology, Pastoral Ministry, Pastoral Counseling or, equivalent education required by the applicable certifying body
  • Licensure / Certification: Four units of accredited Clinical Pastoral Education completed from an accredited ACPE center. Certification as a chaplain in the National Association of Catholic Chaplains (NACC), Association of Professional Chaplains (APC); or National Association of Jewish Chaplains (NAJC) required; or, eligible to be certified
  • Must be certified by one of the above certifying bodies within three years of employment if not currently certified. Expected to maintain certification once received
  • Current knowledge of the theological, medical-moral issues which supports the teaching of the Roman Catholic Church (i.e. Ethical and Religious Directives of Catholic Healthcare Facilities)
15

Community Care-manager Revenue & Account Receivable Resume Examples & Samples

  • Manages the collection and billing operations and develops credit/collection strategies to maximize profits and minimize loss. Ensures that maintenance strategies of accounts receivable past due balances are within stated objectives
  • Interprets to customers and field personnel Company policies/practices/procedures related to billing processes, accounts receivables, and financial issues regarding non-clinical processes and clinical specifications impacting accounts receivable
  • Manages the analyses/report preparation of trends of consolidated account receivables. Reports information to appropriate line management
  • Assumes responsibilities of Director, as assigned, during Director’s absence
  • Prepares departmental budget and monitors expenses to ensure compliance with approved budgetary constraints
  • Develops department tools and training programs, along with the Training Specialist, to encourage growth and development. Analyzes/monitors their implementation
  • Adheres to and participates in Company’s mandatory HIPAA privacy program/practices and Business Ethics and Compliance programs/practices
  • Reviews and adheres to all Company policies and procedures and the Employee Handbook
  • Bachelor’s degree or the equivalent
  • Minimum of five years healthcare related billing/collection experience with at least three years in a management role generally required
16

Community Care Registered Nurse Resume Examples & Samples

  • Current, unencumbered Oregon Registered Nurse (RN) license
  • American Heart Association Basic Life Support (AHA-BLS) for Healthcare Provider certification within 6 months of hire
  • 1 year of experience working with the frail or elderly population
  • Bachelor’s degree in nursing, required for newly hired Registered Nurses as of 2018
  • 1 year of home health RN experience
17

Community Care Coordinator Resume Examples & Samples

  • Demonstrated ability to interface with community agencies and providers
  • Experience working as part of a health care team
  • Minimum of one (1) year of experience working with homeless and/or underserved populations
  • Knowledge of healthcare systems
  • Knowledge of homeless issues and working with at-risk populations
  • Able to work evenings and weekends
  • Ability to work in a fast paced setting
  • Computer skills including Word, Excel and Outlook
  • Background in Social Work, Psychology or Marriage and Family Therapy preferred
  • College degree preferred, but professional experience in lieu of a degree is acceptable
  • Bilingual (Spanish/English)
18

Community Care Specialist Resume Examples & Samples

  • Address tickets from users regarding potential violations of policy
  • Review concerns in light of established policy and make a determination of appropriate action to take to resolve the issue
  • Content Moderation
  • Verification of account authenticity
  • Review potentially graphic or intense content and determine if it should remain or be removed from the site
  • Work with team and supervisor to ensure a safe, hospitable experience for all users
  • Comfortable with desktop and mobile computing/communications platforms
  • Critical thinking and analytical mindset
  • Flexibility and Resilience
19

Registered Nurse Hospice & Palliative Care Community Care Resume Examples & Samples

  • Assesses and evaluates patient care for an assigned group of patients, utilizing evidence based practice. Collaborates with patient and family to develop and implement a plan of care that includes physical, spiritual and educational components
  • Accurately communicates pertinent information to appropriate team members in a timely manner. Keeps patient/family apprised/updated
  • Assumes responsibility and accountability for care provided and documented by other licensed and unlicensed care givers as appropriate
  • Minimum of 2 years' experience in Hospice or Homecare
  • Criminal Fingerprinting as required by Ohio law
20

Intensive Community Care Support Resume Examples & Samples

  • Bachelor's Degree from an accredited university in psychology, social work or related human services field
  • 3-5 years experience in community-based behavioral health support program
  • Candidate may be a licensed clinician who does not have the credentials to practice independently (e.g., LPN, LSW, or degree in a related health care field)
  • Strong time management and organization skills
  • Must demonstrate good boundaries regarding confidentiality and personal relationships
  • Strong ability to evaluate what is needed by each individual and adjust approach accordingly
  • Strong problem solving ability and analytical skills
  • Experience with accessing local resources and navigating mental health and/or substance abuse treatment systems
  • Ability to utilize computers, web-based applications, and MS Office application
21

Dietitian Community Care-central Region Resume Examples & Samples

  • Bachelor’s degree in Dietetics
  • One year of experience in acute care – acute care outpatient setting preferred
  • Proficiency in Microsoft office and ability to adapt to new software programs
  • Ability to develop the philosophy, determine the guidelines and assume the overall supervision of the medical nutrition therapy provided to the patient
  • Ability to communicate patient nutrition needs to the physician, nursing staff and other appropriate staff
  • Ability to support departmental and organizational mission
  • Current active State of Florida license as a Dietitian/Nutritionist
  • Current active Registered Dietitian (RD) through the Commission on Dietetic Registration (CDR)
  • Current valid State of Florida driver’s license, class E, and driving record in accordance with Florida Hospital policy
  • Current valid auto insurance
  • Current Basic Life Support (BLS) certification
  • Certified Diabetes Educator (CDE)(Preferred)
22

Community Care Management Coordinator Resume Examples & Samples

  • Assists in the auditing of chart compliance and program reports
  • Develops, implements and monitors individualized Residential Program Plans
  • Responds to critical/emergency residential incidents on a 24 hour on call basis as scheduled
  • Assists residents with person care needs and provides hands on assistance, including coaching and teaching activities of daily living
  • Provides transportation to scheduled appointments/activities as needed
  • Other Duties as assigned
  • Master's Level Degree
23

Field Supervisor Community Care Resume Examples & Samples

  • Two years full-time study at an accredited college or university or individuals hired with a high school diploma or equivalent (GED) may substitute one year of full time employment in a supervisory capacity in a health care facility, agency or community based agency for each required year of college
  • PHC, CBA, MC experience preferred
  • Must be able to communicate effectively and to document pertinent information
  • Must be organized and detail oriented
  • Bilingual skills preferred (Spanish)
24

Community Care Program Manager, Home Health Resume Examples & Samples

  • Responsible for direct marketing and sales of the Community Care Program
  • Represent the Agency in activities involving professional contacts with all senior housing environments and apprise them of the Agency’s Medicare services
  • Must be a graduate of an approved school of professional therapy or nursing and currently licensed in the state of employment - Physical Therapist (PT), Occupational Therapist (OT) , Speech Language Pathologist (SLP), Registered Nurse (RN)
  • Must have a minimum of two years therapy or nursing experience
  • Medicare home health and/or Senior Housing experience is preferred
  • Management experience is desired
25

Community Care Sales Liaison ALF / ILF Resume Examples & Samples

  • Represent Encompass in activities involving professional relationships with physicians, hospitals, public health agencies, nurses' associations, state and county medical societies to apprise them of the availability of services
  • Serve as a public awareness representative for Encompass
  • Responsible for public education relative to home health care and hospice services available through the agency and methodologies for obtaining such services
  • Must be comfortable with making cold calls
  • Ability to execute presentations to physicians with confidence and composure
26

Community Care Registered Nurse Resume Examples & Samples

  • Current, unencumbered Oregon RN license
  • Current Basic Life Support (BLS) certification at time of hire
  • American Heart Association Basic Life Support (AHA-BLS) for Health Care Provider certification required within 6 months of hire
  • Bachelor’s Degree in Nursing, required for newly hired Registered Nurses as of 2018
27

Rn-community Care Manager Resume Examples & Samples

  • Provides access to a single point of contact for member questions or inquiries
  • Conducts in-home environmental and physical assessments for high risk members to identify unmet needs and barriers to care
  • Develops an Individualized Care Plan that is periodically reviewed and updated
  • Provides disease self-management and coaching
  • Conducts medication review, including reconciliation during transitions of care settings
  • Ensures the provision of services in the lease restrictive setting and transition support across and between specialties and care settings
  • Connects members to services that promote community living and help to delay or avoid nursing facility placement
  • Establishes points of contact in order to collaborate with identified community, medical and/or behavioral health teams
  • Works closely with and directs and supervises the work of the Community Care Connectors as they deliver in-community care support pathways to establish connections to appropriate services
  • Minimum of three years similar level or related experience including demonstrated expertise conducting health assessments and delivering care in a clinical and community environment
  • Ability to travel extensively within assigned communities. Valid driver’s license required
  • An unrestricted license to practice nursing in the Plan’s state and any other state in which he/she works
28

Community Care Manager, Registered Nurse Resume Examples & Samples

  • Current and unrestricted RN license in PA
  • Minimum of three years of similar level or related experience including demonstrated expertise conducting health assessments and delivering care in a clinical and community environment
  • Prior experience in leading teams in a matrixed environment
  • Requires completion of medical exam/testing as required by Federal and State regulations upon conditional offer of employment and post-employment
  • Proficient in MS Office (Word, Excel, and Outlook) within a Windows-based environment, Internet applications, electronic medical records (EMRs), and electronic documentation programs
  • Ability to travel extensively within assigned communities in Chester and Delaware counties. Valid driver’s license required
29

President Community Care of Florida Resume Examples & Samples

  • Responsible for the leadership and management of associates and achieving Board-approved operating goals
  • Identifies and develops new business opportunities that fall within the context of managed care, and advancing provider performance
  • Ensures compliance with state and federal requirements and to all contractual Service Level Agreements
  • Leadership participation to ensure all provider contracting (rates and terms) efforts serve the larger business and operational constraints and goals of the Prestige health plan
  • Analyzes claim trend data and/or market information to support contract negotiations
  • Accountable for delivering the results defined in the Quality Performance Program
  • Responsible for defining and implementing the Community Care of Florida regulatory and legislative affairs activities; these activities will be aligned with those of Prestige Health Choice
  • Develops and maintains appropriate external relationships in support of Community Care of Florida and aligned with the Prestige Health Choice
  • Communicates the strategic plans, budgets, and management action plans as a basis for aligned management decision making at all levels of the Community Care of Florida organization
  • Fosters constructive positive relationships between Prestige Health Choice and the community of Medicaid providers
  • Provides senior level representation to all level of work groups, steering committees and other forums which have oversight to product development and program implementation
  • Stays current with national “best practice” related provider contracting and strategic provider arrangement; makes recommendation for program improvements as indicated
  • Develops annual goals for the Community Care of Florida organization in tandem with the Prestige Health Choice network and communication strategies and ensures execution to deliver results
  • 10 or more years of leadership experience in Medicaid, the health insurance industry and provider contracting. Progressive responsibility in business or government, health care management required
  • Bachelor’s Degree in Business or equivalent work experience in the health care Industry, Masters Preferred
  • Demonstrated knowledge and successful track record of health plan operations including provider contracting, provider relations, and regulatory compliance required
  • Demonstrated ability to collaborate and interact cooperatively with all levels of management and their staff required
  • Proven success in leadership of program management, execution and development
30

Community Care Manager, Lmsw, Llmsw Resume Examples & Samples

  • Required current unrestricted Social Worker LICSW/LMSW license in plan’s state
  • Required minimum of 3 years of similar level or related experience including demonstrated expertise conducting health assessments and delivering care in a clinical and community environment
  • Required Managed Care experience required with focus on Medicaid population preferred
  • Required completion of medical exam/testing as required by Federal and State regulations upon conditional offer of employment and post-employment
  • Required ability to travel extensively within assigned communities. Valid driver’s license required
31

Community Care Licensing Specialist Resume Examples & Samples

  • Maintaining a workload of licensed child care facilities
  • Processing licensing applications for pending facilities
  • Applying knowledge of complex statutes, regulations, and policies and procedures to specific situations, and being able to convey this information to other team members, providers, partner agency members and the general public
  • Conducting on-site inspections and investigations to determine compliance with State of Alaska Child Care Licensing Regulations and Statues
  • Conducting interviews during inspections and investigations and documenting the results
  • Generating and issuing Reports of Inspection, Reports of Investigation, Notices of Violation, Enforcement Actions and Child Care Licenses
  • Work experience demonstrating the ability to read, understand, interpret, apply and explain complex regulations and statutes
  • Experience in conducting on-site inspections and/or investigations, including conducting interviews, taking notes, and reviewing documents to determine compliance with Program Requirements and/or Regulations and Statues
  • Full-time professional work experience within the field of early childhood care and education
  • Ability in responding appropriately to inquiries and complaints from the general public combined with the ability to determine if the allegations are substantiated or not
  • Experience in dealing with stressful situations and managing interactions with angry or upset individuals in a professional manner
  • Enthusiasm and passion for your work with exceptional attention to detail
  • Ability to work as an individual and as a team member with critical thinking and effective decision making skills
  • Experience in dealing with the various cultural and ethnicities through-out the State of Alaska
  • Proven ability to multi-task, manage time and adhere to established time lines with frequent interruptions and changes in priorities
  • Excellent oral communication skills, including experience in speaking in front of small or large groups of people
  • Excellent written communication skills, including generating and issuing comprehensive Inspections or Investigations Reports
  • A high level of computer skills: including experience demonstrating the ability to enter and retrieve data using a computerized records system
  • A copy of academic transcripts, to verify post-secondary education used to meet the minimum qualifications. Transcripts are required with each application
32

Community Care Licensing Specialist Resume Examples & Samples

  • Licensing experience with vulnerable adults and/or children living in a residential setting
  • Providing oversight and technical assistance to programs for vulnerable adults or children
  • Coordinating with other professionals and agencies to accomplish common goals
  • Interpreting and applying regulations and statutes to a work situation on a regular basis
  • Writing comprehensive reports based on objective observations, assessments, interviews, findings, and/or research
  • Managing sometimes hostile situations and people
  • Collecting and analyzing facts and complex information to formulate a report
  • Ability to effectively manage a caseload
  • Using computer programs such as Microsoft Word, Excel, Outlook, and Access
  • A copy of academic transcripts, to verify post-secondary education used to meet the minimum qualifications. Transcripts are required with each application. (Unofficial are okay, please ensure that the institution name is listed on the transcripts)
33

Community Care Coordinator Resume Examples & Samples

  • Must understand and carry out directions and instructions
  • Basic office skills including filing, photocopying and telephone skills are required
  • Previous office experience is preferred
  • Must be able to read, write and understand English
  • Bilingual skills are preferred (Spanish)
34

Community Care Coordinator Resume Examples & Samples

  • Ensure the highest level of service is provided to patients and referral sources
  • Ensure patients and family members are provided with educational materials, appropriate community resources, and emotional support
  • Keep the patients, their family members, and their physicians updated on re: prosthetic process, next steps as well as provide general support to assist the patient during this life changing period
  • Remain accessible via phone, email, text to patients and referral sources and provide contact information for after-hours emergencies
  • Provide resources and connect patients and family members to amputee support groups, Ampower volunteers, and/or grief support options
  • Meet with all new prosthetic patients before surgery if possible, daily while inpatient, weekly while in rehabilitation facility, and attend physician visits with patients as required
  • Maintain accurate and complete patient files, ensuring that they are in compliance with the Hanger Compliance Policies
  • Ensure the privacy and security of protected health information per HIPAA rules
  • Assist with patient follow-up as directed
  • Enter patient demographics and insurance verifications as appropriate
  • Record CRM documentation that is clear, concise, and accurate
  • File all patient charts and other documentation, following established guidelines
  • Coordinate scheduling of practitioner schedules to ensure proper coverage of patient appointments and out-of-office calls
  • Process and monitor referrals/authorizations/prescriptions to ensure complete and final information is received in a timely manner
  • Perform other duties or special projects as assigned
  • Strong interpersonal, oral and written communication skills
  • Experience interfacing with physicians, nurses, physical therapists, occupational therapists and various clinical support personnel
  • Ability/willingness to work with handicapped individuals
  • SharePoint Post-Acute CRM versed
  • Understanding of medical reimbursement and terminology and an understanding of Hanger Clinic front office duties preferred
  • Ability to use a computer, including Windows-based software and e-mail
  • Ability to use all necessary office equipment
  • Non revoked, valid passenger vehicle driver’s license
  • BS/BA degree strongly preferred
  • Clinical degree a plus (LPN, RN, PT, OT, etc.)
  • Minimum two years of experience in healthcare sales, health care oriented customer service with patient interaction preferred
35

Community Care Transitionist Resume Examples & Samples

  • Referral Management: Monitors pending and prioritized referrals for the CCM team. Maintains a record of the average daily caseload and workload
  • Pre-Screening: Pre-screens new cases and assigns an appropriate primary planner based on the patient's primary needs
  • Patient Consultation: Promptly contacts new patients by phone to introduce them to the CCM program, obtain verbal consent to participate, and schedules the initial assessment/evaluation
  • Intervention: Responsible for patient follow-up calls, as assigned by the CCM/CSW, to re-enforce education, self-management, and other care planning actions needed
  • Intervention: Advocates on behalf of patient, communicating and collaborating with healthcare providers, payers, physicians, and community-based services, where appropriate, to assist in establish an appropriate and integrated care plan for each patient
  • Intervention: Promotes mental health integration by collaboration with mental health/behavioral health providers
  • Intervention: Responsible for designated transition management duties to ensure an effective transition of care from one healthcare setting to another. Actively participates in system and regional process improvement initiatives to improve transitions of care
  • Clerical/Support: Establishes and maintains current community-based services and provider resource lists
  • Clerical/Support: Promptly and accurately performs duties, as assigned, to facilitate effective and efficient day-to-day operations and communication. Promptly escalates concerns to appropriate chain of command
  • Clerical/Support: Effectively and efficiently supports interdisciplinary care conferences, using collaborative practice models that promote interdisciplinary care planning and teamwork
  • Completes timely and accurate documentation in the medical record using knowledge of documentation standards for the department to facilitate communication with team members. Documentation is done in compliance with all clinical guidelines and billing/reimbursement standards
  • Organizes and prioritizes daily work by assessing new, current, and discharging patient needs in area(s) of responsibility
36

Social Media Community Care Coordinator Resume Examples & Samples

  • Monitors and administer response to public and customers comments and queries on 3M Consumer social channels
  • Monitors and administer response to customer ratings and reviews across multiple rating and review platforms
  • Coordinates and responds to customers appropriately ensuring accurate tone of voice is utilized based on brand
  • Utilizes social listening to help manage 3M risk as an early warning indicator/monitoring solution for product issues and concerns, channel issues and end user issues
  • Minimum of two (2) years of combined experience in Social Media, Customer Service, Marketing, Public Relations, and/or Communications
  • Previous customer service or social care experience with consumer related products
  • Understanding of social community care as well as responding to customer ratings and reviews
  • Ability to multi-task and work in multiple systems at one time
  • Excellent analytical, written and oral communication skills
37

Registered Nurse Community Care-milwaukie Elderplace Resume Examples & Samples

  • Current, unencumbered Oregon Registered Nurse license
  • Current Basic Life Support (BLS) at time of hire
  • Relevant training and certifications applicable to the position, as specified by the Nurse Manager
  • In compliance with company policy and state regulations, a Department of Human Services (DHS) criminal background check may be required for this position based upon the location of the position. Fingerprinting may be required also
  • Bachelor’s Degree in Nursing strongly preferred. Required for newly hired Registered Nurses as of 2018
38

Rn-community Care Coordinator Resume Examples & Samples

  • Masters’ degree in nursing or equivalent Master of Science degree preferred
  • Certified Case Management or other clinically sound certification preferred
  • Clinical experience in myriad of service areas such as hematology and oncology, neurology/neurosurgery, orthopedic, cardiology/cardiac surgery, nephrology, seizure/epilepsy, and/or gastroenterology highly preferred
  • Demonstrate knowledge of philosophy/principles of comprehensive, community-based, patient-centered, developmentally appropriate, culturally sensitive, and linguistically appropriate care coordination services
  • Prior experience in leadership, advocacy, communication, education and counseling
  • Skill in writing convincing appeals arguments that are sound and supported by evidence that is related to patients’ specific clinical attributes
  • Ability to proficiently read, understand, and abstract information from handwritten patient medical records
  • Ability to work collaboratively and independently and adapt quickly to changing priorities
  • Able to follow instructions and respond to management direction
  • Able to take responsibility for own actions
  • Able to complete tasks on time or provide timely notification to management and leadership with an alternate plan
  • Able to speak clearly and persuasively in positive or negative situations; listens and gets clarification
  • Demonstrates group presentation skills
  • Able to write clearly and informatively
  • Able to read and interpret written information
  • Demonstrates accuracy and thoroughness