Case Manager Home Health
Resume:
Bill Jones
Case Manager - Giving Home Healthcare
Las Vegas, NV 89117
ad69sx@r.postjobfree.com
Knowledgeable Case manager experienced in coordinating care for various individuals. Proactive and resourceful with strong knowledge of community resources. Effective communicator with passion for helping others.
Willing to relocate: Anywhere
Authorized to work in the US for any employer
Work Experience
Member service expert
Molina Healthcare - Las Vegas, NV
February 2022 to Present
Handle inbounds/outbound calls from members and potential members. Identify the reason for the call and either transfer to appropriate departments or handle calls. Assist with insurance needs for medical, dental, and vision. Understands Medicaid and Medicare criteria.
Works directly with different vendors such as; hospitals, dr offices, state Medicaid and any other practice that deals with Medicaid.
Case Manager
Giving Home Health Care - Las Vegas, NV
January 2021 to March 2022
• Monitored care plans for patients and evaluated quality for improvement recommendations
• Evaluated roughly 15 patients per week based on needs and physical parameters discovered through in home nursing
• Managed a case load of 30 or more, providing comprehensive community care
• Educate patients and loved ones about the process of in home health care and the Dept of labor.
• Meet with patients in their home and doctors offices for renewals and updates on their quality of living.
• Organize and maintain doctor, renewal and impairment appointments for 30 or more patients.
• Track all progress of patients through charting and keep trackers updated company wide.
• Prepare and coordinate documentation in compliance with government agency standards.
• Case management and assessment to determine patients needs .
• Assist patients with obtaining necessary medical support and equipment. Behavioral Health Technician (BHT)
Behavioral Health Of southern Nevada - Las Vegas, NV January 2020 to February 2021
• Mentor school age kids and adults with either behavioral problems or diagnosed mental disorders
• set Goals in place for clients to achieve that focused on physical and mental improvements.
• weekly meeting with therapist that discussed clients current behaviors and upcoming goals that should be worked on
• turned In weekly case notes on clients to Medicaid, that targeted clients current status and areas of improvement
Health Care Agent
C3/CustomerContactChannels/ Well care - Las Vegas, NV November 2018 to January 2020
To enroll member in the AEP each year.
• quoted members different products that suited their needs.( Medicare part A, B, C D
• breakdowns to the billing cycles, and any adjustments made to the policies in the middle of the billing month.
• able to handle escalated calls and explain policies and procedures while being professional with a member first attitude.
• Discussed plans with members so they understood what they were signing up for
• inbound/outbound calls to and from members and potential members. Auto/ property Agent
USAA - Las Vegas, NV
September 2017 to November 2018
• To Write household policies for our military based members
• Quoted members different products that suited their needs. ( homeowners, rental, renters, VPP)
• Breakdowns to the billing cycles, and any adjustment made to the policies in the middle of the billing month.
• Handled escalated calls and explained policies and procedures while being professional with a customer first attitude.
• Rebased policies for members moving state to state. Program Manager
North Star LLC - Las Vegas, NV
November 2014 to September 2018
Served as family, hospital, and physician initial contact point for individual patients. Managed 4 group homes with a total of 20 patients and 20 plus staff members. Promoted physical, mental and social development by implementing classroom games and outdoor recreational activities.
I was responsible for keeping all files up to date per state regulations, directing, supervising, evaluating and discipline staff, ensuring the safety of the group homes. My Job responsibilities also included 3 family living provider sites where I completed many of the same responsibilities without the element of staff. They had state regulations to follow it was my job to ensure that they lived up to those standards, while providing support and training. Students each year. Residential lead/ direct support staff
Danville Services - Las Vegas, NV
January 2013 to November 2014
Provides or assist with providing direct patient care, diagnostic procedures and therapeutic interventions. Assist patients with performing activities of daily living. Provides therapeutically effective relationships with assigned patients incorporating developmental age related factors.
Serves as a role model for other staff and assist in orientation/training of new staff. Collections Specialist
Capital One - Las Vegas, NV
March 2011 to January 2013
To assist customer with making payments to prevent account from going delinquent. outbound calls daily to customers for payments or to set up payment arrangement. 150-200 calls daily to customers 1-30 days delinquent Collections Specialist
Grant and Weber Revenue Solutions - Las Vegas, NV
October 2009 to March 2011
Negotiated settlements with attorneys, debtors, while keeping our clients best interest in collecting the payment * H.i.p.p.a certified * 180-200 calls daily/ inbound/outbound * Auto dialer/ manual * Collected on medical accounts/ 180 day * Skip
Customer Service Supervisor
Bank Of America - Las Vegas, NV
August 2004 to August 2009
Assisted with personal checking/ saving accounts * Opened / close accounts.. * Canceled debit cards/ credits due to fraudulent activity.. * Demonstrated exceptional customer service/ account maintenance with customers and potential customers
Education
Bachelor's in Psychology
University of Phoenix - Las Vegas, NV
2003 to 2008
Skills
• Social Work
• Behavioral Health
• Substance Abuse
• Excel
• Administrative Experience
• Microsoft Word
• Business Management
• Case Management
• Individual / Group Counseling
• Help Desk
• Medication Administration
• Mental Health Counseling
• Program Development
• Behavioral Therapy
• Conflict Management
• Crisis Intervention
• Autism Experience
• Motivational Interviewing
• Social work
• Mentoring
• Conflict management
• Training & development
• Program management
• Supervising experience
• Typing
• Customer service
• Negotiation
• Recruiting
• Direct sales
Certifications and Licenses
First Aid and CPR
life and property/casualty insurance
September 2018 to Present
driver's license
Additional Information
Life/Health Insurance License
Contact this candidate