Summary
Overview
Work History
Education
Skills
Timeline
Generic

Andrea Maloney

Green Bay

Summary

Over 20 years of experience in long-term care, transitioning from direct care staff to care management. Expertise in Home and Community Based Waiver services, Medicaid, Medicare, and Wisconsin's Long Term Care system. Knowledgeable in client rights and responsibilities. Skilled in building positive relationships, navigating challenging conversations. Driven to support individuals to understand the benefits and rights afforded to them within these programs through outreach, education and advocacy.

Overview

16
16
years of professional experience

Work History

IRIS Consultant

Molina- TMG
01.2022 - Current
  • Manage caseload of 47 IRIS participants, completing quarterly face to face visits and monthly phone calls to address needs as they arise through appropriate referrals, education, resources and support with accessing services.
  • Empower participants in self-direction, providing resources and guidance on budget management while fostering understanding of program rights and responsibilities.
  • Provide advocacy and support when services or budget amendments are denied assuring they understand next steps in appeal process.
  • Mentor fellow IRIS Consultants through providing shadow opportunities, resource sharing and development of tools.
  • Utilize Power BI for data-driven workload management.
  • Write comprehensive budget amendment requests utilizing contract language to support requests.
  • Recipient of Molina Spotlight Award in 2024 and 2025.
  • Created role plays and developed Person Centered Planning tools for regional staff meeting.
  • Collaborated with 9 new service providers to assist them in becoming IRIS vendor addressing service gaps for participants.

Care Manager

Lakeland Care
07.2018 - 01.2022
  • Managed 60 member caseload of individuals with complex medical and behavioral needs through community and residential supports.
  • Adhered to program timelines for service approvals and denials assuring NOA's sent as required by contract.
  • Fostered positive relationships with facility staff and providers, ensuring proactive problem-solving and excellent customer service.
  • Educated members on program benefits, explaining coordination of benefits with Medicaid, Medicare, and Social Security to assure individuals were aware of their resources and rights.
  • Advocated for 40 residents during CBRF closure to identifying appropriate care settings and minimizing health risks.
  • Collaborated with guardians and caregivers to assure members voices were heard during care planning process.
  • Provided technical assistance to assisted living providers in understanding Family Care contracts, waiver services and individual’s rights within these programs.
  • Offered monthly tips and tricks training for care managers on a variety of topics to support best practices within Family Care.

Information and Assistance Specialist

Aging and Disability Resource Center of Brown County
11.2012 - 10.2017
  • Participated in intake rotation, assessing client needs through walk ins, in-person meetings, phone consultations, and home visits to provide information and education on community resources, supports and options available.
  • Conducted comprehensive Long Term Care functional screens to determine program eligibility.
  • Actively participated in diverse committees, including Brown County Housing and Homeless Coalition, Prison After Care Network, Motivational Interviewing, Employment, Transition and ADRC Resource Committee.
  • Participated in Motivational Interviewing and Mediation training opportunities through DHS pilot program.
  • Facilitated community engagement through presentations on ADRC services, prevention programs, assistive technology and youth in transition. Enhancing public awareness to empower client self-advocacy.
  • Mentored new staff members, facilitating smooth onboarding and promoting consistent, high-quality service standards throughout the team.

Elderly Benefit Specialist/Prevention Program Coordinator

Aging and Disability Resource Center of the Lakeshore
06.2009 - 11.2012
  • Supported individuals aged 60 and older in understanding, accessing and applying for public benefits including Medicare, Medicaid, Social Security and other financial assistance programs.
  • Coordinated Medicare Annual Enrollment outreach and enrollment assistance through community outreach, presentations and one on one meetings, providing individualized support with enrollment into Medicare Part D plans to assure cost effectiveness and best coverage for Kewaunee County residents.
  • As Prevention Coordinator, responsible for volunteer management, marketing, outreach and coordination of evidence based programs; Living Well and Stepping On.
  • Developed outreach strategies, through press releases, news letter articles, presentations, and radio interviews to boost public awareness of Medicare and Medicaid benefits.
  • Provided technical assistance to area service providers in understanding Medicaid and Medicare benefits.
  • Provided effective advocacy for individuals receiving benefit denials. Assisting with appeals and grievances as needed.

Education

Bachelor's of Science - Human Development, Psychology with a Social Work Emphasis

University of Wisconsin-Green Bay
05.2009

Masters of Arts - Special Education

Marian University
06.2018

Masters of Social Work - undefined

University of New England
05.2016

Skills

Advocacy

Budget Management
Case Management
Certified Functional Screener

Client Rights
Crisis Intervention
Customer Service
Data- Driven Tools
Dementia Care
Discharge Planning
Event Organization

Home and Community Based Services
Long Term Care
Medicaid
Medicare
Mentoring
Motivational Interviewing
Outreach Strategies
Person Centered Planning
Positive Behavior Supports
Problem Solving
Program Compliance
Public Benefits
Resource Management
SHIP Counselor
Social Security
Volunteer Management

Timeline

IRIS Consultant

Molina- TMG
01.2022 - Current

Care Manager

Lakeland Care
07.2018 - 01.2022

Information and Assistance Specialist

Aging and Disability Resource Center of Brown County
11.2012 - 10.2017

Elderly Benefit Specialist/Prevention Program Coordinator

Aging and Disability Resource Center of the Lakeshore
06.2009 - 11.2012

Masters of Arts - Special Education

Marian University

Masters of Social Work - undefined

University of New England

Bachelor's of Science - Human Development, Psychology with a Social Work Emphasis

University of Wisconsin-Green Bay

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