Andreia Leon
Oak Park
Summary
Professional in program management with history of overseeing and optimizing projects, driving project success and ensuring operational excellence. Known for collaborative approach and delivering results that align with organizational objectives. Dependable and adaptable, bringing strong leadership and communication skills to foster teamwork and manage changing priorities effectively.
Overview
12
12
years of professional experience
Work History
Telehealth Program Supervisor
Boomerang Healthcare
California
03.2023 - Current
- Created and refined operational processes, policies, workflows for telehealth workflows for the Interdisciplinary Medication Assistance Program(IMAP) and Buprenorphine Virtual Clinic program(BVC) ensuring consistency and efficiency across the program.
- Use of Smartsheets to build monthly reports on program performance metrics and for ongoing monitoring of program trends and referral base.
- Performs initial employee counseling, advance practice provider onboarding and orientation to the telemedicine program.
- Worked closely with the internal compliance department to monitor and ensure program compliance with federal policies, procedures and clinical protocols.
- Coordinated with the Revenue Cycle Manager/Director and billing manager/coordinator to ensure timely submission of claims and appeals to accomplish a Program Revenue Cycle Collection Rate of 93%.
- Coordinated with the internal new patient intake department to develop workflows to target growth of internal and external referrals to the Interdisciplinary Medication Assistance Program.
- Created Letter of Agreements(LOAs) for external commercial payers to increase external referral base and insurance coverage and patient access to the telehealth programs.
- Developed internal referral pathways and EMR scheduling procedures for the interdisciplinary medication assistance program and the buprenorphine virtual clinic.
- Streamlined onboarding process for patients into telemedicine programs and ensured continued support during program participation.
- Developed and implemented streamlined processes for telehealth appointment scheduling, enhancing patient access and satisfaction.
- Coordinate and monitor providers schedules for operational efficiency.
- Initiated prior authorization requests to payers, communicated with providers and insurers regarding the status of authorization.
- Conducted regular audits of telehealth services to ensure adherence to clinical protocols and regulatory compliance.
- Collaborated with healthcare providers to optimize care delivery within the telehealth framework, improving patient outcomes.
- Analyzed patient feedback and performance data to identify areas for program improvement and enhance service delivery.
- Implemented training sessions for clinical staff on telehealth best practices/onboarding, ensuring high-quality patient interactions.
- Established partnerships with community organizations to promote telehealth services and expand patient reach.
- Monitored and reported on key performance indicators to track program effectiveness and inform strategic planning.
- Facilitated communication between clinical teams and administrative staff to support seamless patient care transitions.
- Designed patient education materials tailored for telehealth services, improving understanding and engagement.
- Coordinated interdisciplinary team meetings to discuss patient cases and promote collaborative care approaches.
- Facilitated regular team meetings, keeping staff informed about updates, changes, or upcoming events related to the program they supervised.
- Scheduled and supervised staff meetings to discuss new ideas and update participants on program details and milestones.
- Experience with Microsoft office (word, excel), Smartsheets
- Electronic Medical Records experience include Nexgen, IMS, PrognoCis, Epic.
Care Navigation Reviewer Supervisor
Boomerang Healthcare
California
10.2022 - 03.2023
- Collaborated with interdisciplinary teams to facilitate care coordination and ensure seamless transitions for patients navigating treatment options.
- Performed chart reviews of patient medical records using self-report health assessment questionnaires, and treatment notes (internally and externally) to perform Health Assessment Questionnaire evaluations and Care Plan Reviews.
- Functioned in a supportive role to the provider to ensure execution of the provider treatment plan within the internal matriculation model.
- Communicate with legal, external specialists, and independent medical reviewers to obtain medical progress reports.
- Utilize Microsoft Excel to capture, maintain departmental data and assist with analysis of productivity trends.
- Provided administrative and operational support within the Care Navigation Department.
- Responsible for conducting ongoing internal audits to ensure quality of documentation to support consistent, and individualized reviews of patient treatment plans.
- Led bi-monthly team meetings to discuss updates, share insights, and foster a collaborative work environment among Care Navigation Reviewers.
- Used California MTUS guidelines to make recommendations in support of initiation/continuation of conservative treatment as well as to refute denials for request for authorizations.
- Communicate with providers, insurance carriers regarding the status of authorization requests.
- Investigate barriers to patient treatment and collaboratively work with providers to help get necessary treatment requests authorized and an authorized treatment scheduled if necessary.
- Responsible for scheduling patient follow up appointments and wellness classes as necessary.
- Assess and monitor patient treatment progress monthly to determine continued appropriateness for care navigation reviews and conservative care.
- Recommend comprehensive multidisciplinary functional restoration program when appropriate.
- Communicate with patients to discuss their treatment history, progress, and deficits in recovery and make recommendations for conservative care.
- Assisted with developing training materials and performing training of new onboarding Care Navigation Reviewers.
- Provide continuous support/coaching for CNR team members to ensure standardization of reviews and adherence to established policy and procedures of the Care Navigation Dept.
- Provided interdepartmental support in the larger company by assisting with auditing medical provider networks as well as piloting new roles to help streamline patient access/authorization and scheduling the start of tertiary pain programs.
- Developed Standard Operating Procedures for select Care Navigation actions for my team as well as assisted with development of SOPs for piloted programs with the Functional Restoration Program.
- Responsible for timely submission of Independent Contractor timesheets to payroll.
Physical Therapist
Aspire Home Health
Morton Grove, Illinois
01.2016 - 01.2023
- Evaluate and treat patients in the home setting recovering from joint arthroplasty, back surgery, general debility impacting functional independence.
- Performed medical chart review of acute care hospitalization.
- Responsible for completion of all updated plans of care, discharge summaries and re-evaluations.
- Communicated identified patient care needs and plan of care with MD, Clinical Director and Nursing.
- Ensured seamless transition from home health to outpatient care including but not limited to scheduling of appointments.
- Lead family training and education to ensure safety of mobility, as well as educate the patient regarding resources needed to maximize safe return to the community.
Clinical Liaison
Kindred Rehabilitation Hospitals (Northwest Community Hospital)
Arlington Heights, Illinois
01.2021 - 01.2022
- Conducted comprehensive review of acute hospital medical records including notes from Attending Physician, Physician Specialist, imaging, physical, occupational, speech therapy notes to facilitate appropriate admission to acute inpatient rehabilitation program.
- Completed patient screening assessments and documentation needed to support request for admission into the acute inpatient rehabilitation program for insurance review.
- Contacted insurance for pre-service authorization
- Coordinates transmission of clinical and benefit of treatment to patients, families and outside agencies to facilitate informed decisions.
- Responsible for delivering efficient, and prompt transitions of patient care.
- Established initial targeted length of stay for patients prior to admission to the acute inpatient rehabilitation unit.
- Responsible for managing the referrals and admissions that are generated through the hospital as well as managing the external referrals and admissions.
- Maintain contacts and positive relationships with both potential internal and external referral sources.
- Utilized educational opportunities to present the hospital to referral sources.
- Acted as liaison for outside agencies, non-plan facilities, and outside providers.
Physical Therapist
Athletico Physical Therapy
Chicago, Illinois
01.2017 - 01.2020
- Staff therapist at an Outpatient Rehab center with a case mix of Worker’s Compensation, Medicare and commercial insurance patients. Extensive experience treating orthopedic musculoskeletal/post surgical, neurological diagnoses such as post CVA, Brain injury, post CA conditions.
- Managed daily caseloads of 10-15 patients (generally > 30% medicare clinic caseload clinic wide.
- Communicated with Physical/Occupational Therapist team members as needed to promote continuity of care and maximize the rehabilitative experience of the patient and facilitate achieving maximal return of function.
- Responsible for completion of all updated plans of care, discharge summaries and re-evaluations.
- Coordinated with other key medical professionals involved in patient care(Physicians, PA, LPN) to plan, implement and assess effectiveness of the rehabilitative program.
- Worked collaboratively and frequently communicated with third party payers, case managers to manage clinical care.
- Continuous improvement strategies to ensure growth and sustainability of the clinic as well as collaborating with my team to establish strategies to meet clinic financial goals.
- Reviewed monthly metrics related to clinician productivity, reimbursement and expenses. Analyzed related data and employed strategies to assist the clinic achieve budgetary goals and to support productivity.
- Self initiated marketing the facility and relationship building with local physicians within and outside of the community to grow the referral base.
- Increased company visibility and community partnership by participation in community events including local races, health fairs for wellness, prevention/free injury screenings, as well as developed/ implemented Patient Appreciation Day celebrations.
- Supervised Physical Therapy Technicians, equipped them with information necessary to assist with patient care.
- Mentored newly graduated Physical Therapists to facilitate smooth transition and allow acclimation to the facility, company environment and company expectations.
Physical Therapist-PRN
West Suburban Medical Center
Oak Park, Illinois
01.2014 - 01.2018
- Evaluated the motor function of patients on the SubAcute/IP Rehab /Acute care units.
- Supported the primary therapists and other disciplines on the care team in achieving set goals for maximizing patient function.
- Communicated with the rehabilitation team to brainstorm treatment approaches in effort to time manage rehab minutes and ensure safety of the patient.
Physical Therapist
University of Illinois at Chicago Hospital
Chicago, Illinois
01.2016 - 01.2017
- Evaluated the motor function of medically complex patients on the Acute care and IP rehab Unit including a case mix of patients s/p CVA, general debility, respiratory/COPD, spinal injuries, joint replacements, transplants, oncology.
- Manage daily caseloads of 3-5 patients.
- Medical Chart reviews performed on patients assigned to daily caseload.
- Responsible for completion of all updated plans of care, discharge summaries and re-evaluations.
- Collaborated in clinical rounds for ICU/general med-surgery/ neuro/oncology
- Experience in multi-disciplinary team approach to case conferencing with MD/RN/ PT/OT/SLP/ SW/Discharge planning staff to discuss functional recovery/progress of the patient and provide support to the family/patient as well as resources upon discharge to ensure a safe transition to the community.
- Participated in weekly rounds to provide updates on patient progress towards discharge goals.
- Lead family meetings to discuss patient progress and anticipated care needed for the patient during post-acute IP phase including but not limited to discharge a lower level of care, home health and/or DME required.
- Co-lead family training/education to ensure the safety of the patient and family regarding care needed to facilitate a safe transition to home.
- Taught weekly Joint Classes for patients undergoing elective Total hip/Total knee Arthroplasty to communicate expectations during stay, recovery and expected post operative rehab needs including DME and Outpatient Rehabilitation Services
Education
Doctor of Physical Therapy -
University of Illinois at Chicago, College of Allied Health and Science Department of Physical Therapy
Chicago, IL05.2006
Bachelor of Science with Honor - Psychology
University of Illinois at Chicago
Chicago, IL05.2003
Skills
- Operational Lead
- Program management
- Referral coordination
- Standard operating procedures
- Process improvements
- Staff training
- Document management
Timeline
Telehealth Program Supervisor
Boomerang Healthcare
03.2023 - Current
Care Navigation Reviewer Supervisor
Boomerang Healthcare
10.2022 - 03.2023
Clinical Liaison
Kindred Rehabilitation Hospitals (Northwest Community Hospital)
01.2021 - 01.2022
Physical Therapist
Athletico Physical Therapy
01.2017 - 01.2020
Physical Therapist
Aspire Home Health
01.2016 - 01.2023
Physical Therapist
University of Illinois at Chicago Hospital
01.2016 - 01.2017
Physical Therapist-PRN
West Suburban Medical Center
01.2014 - 01.2018
Bachelor of Science with Honor - Psychology
University of Illinois at Chicago
Doctor of Physical Therapy -
University of Illinois at Chicago, College of Allied Health and Science Department of Physical Therapy