Ashley McCarthy
Oshkosh
Summary
Experienced care manager with a proven track record of strong performance at Magellan Health. I have a history of excelling in crisis intervention and patient education, and I am adept at building rapport and utilizing strong communication skills to enhance care management. I am skilled at processing authorizations efficiently and ensuring data integrity while meeting performance metrics. I am committed to optimizing patient outcomes through effective collaboration as well as independent work.
Overview
5
5
years of professional experience
Work History
Care Manager
Magellan Health Service Administrator
10.2022 - Current
- Processed off que tasks such as TMS requests and appeals in a timely manner through both collaboration and independent work.
- Utilized MNC criteria to enter and process authorizations for various levels of care with efficiency and proficiency.
- Educated members and families on community resources, treatment options and health care services to better manage conditions.
- Provided crisis intervention services when necessary by assessing risk levels promptly addressing safety concerns.
- Complete crisis call follow up calls, and other miscellaneous tasks assigned.
- Assessed members and discussed plans/care to meet needs.
- Participated in team meetings and trainings to stay updated on best practices and new developments in care management.
- Trained in correcting authorization errors and assist as needed with correcting errors that could impact claims, correspondence, and data integrity.
- Meet call metrics by processing calls timely and efficiently.
Registered Nurse, Intensive Care Unit
ThedaCare Regional Medical Center-Appleton
12.2021 - 02.2022
- Administered medications and treatments as prescribed by physicians.
- Demonstrated advanced critical thinking skills while managing complex clinical situations involving multiple organ systems failures in critically ill patients
- Reduced patient complications by promptly identifying changes in condition and initiating appropriate interventions.
- Increased family involvement in patient care by providing timely updates on their loved one's progress and addressing any concerns or questions they may have had.
- Collaborated with interdisciplinary teams to establish optimal care plans, resulting in improved patient care.
- Administered medications accurately and effectively, preventing adverse reactions through careful monitoring of drug interactions.
- Cared for wounds such as surgical sites and pressure sores to prevent infection and promote healing.
- Maintained confidentiality of sensitive patient information in accordance with HIPAA regulations while fostering trust between medical staff and patients'' families.
Registered Nurse, Cardiac Telemetry
La Palma Intercommunity Hospital
04.2020 - 09.2021
- Improved patient outcomes by consistently monitoring cardiac telemetry and promptly responding to critical changes.
- Optimized patient outcomes in high-stress scenarios by remaining calm, focused, and utilizing critical thinking skills to provide appropriate interventions.
- Provided comprehensive cardiac education to patients and families, empowering them in self-care management postdischarge.
- Ensured optimal clinical outcomes for cardiac patients through timely identification of potential complications and prompt intervention.
- Demonstrated expertise in various cardiac procedures such as EKG interpretation, defibrillation, cardioversion, and administration of emergency medications.
Education
Associate of Science - Registered Nurse
Stanbridge University
Irvine, CA10-2019
Skills
- Time management
- Ability to de-escalate crisis call members
- Building rapport
- Teaching skills
- Strong communication skills
- Performance metrics
- Flexibility
Timeline
Care Manager
Magellan Health Service Administrator
10.2022 - Current
Registered Nurse, Intensive Care Unit
ThedaCare Regional Medical Center-Appleton
12.2021 - 02.2022
Registered Nurse, Cardiac Telemetry
La Palma Intercommunity Hospital
04.2020 - 09.2021
Associate of Science - Registered Nurse
Stanbridge University
Similar Profiles
Esther Omawumi AkereleEsther Omawumi Akerele
Caregiver at Health Care Service AdministratorCaregiver at Health Care Service Administrator
Rakesh Singh JamwalRakesh Singh Jamwal
Support Technician at Rackspace Technology | System Administrator - IT Infrastructure & Cloud service deliverySupport Technician at Rackspace Technology | System Administrator - IT Infrastructure & Cloud service delivery
Humfred MayahHumfred Mayah
Lead Tableau Developer / BI Product Manager at Magellan HealthLead Tableau Developer / BI Product Manager at Magellan Health