Summary
Overview
Work History
Education
Skills
Additional Information
Timeline
Generic

Belinda Mangle

Beverly,NJ

Summary

Experienced healthcare professional offering diverse experience in utilization management, direct patient care, staff supervision and department operations. Proven clinical knowledge, natural interpersonal strengths and technical abilities.

Overview

25
25
years of professional experience

Work History

Utilization Management Coordinator- Pediatric Lead

Friends Hospital
05.2019 - Current
  • Manages caseload of 35 patients, averaging 25 review, follow up, meeting calls daily.
  • Continually improves knowledge, skills and performance based on feedback and self-identified professional developmental needs.
  • Serves as department expert in Pediatric Utilization Management.
  • Closely collaborates with management team to make necessary improvements.
  • Provides documentation and active treatment training to staff across disciplines.
  • Utilizes MCG Guidelines to review admitted patients for appropriate status placement and concurrent medical necessity.
  • Established and maintained effective communication with staff, physicians and community organizations to promote high quality patient care.
  • Reduces hospital readmission rates through thorough assessment of patient needs, developing appropriate post-discharge plans.
  • Actively participates in interdisciplinary team meetings to provide input on patient care, discharge planning, and resource utilization.
  • Maintains accurate documentation of all reviews, appeals, and decisions in line with organizational standards and requirements.
  • Manages complex cases effectively, working closely with interdisciplinary teams to develop comprehensive care plans tailored to individual needs.

Intake Supervisor

Sunspire Health
11.2017 - 12.2018
  • Led team of intake specialists, providing guidance, support, and feedback on their work performance.
  • Delegated tasks to administrative support staff to organize and improve office efficiency.
  • Managed over 50 customer calls per shift for 8 in network facilities.
  • Implemented new software solutions to streamline workflow processes, resulting in increased efficiency within department.
  • Provided clinical support and treatment options in remote setting via phone, email and online chat for clients and family members seeking substance abuse services both within and outside of our national facility network.
  • Evaluated individuals for treatment utilizing EMR to document identified psychosocial, co-occurring and medical concerns.
  • Assessed care advocate live/recorded phone calls for competencies, provided coaching as needed.

Intake Supervisor

Horsham Clinic
08.1999 - 12.2017
  • Managed high volume admissions and referral center for 206 bed facility,
  • Reviewed criteria for authorizations, admission and eligibility of benefits for patients.
  • Worked closely with medical directors in review of cases for medical necessity and benefit coverage.
  • Functioned as resource to other departments and providers.
  • Conducted regular meetings with intake team to discuss performance metrics, identify areas for improvement, and develop action plans accordingly.
  • Assisted QA in development of new patient safety measures within department setting ie rounds, structures, privacy initiatives, new staffing assignments and responsibilities.
  • Conducted level of care assessments for walk in patients seeking psychiatric and/or co-occurring substance abuse treatment.
  • Assisted Admissions Director with new hire interviews, training, scheduling, call monitoring.

Utilization Review Coordinator

Hampton Hospital
12.2015 - 11.2017
  • Performed concurrent reviews, pre authorizations and evaluated charts for provider accuracy including initial certifications, re-certifications, resumption and discharge plans.
  • Created customized care plans, working with hospital staff and families to assess and meet individual needs.
  • Supported positive working relationships between physicians, nursing staff, and other healthcare professionals through clear communication and collaboration on patient-centered goals.
  • Reviewed requests for denial appeals, reviewed records and compiled summary of information for use by Appeals Committee.

Education

Bachelor of Arts - Psychology

Moravian College
Bethlehem, PA

Skills

  • Knowledge of Medicare and Pennsylvania Medicaid regulations and MCG guidelines
  • Work well independently
  • Proficient computer skills
  • Time management skills
  • Independent judgment, creative thinking and decision making
  • Attention to detail

Additional Information

Server, Olive Garden Sep 2021-present

League Administrator Riverfront Softball Mar 2019-present

Soccer/Softball Commissioner/Head Coach Aug 2011-present

Sports Director, Delanco Youth Sports Association Jan 2014- Nov 2022

Timeline

Utilization Management Coordinator- Pediatric Lead

Friends Hospital
05.2019 - Current

Intake Supervisor

Sunspire Health
11.2017 - 12.2018

Utilization Review Coordinator

Hampton Hospital
12.2015 - 11.2017

Intake Supervisor

Horsham Clinic
08.1999 - 12.2017

Bachelor of Arts - Psychology

Moravian College

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Belinda Mangle