Bethy C. Jean-Philippe
Silver Spring,USA
Summary
Dedicated and results-oriented professional with 15+ years of experience in Healthcare Administration industry, including Medicare, Medicaid Long Term Services and Supports, Managed Care Organization (MCO) protocols and optimizing operations. Proven track record of achieving cost savings, improving patient satisfaction and implementing efficient administrative processes. Adept at implementing business plans with quantifiable metrics and collaborating with stakeholders to ensure the delivery of high-quality patient care. Bilingual in English and Haitian Creole (reading/writing/speaking). Proficient in delivering clear and concise oral presentations and training sessions to diverse audiences.
Overview
16
16
years of professional experience
Work History
Supervisor, Care Management - Long Term Services and Supports (LTSS)
Centene Corporation, PA Health and Wellness
11.2019 - Current
- Applies strong leadership talents and problem-solving skills to maintain team efficiency and organize workflows to a team of over 13.
- Oversee daily operations of the department, ensuring smooth workflow and timely completion of tasks.
- Develop staff skills through targeted training programs, resulting in improved performance and career growth opportunities.
- Identify operational inefficiencies and implemented corrective measures to increase effectiveness.
- Demonstrate success in implementing process improvements to boost operational performance.
Case Manager (LTSS and HCBS)
Centene Corporation, Sunshine Health
01.2015 - 10.2019
- Maintained accurate documentation on all cases, ensuring compliance with regulations and confidentiality requirements. Managed a caseload of over 110 files.
- Conducted thorough assessments of clients'' situations, identifying issues, goals, and necessary interventions.
- Developed and implemented training programs for staff; Serve as a (SME)-Subject Matter Expert on committees of testing processes, providing feedback, publishing internal guidelines and processes.
- Partnered with physicians, social workers, activity therapists, nutritionists, and case managers to develop and implement individualized care plans and documented patient interactions and interventions in electronic charting systems.
- Trained new case managers, raising team's overall competency and service delivery standards.
CARES Assessor
Florida Department of Elder Affairs
08.2010 - 01.2015
- Identified individuals at risk of nursing home placement by evaluating level of care and recommended most safe and appropriate placement for identified clients with nursing home diversion potential.
- Provided services and resources to keep the aging individuals independent. Service over 200 families across Broward County.
- Monitored patient progress closely, adjusting care plans as needed to promote ongoing improvement.
- Analysis of met and unmet psychosocial and service needs; Assisted clients with daily living needs to maintain self-esteem and general wellness; Promoted patient self-management by providing education on chronic condition management and healthy lifestyle choices.
- Staffed for appropriate level of care with medical doctor and/or Registered Nurse and served as a liaison with external community health care and social service agencies
Medicaid Waiver Specialist
Aging and Disability Resources Center
08.2008 - 07.2010
- Conducted and instructed 701B (comprehensive assessment) instrument, coordinated with appropriate State Department, such as the local Adult Payments Unit and the local CARES Unit.
- Created, planned, and hosted on- and-off campus community service activities and educational presentations for Medicaid Waiver Programs, schedule, track and prepare monthly, quarterly, annual, and other required reports.
- Championed the adoption of new software tools that streamlined workflows across multiple departments.
- Led quality assurance efforts, maintaining high standards for all products and services.
- Investigated provider performances, prepared reports, initiated corrective action, and tracked progress when required.
Education
Master of Science - Healthcare Administration
University of Maryland Global Campus
Adelphi, MD05.2019
Bachelor of Science - Gerontology
University of South Florida
Tampa, FL12.2007
Skills
- Leadership and management skills
- Complex Problem-Solving
- Medicaid and Medicare Programs
- Quality Assurance
- Training and mentoring
- Complex verbal and written reports
- Staff Management
- Presentation skills
- Analytical skills
- Process Monitoring and Improvement
Accomplishments
- Lead staff of 12-14 employees to an average of 76%-90% productivity for the fiscal year in the continuation of a state Medicaid program
- Created/Implemented an effective and successful training system that led to the effective productivity program for new processes and procedures
Otherprofessionalexperience
- Comprehensive understanding of Managed Care, products, operation, delivery systems and process improvement (Medicare, Medicaid, LTSS, DSNP)
- Over four years’ experience in leading and managing cross functional teams on large scale projects
- In-depth Knowledge of managed care marketplace
- All Microsoft programs
- Detail oriented and organized
- Nonprofits
Affiliations
- National Association of Health Services Executives (N.A.H.S.E) member
- American College of Healthcare Executives (ACHE) Member
Timeline
Supervisor, Care Management - Long Term Services and Supports (LTSS)
Centene Corporation, PA Health and Wellness
11.2019 - Current
Case Manager (LTSS and HCBS)
Centene Corporation, Sunshine Health
01.2015 - 10.2019
CARES Assessor
Florida Department of Elder Affairs
08.2010 - 01.2015
Medicaid Waiver Specialist
Aging and Disability Resources Center
08.2008 - 07.2010
Master of Science - Healthcare Administration
University of Maryland Global Campus
Bachelor of Science - Gerontology
University of South Florida
Similar Profiles
TRINA Y. COXTRINA Y. COX
Senior Manager, Vendor Management at Centene/PA Health & WellnessSenior Manager, Vendor Management at Centene/PA Health & Wellness
Tanika TaylorTanika Taylor
Director, Grievance & Appeals, DHS Fair Hearing Coordinator, Critical Incident & Rapid Response at PA Health & WellnessDirector, Grievance & Appeals, DHS Fair Hearing Coordinator, Critical Incident & Rapid Response at PA Health & Wellness
Tisha WilsonTisha Wilson
TRICARE Education Specialist at Health Net Federal Services/Centene CorporationTRICARE Education Specialist at Health Net Federal Services/Centene Corporation