Blossom Raymond-Lyle
Fresno,CA
Summary
Versatile healthcare professional with nearly two decades of experience spanning patient advocacy, case management, department leadership and healthcare consulting. Proven track record in optimizing processes, enhancing patient care and driving organizational efficiency. Expertise includes: Strategic Implementation of healthcare products and services. Patient-centered care coordination and advocacy. Department management and project management. Stakeholder communication and relationship building. Regulatory compliance and quality assurance. Data analysis and performance optimization. Demonstrated ability to navigate complex healthcare systems, lead cross-functional teams and implement sustainable improvements. Committed to empowering patients, fostering collaboration among healthcare providers and driving positive outcomes in diverse healthcare settings
Overview
20
20
years of professional experience
Work History
Independent Consultant Non-Profit Organizations
NSITE CONSULTING AND TRAINING LLC
09.2023 - Current
- Develop improvement strategies in collaboration with clients to define measurable objectives and key performance indicators, research industry best practices and design innovative solutions to optimize processes, enhance productivity and drive cost savings
- Lead process improvement initiatives by creating detailed project plans, timelines and resource requirements
- Manage cross-functional teams to ensure effective implementation
- Provide guidance and coaching to client personnel to build internal capabilities
- Implement sustainable changes with the deployment of new processes, comprehensive training programs and establish ongoing monitoring and continuous improvement mechanisms
- Serve as primary point of contact funders, respond to inquires and provide updates on the use of funds
- Prepare and deliver high quality impact reports, site visits and other funder facing communications
- Work collaboratively with the finance team to provide financial information and transparency to funders
- Foster meaningful long-term partnerships with funding sources through personalized engagement
- Work closely with the development, marketing and program teams to align funding priorities and activities
- Ensure that all proposals and applications adhere to funder guidelines and requirements
- Coordinate the timely submission of proposals and maintain centralized tracking system
Senior Implementation Analyst Manager
CVS / AETNA HEALTH
10.2015 - Current
- Lead successful implementation of new products and services across Aetna Health’s operations
- Subject matter expert responsible for guiding cross-functional teams through implementation lifecycle, from planning and project management to support
- Primary point of contact and project lead for complex, high priority implementation initiatives
- Collaborate with stakeholders across various departments to define project scope, objectives and success criteria
- Develop comprehensive implementation plans, including detailed timelines, resource requirements and risk mitigation strategies
- Facilitate effective communication and coordination among team members, vendors and external partners to ensure seamless execution
- Provide mentorship and guidance to new team members assisting them in building their skills and capabilities
- Monitor project progress, identify and address potential roadblocks and recommend corrective actions as needed
- Ensure all implementations adhere to Aetna’s policies, procedures and regulatory requirements
- Collect and analyze implementation data to measure performance and identify improvement opportunities
Intake Department Manager
INTERIM HEALTHCARE
01.2013 - 10.2015
- Responsible for all operations of the intake and referral management functions, while serving as a gateway for new patient referrals
- Lead a team of intake coordinators and worked collaboratively with clinical and administrative staff to deliver high quality, patient centered care
- Managed day-to-day operations of the intake department, including staffing, scheduling and workflow optimization
- Developed and implemented policies, procedures and best practices for intake processes to maximize efficiency and support compliance
- Primary point of contact for referral sources, such as hospitals, physicians and case managers, building and maintaining strong relationships
- Ensured all incoming patient referrals were promptly reviewed, triaged and assigned to the appropriate clinical care teams
- Managed intake coordinators processes, ensuring timely completion of comprehensive patient assessments, including gathering necessary medical information and insurance verification
- Collaborated with clinical director to determine the appropriate level of care and coordinate the onboarding of new patients
- Monitored key performance indicators, such as patient response times, conversion rates and patient satisfaction and implemented data driven improvements
- Ensured compliance with all applicable home health regulations, policies and industry standards
- Provided coaching, training and ongoing support to intake coordinators to enhance their skills and knowledge
Healthcare Patient Advocate Case Manager
SPARROW HEALTH SYSTEMS
02.2005 - 04.2012
- Served as primary liaison between patients, their families and healthcare teams
- Coordinated patient care and assisted patients with navigating their way through complex healthcare systems to ensure best possible outcomes
- Provided patient support, education and guidance to empower patients and their loved ones throughout the car continuum
- Central point of contact for patients and their families by addressing questions and concerns in a caring, empathetic manner
- Assess patients’ physical, emotional, social and financial needs to develop comprehensive care plans to address them
- Coordinate communication and collaboration between patients, families, physicians, nurses and other healthcare providers by facilitating healthcare conferences
- Navigated insurance coverages, referrals and community resources to help patients access necessary services
- Identified potential barriers to care and worked with teams to remove and mitigate those barriers
- Provided education and support to help patients and their families understand medical conditions, treatment options and self-care requirements
- Analyzed complaint data to identify trends, patterns and opportunities for improvement
- Developed and implemented service recovery strategies and protocols to address patient concerns in a timely and effective manner with department managers
- Ensured all complaints were thoroughly investigated, documented and resolved according to the health systems policies and regulatory requirements
- Collaborated with cross-functional teams to design and implement process improvement strategies that prevent reoccurring issues
- Delivered regular reports and presentations to leadership on complaint trends, resolution effectiveness and recommended actions
Patient Access Rep Emergency Department
SPARROW HEALTH SYSTEMS
02.2005 - 02.2010
- Managed admissions and the registration process for patients seeking emergency care
- First point of contact for patients and their families, while providing exceptional customer service and efficiently gathering required information to ensure accurate data entry into the healthcare system
- Obtained and verified patient demographics, insurance, and medical information required for registration into electronic health record system
- Assisted patients with completing necessary forms and paperwork
- Communicated effectively with clinical staff to coordinate patient flow and care
- Maintained calm, organized and efficient workflow during periods of high patient volume in a level Trauma Emergency Dept
- Always protected the privacy and confidentiality of patient information
- Provided information about hospital services, policies and procedures
- Provided patients and families with community financial assistance, Medicaid packets and other resources to assist with any necessary follow up care
Education
Master of Science - Human Services – Public Health
Capella university / Central michigan university
Bachelor of Science - Community Development
Capella university / Central michigan university
Post Graduate Certification - Public Health – Education and Promotion
Capella university / Central michigan university
Skills
- Operations Management
- Organizational Development
- Management Coaching
- Continuous Improvement
- Performance Tracking
- Employee Management
- Client Engagement
- Processes and procedures
- Strategic Planning
- Client Relationships
- Project Management
- Project Leadership
Timeline
Independent Consultant Non-Profit Organizations
NSITE CONSULTING AND TRAINING LLC
09.2023 - Current
Senior Implementation Analyst Manager
CVS / AETNA HEALTH
10.2015 - Current
Intake Department Manager
INTERIM HEALTHCARE
01.2013 - 10.2015
Healthcare Patient Advocate Case Manager
SPARROW HEALTH SYSTEMS
02.2005 - 04.2012
Patient Access Rep Emergency Department
SPARROW HEALTH SYSTEMS
02.2005 - 02.2010
Master of Science - Human Services – Public Health
Capella university / Central michigan university
Bachelor of Science - Community Development
Capella university / Central michigan university
Post Graduate Certification - Public Health – Education and Promotion
Capella university / Central michigan university
Similar Profiles
Samuel GarrettSamuel Garrett
Intern Coordinator at Vista Law Enforcement Training and Consulting LLCIntern Coordinator at Vista Law Enforcement Training and Consulting LLC
ALAN KIPNISALAN KIPNIS
Owner at High Impact Sales Managment, Event Training and Consulting LLCOwner at High Impact Sales Managment, Event Training and Consulting LLC
KAYLA GRIFFINKAYLA GRIFFIN
Account and Investigations Manager at ProFirst Training and Consulting, LLCAccount and Investigations Manager at ProFirst Training and Consulting, LLC
Brian CarnesBrian Carnes
Flight Paramedic II at Air MethodsFlight Paramedic II at Air Methods
Joshua ZepedaJoshua Zepeda
DSP at Paradise Community Care HomesDSP at Paradise Community Care Homes