Mandi Dillow
Troy,OH
Summary
Results-driven professional provides customers with tailored solutions to meet needs. Successfully establishes relationships with customers and delivers quality service. Agile individual with excellent communication and customer service skills.
Overview
17
17
years of professional experience
1
1
Certification
Work History
Independent Health Insurance Broker
Medicare Resource Center | USA Benefits
03.2023 - Current
- Performed needs analysis to obtain information required to make appropriate health insurance product recommendations.
- Conducted thorough research on available health insurance plans, staying up-to-date on industry trends and policy changes.
- Developed strong relationships with healthcare providers to ensure optimal coverage options for clients.
- Educated clients on the intricacies of their health insurance policies, empowering them to make informed decisions.
Utilization Management Nurse Consultant
Aetna, CVS Health
11.2019 - 03.2023
- Utilizes clinical experience and skills in a collaborative process to assess, plan, implement, coordinate, monitor, and evaluate options to facilitate appropriate healthcare services and benefits for members
- Maintains knowledge of criteria and guidelines, policy and procedures to render coverage determination for continuum of care
- Identifies opportunities to promote quality effectiveness of healthcare services and benefits, while collaborating with facility staff to meet complex needs of the member
- Assesses the social, economic, environmental factors that interfere with patient and family adjustment to illness and treatment, referring to the Enhanced Discharge Planning team when high-risk cases are identified
- Adheres to accreditation, contractual and regulatory timeframes in performing all utilization management review processes, while exceeding above average productivity
Nurse Liaison/Marketing
Heartland Hospice
02.2016 - 11.2019
- Identified opportunities to promote quality effectiveness of Healthcare Services, while using communication and project management skills to increase admissions
- Gathered clinical information from medical records and applied the appropriate clinical criteria and judgment to render recommendation for continuum of care
- Collaborated and coordinated with Interdisciplinary team and community resources to provide consistency, necessary to transition patient's care between care settings, while utilizing the hospice benefit
- Actively participated in Independent Living, Assisted Living and Long Term Facility care team meetings and care conferences to identify issues, while developing and implementing solutions
- Established and developed new business contacts, maintained current relationships, while developing and implementing a sales and marketing plan
Nurse Navigator/Clinical Educator
Visiting Physician Association
09.2015 - 02.2016
- Interacted with physicians, staff, patients/families, community agencies, while serving as an educational resource regarding hospice and home care benefits
- Performed needs assessment and provided education of very high-risk patients to maximize or improve current health status and independence for patient safety
- Facilitated positive relationship development among the continuum to facilitate appropriate utilizations of resources to meet patient and family needs
Case Manager/Hospital Liaison
Ohio's Hospice
09.2012 - 08.2015
- Assessed and evaluated the patient and family including physical, spiritual and psychosocial needs, whether residing in hospital nursing facilities (ECF, AL, IL) home and other settings
- Presented hospice philosophy and services offered to referred patients and families in a manner that results in timely admission of eligible patients
- Developed and maintained relations with hospital discharge planners, physicians, social workers, and case managers, while providing education to generate new referrals
Clinical Nurse
Good Samaritan Hospital
06.2008 - 09.2012
Education
Bachelor of Science - Nursing
Ohio University
Athens, OH2011
Associate of Science - Nursing
Edison Community College
Piqua, Ohio2008
Associate of Science - Marketing
Sinclair Community College
Dayton, Ohio2004
Certification
- Licensed Health and Life Insurance
Timeline
Independent Health Insurance Broker
Medicare Resource Center | USA Benefits
03.2023 - Current
Utilization Management Nurse Consultant
Aetna, CVS Health
11.2019 - 03.2023
Nurse Liaison/Marketing
Heartland Hospice
02.2016 - 11.2019
Nurse Navigator/Clinical Educator
Visiting Physician Association
09.2015 - 02.2016
Case Manager/Hospital Liaison
Ohio's Hospice
09.2012 - 08.2015
Clinical Nurse
Good Samaritan Hospital
06.2008 - 09.2012
Bachelor of Science - Nursing
Ohio University
Associate of Science - Nursing
Edison Community College
Associate of Science - Marketing
Sinclair Community College
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