Brenda Dutan
Flushing,NY
Summary
Highly motivated professional with expertise in case management, care planning, and healthcare transformation. Strong understanding of care coordination, population health initiatives, and performance-based programs. Passionate about improving patient outcomes and enhancing provider efficiency through data-driven decision-making.
Overview
11
11
years of professional experience
Work History
Practice Transformation Facilitator
Cinq Care NY
03.2023 - Current
- Deliver scorecards and review performance metrics with practices and care teams to drive data-driven decision-making
- Identify performance gaps using report data and collaborate with providers to implement tailored solutions
- Prioritize key quality and utilization initiatives critical to success under performance-based programs, ensuring alignment with value-based care models
- Collaborate with internal teams to monitor and report key metrics for Medicaid VBP, Medicare ACO, and Health Homes, ensuring compliance and performance optimization
- Partner with third-party organizations, including health plans, to resolve operational and roster issues, streamlining provider participation in value-based programs
- Build trust-based relationships with practices and care teams to facilitate change management, engagement, and sustainability of population health initiatives
- Provide hands-on coaching and support to clinical and administrative teams, fostering a culture of continuous improvement and innovation
- Analyze practice workflows, identify inefficiencies, and recommend strategies for enhancing care coordination, patient outcomes, and provider efficiency
- Develop and implement action plans to improve quality measures, patient engagement, and cost-effectiveness across provider networks
- Obtain EMR access and provide support to close gaps in care
Value-Based Payment Case Manager
Vis A Vis Health
01.2023 - 03.2023
- Act as the primary liaison between Vis-Á-Vis Health and various insurance partners, managing relationships to optimize patient care outcomes
- Collaborate with providers to close care gaps assigned by insurance companies, ensuring compliance with healthcare standards and enhancing patient outcomes
- Oversee provider order processing, including lab work, durable medical equipment, home health orders, and other healthcare services, ensuring timely and accurate execution
- Conduct Pod meetings with providers, support staff, and lead supervisors to maintain open communication and provide quality care to patients
- Enhanced communication between clients and providers through consistent follow-ups and progress updates.
- Contributed to team discussions and case conferences actively, sharing insights and expertise with colleagues to optimize client support strategies.
Patient Care Coordinator
Heal Doctors
07.2022 - 12.2022
- Acted as the main point of contact for patients and doctors
- Coordinated individualized patient care and assisted with social, behavioral, and medical needs
- Assisted with scheduling imaging appointments, transportation referrals, and prior authorizations
- Conducted outreach to identify patients’ social determinants of health and referred them to appropriate social service programs
- Monitored care gaps and worked with providers to improve STAR ratings and health outcomes
Bilingual Intensive Care Coordinator
NADAP
10.2019 - 07.2022
- Managed a caseload of 35 high-risk clients and conducted comprehensive assessments
- Connected patients to medical, behavioral, and social services
- Developed client-centered care plans and used motivational interviewing for service engagement
- Conducted fieldwork, home visits, and crisis planning
Bilingual Care Coordinator
NADAP
03.2019 - 10.2019
- Managed a caseload of individuals with chronic/mental illness, developing care plans and coordinating services
- Managed patient caseloads effectively, ensuring timely follow-up and appropriate interventions.
- Maintained accurate and up-to-date documentation of patient records in accordance with HIPAA regulations.
- Coordinated discharge planning, ensuring a smooth transition from hospital to home or other facilities.
- Facilitated appointments and transportation for patients, streamlining access to essential medical services.
- Collaborated with social services to connect patients with resources for housing, nutrition, and financial assistance, improving their overall wellbeing.
- Conducted thorough assessments of patient needs to devise personalized care plans, addressing both health and social determinants.
- Reduced hospital readmission rates by coordinating effective post-discharge care plans.
- Conducted peer interviews and documented progress notes in EHR systems
Bilingual Service Coordinator
Los Ninos Services Inc
08.2017 - 03.2019
- Managed a caseload of 30-50 cases, providing early intervention services
- Assisted families in securing services for children and facilitated Individualized Family Service Plans.
- Assure timely documentation of care coordination activities via electronic database.
- Support families though the evaluation process and obtain proper services for eligible children.
- Advocate for children by monitoring the quality of services provided.
- Provide information on available services, resources and options.
Billing Associate
Los Ninos Services Inc
08.2014 - 07.2017
- Processed insurance claims, managed payments, and ensured data accuracy in multiple systems
- Acted as a liaison between the agency and insurance companies to resolve billing issues.
- Accurately apply and keep record of payments or denials.
- Maintaining consistent communication with the State Fiscal Agent outside agencies and service coordinators to obtain and correct information that can delay payments.
- Ensures timely data entry in various systems.
- Assist during department and company audit and special projects as needed.
- Process payments for independent therapists.
- Thoroughly investigated past due invoices and minimized the number of unpaid accounts.
Education
Bachelor of Arts - Sociology
Hunter College
New York, NY08-2017
Skills
- Strategic planning
- Critical thinking skills
- Strong knowledge of Early Intervention and Health Homes
- Articulate communication and relationship-building skills
- Expertise in electronic health records (EHR) systems
- Medical terminology and HIPAA compliance
- Value-Based Payment Model Knowledge
- Data security and confidentiality
- Change management and workflow optimization
- Bilingual: Spanish & English
- Knowledge of community services and programs
- Quality improvement and patient-centered care models
Languages
Spanish
Native or Bilingual
Timeline
Practice Transformation Facilitator
Cinq Care NY
03.2023 - Current
Value-Based Payment Case Manager
Vis A Vis Health
01.2023 - 03.2023
Patient Care Coordinator
Heal Doctors
07.2022 - 12.2022
Bilingual Intensive Care Coordinator
NADAP
10.2019 - 07.2022
Bilingual Care Coordinator
NADAP
03.2019 - 10.2019
Bilingual Service Coordinator
Los Ninos Services Inc
08.2017 - 03.2019
Billing Associate
Los Ninos Services Inc
08.2014 - 07.2017
Bachelor of Arts - Sociology
Hunter College
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