BUDDY-ANN WARD
PARRISH,FL
Summary
Proactive, detail and goal-oriented professional with excellent Communication, time management, project management and problem-solving skills. Tech-savvy with hands-on experience in emerging technologies and passion for continuous improvement. Known for reliability and adaptability, with swift capacity to learn and apply new skills. Proven ability to handle multiple tasks effectively and efficiently in fast-paced environments. Recognized for taking proactive approach to identifying and addressing issues, with focus on optimizing processes and supporting team objectives.
Overview
25
25
years of professional experience
1
1
Certification
Work History
Case Manager/Utilization Management
Simply Healthcare
03.2017 - Current
- Complete 10 -12 utilization reviews daily: ICD 10, CPT, HCPCS, verify insurance eligibility and benefits.
- Communicate with providers & third party vendors in appeals process.
- Maintain HIPAA guidelines, accurate documentation on all cases, ensuring compliance with regulations and confidentiality requirements.
Complex Case Manager
Amerigroup Inc
11.2015 - 03.2017
- Worked remotely with medical teams, patients and families to implement effective treatment plans for monthly management of 30 assigned members.
- Advocate for members to receive quality, timely and cost-effective care.
- Educate members on navigating medical benefits effectively
- Collaborated with healthcare providers to drive continuity of care.
Humana Cares Manager
Humana Inc
06.2011 - 11.2015
- Assist 30 assigned members to identify needs, and provide resources to achieve management of personal health goals monthly.
Substitute School Nurse
Manatee County School Board
04.2007 - 07.2011
- Developed strong relationships with diverse student populations, fostering trust in the nurse''s office as a safe space for support and assistance while enhancing student health and well-being.
Per Diem Float Staff Nurse
Manatee County Rural Health Services
07.2005 - 07.2011
- Rotation in Family practice, internal medicine, acute care, obstetrics and gynecology, podiatry, general surgery, and infectious disease as needed.
- Coordinate care with Specialist, pharmacy and support team.
- Obtain prior authorizations for procedures, consults and medications.
Per Diem Staff Nurse
Blake Medical Center
07.2000 - 06.2005
- Enhanced patient care by implementing evidence-based nursing practices and maintaining up-to-date knowledge on industry advancements.
- Reduced medication errors by diligently reviewing and verifying physician orders before administering treatments.
- Coordinated with case managers and social workers to connect patients with appropriate community resources upon discharge from the hospital setting.
Education
Master of Science - Nursing Leadership And Management
Post University
Waterbury, CT01-2025
BSN -
University of South Florida
Tampa, Florida08.2010
Associates Degree - Nursing
Manatee Community College
Bradenton, Florida1994
Skills
- Certified Case Manager
- Time management
- Attention to detail
- Email and telephone etiquette
- Documentation proficiency
- Data entry and analysis
- MS office
- Utilization management
- Chronic disease management
- EMR / EHR
- HIPAA compliance
- Excellent verbal and written communication
- Insurance regulations
- Utilization criteria
Certification
- Certified Medical Reimbursement Specialist certification - will complete in 2months
- Certified Case Manager, Commission for Case Management Certification: 2014 - 2029
- Registered Nurse License: 1994 - 2026
Timeline
Case Manager/Utilization Management
Simply Healthcare
03.2017 - Current
Complex Case Manager
Amerigroup Inc
11.2015 - 03.2017
Humana Cares Manager
Humana Inc
06.2011 - 11.2015
Substitute School Nurse
Manatee County School Board
04.2007 - 07.2011
Per Diem Float Staff Nurse
Manatee County Rural Health Services
07.2005 - 07.2011
Per Diem Staff Nurse
Blake Medical Center
07.2000 - 06.2005
Master of Science - Nursing Leadership And Management
Post University
BSN -
University of South Florida
Associates Degree - Nursing
Manatee Community College
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