Camille Edosa
Maple Grove,US
Summary
Versatile professional skilled in investigations, case management, research and process improvements. With a focus on social service and criminal justice efforts to build awareness and equity within the community and throughout organizations.
Overview
23
23
years of professional experience
1
1
Certification
Work History
SDoH Program Manager
UnitedHealthcare
10.2022 - Current
- Ensure compliance of applicable federal/state regulations or contractual obligations
- Develop goals and objectives, track progress and adapt to changing priorities
- Respond to incoming calls from providers regarding claims inquiries and provide excellent customer service; document calls and interactions
- Managed and supervised administrative and daily program operations, complying with policies and regulations for Housing Stabilization authorization process
- Investigate complex Medicaid reimbursement cases of fraud, waste and abuse
- Assists in the reviews of state or federal complaints related to claims
- Supports other team members with several internal departments to determine appropriate resolution of issues
- Research tracers, adjustments, and re-submissions of claims
- Served as a liaison between patients, providers, insurers, and community resources to ensure optimal service delivery throughout the continuum of care.
- Reduced hospital readmission rates through effective discharge planning and coordination of Housing Stability services.
- Collaborate with other departments to address high volume of claims in a timely manner to ensure compliance to departmental turn-around time and quality standards
- Manage Housing Provider denied claims escalations by identifying and communicating error issues and potential solutions to management
- Handle special projects as assigned during revision
- Collaborates with a team of clinical and social support colleagues to meet the physical, behavioral health and long term service needs of each member
- Daily use of systems, ICUE, Community Care, Orbit, FACETS, MN ITS, HMIS and Client Track
- Championed patient advocacy, ensuring that the unique needs and preferences of each individual were respected and addressed throughout the care process.
- Supported organizational performance improvement initiatives by participating in data analysis, root cause identification, and action plan development efforts.
- Implemented new policies and educated staff on changes.
Diversity and Inclusion Engagement Specialist
Love Investments
09.2019 - 08.2022
- Assisted Diversity and Inclusion Director and Marketing team to prompt new strategies and ideas to build awareness and access to low income and diverse communities
- Networked with local organizations, leaders and consumers, resulting in establishment of new and lasting partnerships and relationships
- Connected individuals with available and relevant resources
- Acted as main point of contact between management, staffs and external community
- Wrote content for newsletters, social media pages and informational packets as directed by Executive Director
- Conducted community workshops with team lead to promote different programs and educate public on available services
- Documented and analyzed performance of different programs in order to make proactive decisions about services
- Facilitated community involvement and education of non-profit theatre events by maintaining and developing community partnerships to encourage connections
- Worked with senior case managers to coordinate team development activities and trainings
- Referred families to shelters, legal resources and educational programs
- Educated families and community members about the value of underserved populations experiencing unemployment
- Referred clients to appropriate team members, community agencies and organizations help achieve employment
- Planned marketing initiatives and leveraged referral network to promote business development
- Increased brand awareness by developing technical and non-technical marketing collateral and presentations, public relations campaigns, articles and newsletters
- Built strong relationships with clients through active listening and empathy, resulting in increased loyalty and retention.
- Continuously sought opportunities for professional growth by attending workshops, webinars, and training sessions relevant DEI work.
- Conducted regular follow-ups with clients to ensure satisfaction and address any concerns that may arise.
MnCHOICE Certified Assessor Social Worker 2 Temp.
Ramsey County Social Services
05.2019 - 09.2019
- Interviewed adults or children who may have a variety of mental, physical or behavioral limitations to determine service needs
- Collaborated with multidisciplinary teams to ensure appropriate care coordination and resource allocation for clients.
- Interviewed other persons or groups closely associated with clients, such as families, school personnel, employers, or neighbors to further assess client needs
- Investigated, document and present information to the County Attorney to petition juvenile, family, probate or criminal court for legal intervention, CPS, Law Enforcement and testify at proceedings as needed
- Provided crisis intervention services including referrals to meet emergency needs for housing, food, clothing or financial assistance
- Spoke to community groups to present information about programs and to recruit people to provide day care, foster care or various volunteer services
- Maintained accurate case records and complete forms for documentation of eligibility, treatment cost reimbursements, services referrals, evaluation of client outcomes and general case management purposes
- Managed a workload of 30-50 clients effectively by prioritizing tasks according to deadlines while maintaining attention to detail in all aspects of the case management process.
- Maintained up-to-date knowledge of Social Work best practices, attending professional conferences and participating in ongoing training opportunities.
- Trained in working with assessment and case management tools such as, SSIS, MMIS and MNCAT
- Experienced in working with diverse, low income populations experiencing homelessness, mental illness and trauma
Community Outreach and Connect Navigator
Vail Place
07.2018 - 03.2019
- Built network relationships with industry professionals to enhance community awareness and promote services
- Worked with senior case managers to coordinate resources for clients
- Supported clients who were dealing with medical concerns
- Advocated for clients that were experiencing trauma
- Worked with professionals in the Criminal Justice system to assist clients with background concerns
- Created holistic approach to better serve the whole individual
- Developed goals and case management plans for clients outcomes
- Encouraged and supported health and wellness habits and behavior
- Served as a liaison between the members and insurance companies, North Memorial Hospital staff and other external partners
- Provided educational material to help members better understand logistics
- Efficiently collected information using EPIC
- Exercised strong decision-making skills during high-stress emergency scenarios while adhering to company policies and procedures.
Relocation Case Manager Housing Specialist
Superior Health And Human Services
06.2016 - 01.2018
- Provided excellent customer service to clients
- Partnered with physicians, social workers, activity therapists, nutritionists and case managers to develop and implement individualized care plans
- Documented all patient interactions and interventions in electronic charting systems
- Maintained open communication with nursing facility social workers in order to ensure successful discharge
- Helped each client understand their goals with relocating and contributing personal, social and economic factors
- Referred clients to community resources and outside agencies, to assist with personal goals
- Maintained regular contact with clients, including visiting clients' homes
- Assisted clients with obtaining a drivers license, social security card and paper work to apply for MA to be found eligible for services
- Assisted and accompanied clients and families to court, legal appointments, health care meetings, public benefits and social or community agencies relative to client short- and long-term housing stabilization goals
- Referred families to shelters, legal resources and educational programs
- Coordinated individual referrals to obtain community services, advocated for client needs and resolved roadblocks
- Coordinated with local agencies to provide housing and prevent homelessness, decreasing homelessness
- Conducted home and apartment inspections to identify safety issues and needed repairs for successful placement
- Monitored ongoing cases closely, adjusting case management strategies as needed based on evolving circumstances or new information.
- Educated clients on available programs, benefits, and services, empowering them to make informed decisions about their care needs.
- Achieved positive client outcomes by developing and implementing comprehensive case management plans.
- Contributed to team discussions and case conferences actively, sharing insights and expertise with colleagues to optimize client support strategies.
Case Manager
All Home Care/ Temp Inc.
09.2001 - 09.2013
- Connected clients to community services and or resources
- Encouraged interpersonal and communication skills
- Developed activities that encouraged positive self reflection
- Taught problem solving
- Encouraged safety and boundary awareness
- Conducted thorough assessments of clients'' situations, identifying issues, goals, and necessary interventions.
- Assisted patients with daily living activities, promoting independence and wellbeing.
- Provided emotional support to patients and families during difficult times, fostering trust and rapport.
- Documented patient information accurately in electronic medical records, ensuring continuity of care among healthcare providers.
Education
Bachelor of Science - Criminal Justice
Metropolitan State University
Saint Paul, MN01.2014
Associate of Science - Social Work
North Hennepin Community College
Brooklyn Park, MN01.2012
Skills
- Time Management
- Referrals and Networking
- Culturally-Sensitive
- Excellent Written and Verbal communication
- Interviewing
- Case Management
- Organization and Multitasking
- Detailed Documentation And Reporting
- Client Advocacy
- Negotiation
- Process Improvement
- Critical Thinking
- Data Collection & Research
Certification
MnChoice Certified Assessor
Timeline
SDoH Program Manager
UnitedHealthcare
10.2022 - Current
Diversity and Inclusion Engagement Specialist
Love Investments
09.2019 - 08.2022
MnCHOICE Certified Assessor Social Worker 2 Temp.
Ramsey County Social Services
05.2019 - 09.2019
Community Outreach and Connect Navigator
Vail Place
07.2018 - 03.2019
Relocation Case Manager Housing Specialist
Superior Health And Human Services
06.2016 - 01.2018
Case Manager
All Home Care/ Temp Inc.
09.2001 - 09.2013
Associate of Science - Social Work
North Hennepin Community College
Bachelor of Science - Criminal Justice
Metropolitan State University
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