Summary
Overview
Work History
Education
Skills
Accomplishments
Received bonus for top territory scores & program compliance
Timeline
Generic

Cara L. Hayes

Louisville,Ky

Summary

Accomplished experienced professional with expertise established by management of complex caseloads connecting clients to resources. Proven ability to build and maintain productive relationships with patients, insurance plans, and healthcare providers. Skilled in analyzing and anticipating client needs, facilitating compassionate correspondence, and providing relationship management for the execution of patient-centered care.

Proven record of success in client correspondence implementing program requirements for personalized case management with detailed accuracy illustrating skilled knowledge of industry standards.

Overview

8
8
years of professional experience

Work History

Pharmacord Case Manager III

03.2021 - Current
  • Facilitate compassionate care for patients by providing access to therapy and resources via patient assistance. Managed over 50 customer calls per day. Increased productivity by 20%.
  • Communicate with patients and healthcare providers with in-depth knowledge of all program medications, including those outside the scope of case management.
  • Develop and present training materials to entire program.

03.2020 - 03.2021
  • Anthem HEDIS Project Management ascertained medical records via direct correspondence with healthcare providers utilizing Medicare compliance knowledge skills and detailed accuracy for obtaining records.

Benefits Verification Specialist

Amerisource Bergen Lash Group
08.2019 - 03.2020
  • Researched benefits and coverage information via correspondence with health care providers, insurance companies, and pharmacies. Provided detailed benefits and coverage information with accuracy.

Business Partner

Humana
03.2019 - 08.2019
  • Humana Licensure and Business Partner Compliance Professional investigated insurance sales allegations and transcribed recordings by creating formal, detailed, time stamped reports utilizing a learned skillset in Medicare and insurance compliance knowledge.

McKesson Case Manager

12.2018 - 03.2019
  • Facilitating prior authorizations/appeals providing performance excellence throughout broad scope of Medicare and insurance compliance utilizing professional relationship management skills via correspondence with health care providers.

Teleperformance Credit Card

USAA
05.2015 - 12.2018
  • Credit Card Specialist for USAA bank demonstrating Customer service excellence building professional relationships with members facilitating competent customer service excellence building professional relationships with USAA members.

Education

Bachelor's Degree - Women, Philosophy & Religious Studies, minors, Interdisciplinary Studies

University of Louisville
Louisville, KY

Skills

  • Proficient in
  • Microsoft Office, Excel, Guidance Care Portal, CORscend, MARS
  • Physician Finder, PA Hub, Argus, ESP, CCP, CRM, Mentor, Marx, and TFS
  • Customer Service excellence in critical thinking, analytical skills, problem
  • Solving, and follow up
  • Medicare, Medicaid, and insurance compliance knowledge
  • Direct Patient Care
  • Case Planning
  • Case Notes

Accomplishments

Given unique opportunity to transfer to a new case manager position facilitating direct care with patients.

Received bonus for top territory scores & program compliance

I received a bonus for being the top of the company case managers and was also offered a position for another program.

Timeline

Pharmacord Case Manager III

03.2021 - Current

03.2020 - 03.2021

Benefits Verification Specialist

Amerisource Bergen Lash Group
08.2019 - 03.2020

Business Partner

Humana
03.2019 - 08.2019

McKesson Case Manager

12.2018 - 03.2019

Teleperformance Credit Card

USAA
05.2015 - 12.2018

Bachelor's Degree - Women, Philosophy & Religious Studies, minors, Interdisciplinary Studies

University of Louisville
Cara L. Hayes