Carlie L. Hall
Wesley Chapel
Summary
Skilled collaborator, committed high achiever, and clinical and managed care professional with a proven record of effective cross-functional communication and solution-oriented thinking. Successful in implementing organization-wide care management and population health initiatives, cultivating strong leadership relationships to achieve organizational goals. Rapid and adaptive to change, seeking a leadership position at Centene to further contribute expertise and drive positive impact in the healthcare industry.
Overview
23
23
years of professional experience
1
1
Certification
Work History
RN Senior Care Manager
WellCare Health Plans Inc.
09.2013 - Current
- Offers remote education and support to Medicare/Medicaid communities.
- Facilitated team building to enhance colleague workflow efficiency.
- Exceeds Monthly Metrics and audits while following NCQA standards
- Reviews Medicaid Fee schedule with DME Providers and Medical staff
- Evaluates alignment of Medicaid and Medicare Providers with regulatory standards and evidence-based practices.
- Developed audit guidelines for team members.
- Guided compliance with appropriate HEDIS measures.
- Facilitates resolution of deficiencies affecting compliance with state and federal HEDIS standards.
- Supports deployment of Emergency Department Diversion program for KY Medicaid Market.
- Delivers Educational PowerPoint presentations to leadership team and staff during departmental meetings.
- Actively demonstrated strong leadership qualities as a valuable team resource.
- Supported oversight of Icario and Health Risk assessment efforts targeting KY market.
Senior Case Manager
Humana
01.2011 - 08.2013
- Provided case management, service collaboration and development of new resources to Medicare population
- Assisted managers and senior leadership in evaluating and improving performance, contributing to strategic program planning and development with six assigned management service organization within Tampa Bay market
- Trained new nurses in proper techniques, care standards, operational procedures, and safety protocols to optimize performance and safety
- Conducted presentations regarding Medicare changes at staff and senior management level
- Humana Star Award given by management for perfect service to members and quality improvement measures
RN Tele Health Coordinator Cardiopulmonary Team
Gentiva Health Services Inc.
07.2009 - 12.2010
- Triage patients nationwide remotely via tele monitoring systems and reported time sensitive information to Branch Directors daily via Microsoft Suite
- Discussed Plans of care with Branch Directors to have LPN sent to patients home for proper care daily
- Promoted evidenced based teaching to members that where in the Cardiopulmonary Pulmonary Program with CHF or HTN
RN ICU6 Month Contract
University Community Hospital
01.2009 - 06.2009
- Recorded patients' medical status and treatment details in electronic charts to accurately document medical care
- Observed patients' vital signs and administered physician-prescribed medications and treatments
- Monitored patients' respiratory status and ventilator operation and adjusted promote stabilization
- Participated in ICU departmental quality improvement initiatives to achieve higher standard of patient care
Staff RN Cardiac Surgical ICU
St. Joseph Hospital
02.2008 - 12.2008
- Provided care to post open heart surgery and pre and post cardiac catheterization patients
- Collaborated with cardiac thoracic surgeons and pulmonologists to implement and promote high level of care post-surgery
- Supported healthcare team by maintaining responsibility for electrocardiogram monitoring, defibrillation, and cardio rehabilitation training
Staff RN ICU Nurse
Florida Hospital
03.2006 - 12.2007
- Delivered outstanding patient care in16 bed critical care unit
- Resource Nurse assisted in implementation of new DNR policy and Comfort measures policy in ICU, CVICU and PCU
- Resource Nurse for prevention of Central Line Associated Blood Stream Infections (CLABSI) protocol and policy
Oncology Staff Registered Nurse III
H. Lee Moffitt Cancer Center and Research Institute Inc.
08.2001 - 02.2006
- Completed chemotherapy administration as dictated by physician's instructions on each patient's chart
- Implemented care plans for patient treatment after assessing physician medical regimens
- Active participant in Clinical Ladder Committee—Promoted twice; assisted RNs with their clinical ladder promotions
- Provided Lecture at SGNO National Conference in2004 In Miami on behalf of Moffitt
- Provided care for patients receiving brachytherapy and administered chemotherapy to patients in a24 bed Gynecological Thoracic Oncology unit
Education
Masters Science in Nursing - Public Health
Aspen University
Phoenix, AZ05.2023
Bachelor of Science - Nursing
University of South Florida
Tampa, FL08.2004
Associate of Science - Nursing
Hillsborough Community College
Plant City, FL05.2001
Skills
- Quality Improvement Initiatives
- Data Privacy Management
- Project Execution
- Strategic Development
- Strategic Policy Planning
- Proficient in Motivational Interviewing Techniques
- Proficient Clinical Decision-Making
- Chronic Illness Management
- Learning and Development Strategies
- Case Management
Certification
Certified Case Manager (CCM)
Affiliations
- The National Society of Leadership and Success (NSLS)
- American Association of Managed Care Nurses (AAMCN)
Timeline
RN Senior Care Manager
WellCare Health Plans Inc.
09.2013 - Current
Senior Case Manager
Humana
01.2011 - 08.2013
RN Tele Health Coordinator Cardiopulmonary Team
Gentiva Health Services Inc.
07.2009 - 12.2010
RN ICU6 Month Contract
University Community Hospital
01.2009 - 06.2009
Staff RN Cardiac Surgical ICU
St. Joseph Hospital
02.2008 - 12.2008
Staff RN ICU Nurse
Florida Hospital
03.2006 - 12.2007
Oncology Staff Registered Nurse III
H. Lee Moffitt Cancer Center and Research Institute Inc.
08.2001 - 02.2006
Bachelor of Science - Nursing
University of South Florida
Associate of Science - Nursing
Hillsborough Community College
Masters Science in Nursing - Public Health
Aspen University