Carolyn Bentley
Case Managment
jacksonville,FL
Summary
Dynamic healthcare professional with extensive experience at Centene-Sunshine Health, excelling in personalized care planning and patient navigation. Proven ability to enhance patient satisfaction through effective communication and resource identification. Skilled in EMR documentation and committed to improving healthcare access and outcomes for diverse populations.
Overview
26
26
years of professional experience
Work History
Senior Care Navigator/Case Manager
Centene-Sunshine Health
06.2024 - Current
- Assesses, plans, implements, and coordinates care management activities based on member needs to provide quality, cost-effective healthcare outcomes.
- Develops or contributes to the development of a personalized care plan/service plan for members and educates members and their families/caregivers on services and benefit options available to improve health care access and receive appropriate high-quality care through advocacy and care coordination.
- Develops or contributes to the development of ongoing care plans/service plans and works to identify providers, specialists, and/or community resources needed for care.
- Coordinates and manages as appropriate between the member and/or family/caregivers and the care provider team to ensure identified services are accessible to members in a timely manner.
- Reviews referrals information and intake assessments to develop or assist in the development of appropriate care plan/service plan for members with higher level of care needs.
- Monitor progress towards care plans/service plans goals and/or member status or change in condition and collaborates with healthcare providers for care plan/service plan revision or address identified member needs, refer to care management for further evaluation as appropriate.
- Provides psychosocial and resource support to members/caregivers, and care managers to access local resources or services such as employment, education, housing, food, participant direction, independent living, justice, foster care) based on service assessment and plans.
- Collaborates with healthcare partners as appropriate to facilitate member care to ensure member needs are met and determine if care plan/service plan revision is needed.
- Collects, documents, and maintains all member information and care management activities to ensure compliance with current state, federal, and third-party payer regulators.
- Other duties or responsibilities assigned by people’s leader to meet the member and/or business needs.
- Comply with all policies and standards.
Care Navigator LPN
Optimize Health
Seattle
10.2023 - 04.2025
- Reviewed care plans with pediatric as well as geriatric patients and hosted monthly calls to document progress and advancements.
- Met team goals and standards outlined in metrics.
- Identified opportunities for expansion with remote care programs based on patients' needs.
- Worked with pediatric (12–18 years old) and geriatric populations, providing support tailored to their developmental and health needs.
- Managed a caseload of 20–40 patients at any given time, conducting over 250 monthly outreach calls to ensure continuous engagement and follow-up.
- Assessed patient community needs across key areas such as food security, housing stability, educational support, and medical care.
- Developed individualized care plans, accordingly, collaborating closely with healthcare providers, including nephrologists, cardiologists, pediatricians, and other specialists to coordinate comprehensive resources and support services.
- Significantly impacted longitudinal patient engagement in remote care programs.
- Educated families on pediatric illnesses, the specific needs of their child, and available community and medical resources to support ongoing care and overall well-being.
- Provided documentation to the patient relevant to the care plan and helped coordinate care and the next steps.
- Led collaborative wellness calls with patients to define health goals outlined by their Care Team.
- Documented required information in the Electronic Medical Record (EMR) systems, including EPIC and CERNER.
- Managed patient messaging.
- Directed patients to the treating providers for routine questions.
- Met patient engagement program goals.
- Escalated urgent care needs to the patient’s provider and directed the patient to 911/ER as appropriate for emergency medical assistance.
- Seattle, WA (Remote)
LPN Virtual Nurse
Banyan Medical Systems
Omaha
05.2022 - 10.2023
- Established connections with patients and family caregivers before, during, and after provider visits as required for appointment types, utilizing technology to perform tasks.
- Educated patients and families/caregivers about the nature of diseases, pediatric illnesses, the specific needs of their child, and available community and medical resources, and provided instructions based on providers’ treatment plans.
- Provided care coordination and support for a diverse patient population, including pediatric patients (ages 3 months to 18 years) and geriatric patients.
- Managed a caseload of approximately 50 patients, ensuring consistent follow-up, needs assessments, and resource connections.
- Obtained pertinent information from patients and family caregivers during appointments, following protocols for each appointment type.
- Documented required information in the Electronic Medical Record (EMR), including reason for visit, medication reconciliation, allergy information, family history concerns, and vital signs.
- Contact patients before visits to ensure smooth telehealth experiences.
- Utilized patient charts to manage admissions and discharges efficiently.
- Coordinated appointment times with patients, family caregivers, and clinic staff to align with clinic schedule templates.
- Informed and updated providers and staff of schedule changes on time.
- Provided professional nursing care to patients per providers' orders and established policies and procedures.
- Maintained quality and safety control standards.
- Omaha, Nebraska (Remote work from home)
Nurse Care Manager (Telehealth/Remote work from home)
Truepill
Hayward
03.2021 - 05.2022
- Worked collaboratively with team members to provide outreach and engagement with patients.
- Worked with geriatric patients, providing age-appropriate support and care coordination.
- Provided patient assistance and advocacy for clients and families regarding entitlements and access to community services.
- Worked closely with in-office providers and staff members to manage day-to-day calls with enrolled patients, addressing symptom control, medication management, patient and family education, health maintenance reminders, medication refills, and referral coordination.
- Received and responded to telephone calls from patients.
- Documented required information in the Electronic Medical Record (EMR).
- Triaged patient needs and provides medical guidance as instructed by the patient’s provider.
- Documented calls according to established guidelines and protocols.
- Connected the patient's care team with updated information as received.
- Participated in education and in-service programs to support ongoing professional development.
- Hayward, California
Bariatric/Telehealth, Nurse
Mayo Clinic
11.2018 - 03.2021
- Worked collaboratively with team members to provide outreach and engagement with patients.
- Supported a broad patient population, working with pediatric patients (ages 5–18), adults, and geriatric patients across various care needs.
- Managed a caseload of 50–70 patients, making approximately 50–70 outreach calls daily to assess needs, provide education, and ensure continuity of care.
- Accurately documented all required patient information and interactions in Electronic Medical Record (EMR) systems, including EPIC and Cerner.
- Provided patient assistance and advocacy to clients and families for entitlements and access to community services.
- Worked closely with in-office providers and staff members to manage day-to-day calls with enrolled patients, addressing symptom control, medication management, patient and family education, health maintenance reminders, medication refills, and referral coordination.
- Received and responded to telephone calls from patients.
- Triaged patient needs and provides medical guidance as instructed by the patient’s provider.
- Documented calls according to established guidelines.
- Connected the patient's care team with updated information as received.
- Participated in education and in-service programs to support ongoing professional development.
Associate Care Provider
Baptist Medical Center
04.2015 - 11.2018
- Provided and documented patient care under the direct supervision of a Registered Nurse.
- Collected and documented data needed for patient assessments.
- Supported and protected the rights of each patient, treating all patients with dignity and care while maintaining confidentiality and privacy.
- Committed to patient safety initiatives, including fall prevention, restraint protocols, and compliance with National Patient Safety Goals.
- Provided appropriate patient and family education under department and hospital policies and procedures.
- (Neuro ICU)
Certified Nursing Assistant
Brooks Rehabilitation Hospital
03.2012 - 04.2015
- Provided and documented patient care under the direct supervision of a Registered Nurse.
- Collected and documented data needed for patient assessments.
- Supported and protected the rights of each patient, treating each patient with dignity and care while maintaining confidentiality and privacy.
- Committed to patient safety initiatives, including fall prevention, restraint protocols, and adherence to National Patient Safety Goals.
- Provided appropriate patient and family education under department and hospital policies and procedures.
- (Spinal Cord)
Owner/Director (Remote work from home)
Bentley Family Daycare
01.2000 - 03.2012
- Taught, educated, and monitored children as needed, fostering a positive environment throughout the school.
- Developed and trained staff to enhance performance and efficiency.
- Promoted the positive image of the company, playing a key role in making the company the provider of choice for educational programs in the communities served.
Education
Diploma - Practical Nursing
Florida State College of Jacksonville
Jacksonville, FL05-2014
Associate’s degree - Psychology
Liberty University
Lynchburg, VA11-2012
Skills
- Microsoft Word
- Excel
- Microsoft Outlook
- Epic
- Cerner
- Patient Navigation
- TrueCare
- Allscripts
- Case management
- EMR documentation
- Personalized care planning
- Healthcare policy compliance
- Telehealth support
- Healthcare systems
- Patient confidentiality
- Problem solving
- Team collaboration
- Healthcare
- Medical recordkeeping
- Community resources
- Resource identification
- Medical insurance
- Records management
- Medical records management
- Improve patient care
- Patient Satisfaction Metrics
- Attention to detail
- Multitasking Abilities
- Clinical data entry
- Appointment confirmation
- Heartsaver CPR AED
- Multitasking capacity
- Building rapport and credibility
- Computer literacy
- Patient rights
- Insurance verifying
- Problem-solving
- Professional bedside manner
- Patient documentation
- Communicating to patients and families
- Detail-oriented
- Customer service
- Active listening
- Critical thinking
- Health Insurance Policies
- Professional networking
- Reliability and dedication
- Heartsaver first aid CPR AED (first aid CPR AED)
Time Off
None
Interview Availability
Anytime with prior notice of 48 hours
Compact License
Licensed Practical Nursing Compact License, Florida, California, New York, Rhode Island, Oregon, Massachusetts, Connecticut, Washington State, Nevada
Timeline
Senior Care Navigator/Case Manager
Centene-Sunshine Health
06.2024 - Current
Care Navigator LPN
Optimize Health
10.2023 - 04.2025
LPN Virtual Nurse
Banyan Medical Systems
05.2022 - 10.2023
Nurse Care Manager (Telehealth/Remote work from home)
Truepill
03.2021 - 05.2022
Bariatric/Telehealth, Nurse
Mayo Clinic
11.2018 - 03.2021
Associate Care Provider
Baptist Medical Center
04.2015 - 11.2018
Certified Nursing Assistant
Brooks Rehabilitation Hospital
03.2012 - 04.2015
Owner/Director (Remote work from home)
Bentley Family Daycare
01.2000 - 03.2012
Diploma - Practical Nursing
Florida State College of Jacksonville
Associate’s degree - Psychology
Liberty University