Caseyvette Reyes

Providing LTSS community-based services. Conduct Assessments with eligible participants to identify individual needs including personal assistance services, home adaptations behavioral health, and physical health.

• Maintain a caseload of 70+ participants and ensure a 95% compliance rate.
• Proactive in critical situations by providing emergency resources. Expertise and experience to address the needs of the Long-Term Services and Support population.
• Assisted with training. associates as tasked.
• Conduct onsite critical incident investigations.
• Document critical incident reports (hospitalizations, abuse, exploitation, or neglect) in the HCSIS/EIM system to maintain accurate records.

• Assisted patients in navigating the healthcare system, helping them resolve medical bills inside and outside of Oak Street Health (advocate for the patients).
• Explained eligibility details and affordability options to patients.
• Organized timely and accurate referrals for access to available resources they may not be aware of.
• Managed welcome visits and the orientation process for new Oak Street Health patients by tracking the process to confirm demographic and insurance information, as well as the completion of onboarding forms.
• Verified patient insurance during the admissions processes through OneSource, HS Connect, and PEAR systems.
• Served as an internal resource in the clinic on insurance questions for physicians and staff.
• Supported the clinic management team on operational activities as needed, including scheduling, and billing.

• Monitored documentation procedures to maintain consistent policies and current records.
• Recognized by supervisor for maintaining accurate and timely records despite 70 participant caseload.
• Kept track of the caseload with completion of the Annual Comprehensive Needs Assessment, Biannual Plan of Care Review, and Quarterly Monitoring Calls for each participant throughout the year.
• Created service authorizations for in-home services, and submitted them in a timely manner to prevent service gaps.
• Fulfilled timely Trigger Event Identification and Critical Incident Reporting into the Enterprise Incident Management (EIM) in the HCSIS database.
• Provided excellent service and attention to participants, whether face-to-face or through phone conversations.
• Gathered community resources and coordinated referrals to obtain services.

• Coordinated support services and optimized communication between healthcare workers and clients.
• Determined and coordinated appropriate level of care to meet individual client needs. Including meal plans and home services.
• Managed all logistics for abuse and neglect cases from start to finish by conducting home visits and observing client's overall health.
• Collaborated with different disciplines to provide cohesive care to clients.
• Reviewed and recorded progress of clients.
• Assisted clients in receiving high-quality, appropriate care with best possible results.