Job Search Status
Open to workDesired start date: 2 weeks notice
Desired Job Title
Case ManagerQASWork Type
Full TimeLocation Preference
HybridRemoteOn-SiteLocation: Keizer, OR, US
Open to relocation: Yes
Open To Work
Danielle Mathes
Keizer,OR
Work Preference
Summary
Results-driven case management professional with a track record of effective client service planning, advocacy, and support. Experienced in conducting thorough assessments and creating individualized care plans to meet client needs. Collaborates seamlessly with multidisciplinary teams and adapts to dynamic situations to ensure optimal client outcomes.
Overview
18
18
years of professional experience
Work History
Case Manager
Northwest Senior And Disability Services
04.2023 - Current
- Coordinated services and care plans for seniors and individuals with disabilities.
- Assessed client needs through comprehensive interviews and evaluations.
- Collaborated with healthcare providers to implement supportive services.
- Prioritized and organized tasks to accomplish service goals.
- Monitored changes in applicable laws, regulations, policies, and procedures affecting service eligibility.
- Granted, modified, denied, or terminated assistance based on key information and eligibility determination.
- Participated in professional conferences and workshops to enhance knowledge.
- Interpreted federal guidelines pertaining to eligibility determination procedures.
- Prepared written responses addressing questions raised by external auditors concerning eligibility determination.
PAS
Salem Health
04.2018 - 03.2023
- Managed patient registration and verification processes for seamless access to services.
- Maintained accurate patient records and ensured compliance with HIPPA privacy regulations.
- Utilized electronic health record systems to update and retrieve patient information promptly.
- Scheduled imaging appointments using electronic health record systems.
- Coordinated scheduling of appointments with various departments within the hospital.
- Participated in ongoing training sessions related to new technologies or software updates impacting hospital processes.
- Coordinated with medical staff to ensure efficient patient flow.
PAR
Adventist
08.2015 - 04.2018
- Registered patients by completing face-to-face interviews to obtain demographic, insurance, and medical information.
- Provided excellent customer service to patients and families in person and on the phone.
- Verified patient insurance information and eligibility for services.
- Assisted patients with understanding financial responsibilities and payment options.
- Collected and processed patient registration forms and co-payments efficiently.
- Obtained necessary signatures for privacy laws and consent for treatment.
- Scheduled patient appointments and managed daily Urgent Care and Primary Care clinic calendars.
- Applied HIPAA privacy and security regulations while handling patient information.
- Stayed current on community-based resources and services useful to patients.
QAS
Albertina Kerr Centers
10.2008 - 08.2018
- Developed and implemented quality assurance policies and procedures.
- Conducted quality audits to ensure compliance with organizational and regulatory standards, identifying areas for improvement.
- Coordinated with cross-functional teams to address quality issues and implement corrective actions.
- Consulted with management and personnel to educate on quality assurance standards.
- Prepared reports to communicate results of quality assurance activities and audit results.
- Determined training needs of staff and organized training interventions to achieve quality standards.
- Assisted in developing training materials related to core competencies and quality assurance topics.
- Facilitated training sessions for staff on core competencies and quality assurance topics.
- Maintained knowledge of current industry developments and regulatory requirements for quality assurance purposes.
Education
Nursing
Clackamas Community College
Oregon City, ORHigh School Diploma - undefined
Colton High School
Colton, ORSkills
- Case Management
- Service intakes
- Care needs assessments
- Risk assessments
- Community referrals
- Community resources
- Service eligibility determinations
- Effective verbal and written communication
- Cross-functional collaboration
- Advocacy
- HIPPA monitoring and compliance
Accomplishments
Achieved case load stability coming out of a public health emergency and Covid. This was achieved through continuous quality reviews, ongoing maintenance of cases, and rewriting/redoing all service plans. This ensured compliance compliance with the State of Oregon and Federal operation regulations.
Languages
English
Native or Bilingual
Timeline
Case Manager
Northwest Senior And Disability Services
04.2023 - Current
PAS
Salem Health
04.2018 - 03.2023
PAR
Adventist
08.2015 - 04.2018
QAS
Albertina Kerr Centers
10.2008 - 08.2018
High School Diploma - undefined
Colton High School
Nursing
Clackamas Community College