DEBORAH ECKLUND
DeLand,FL
Summary
Experienced RN Case Management leader with progressive responsibility across Medicaid and managed care environments. Proven success leading NCQA audits, supervising and developing RN teams, authoring and revising policies and procedures, and implementing quality measures to ensure regulatory compliance, operational excellence, and improved member outcomes. Recognized for collaborative leadership, audit readiness, and driving performance aligned with organizational and payer requirements. Seeking a Manager-level RN Case Management role (remote or hybrid).
Skilled professional ready to excel in leadership role with focus on results-driven performance. Proven ability to streamline operations and foster team collaboration to achieve organizational goals. Known for reliability and adaptability in meeting changing demands while maintaining high standards.
Overview
26
26
years of professional experience
1
1
Certification
Work History
Supervisor, Case Management
Interwell Health / Fresenius
06.2021 - Current
- Provide day-to-day leadership and operational oversight for an RN Case Management team supporting complex care populations.
- Lead NCQA audits and payer reviews, serving as primary driver for annual audit readiness, documentation compliance, and corrective action follow-up.
- Author, review, and revise case management policies and procedures to align with NCQA standards, regulatory requirements, and evolving organizational initiatives.
- Lead implementation of quality measures and performance initiatives, ensuring workflows, documentation, and staff practices meet required benchmarks.
- Oversee implementation and ongoing management of a Complex Care Management program, including staff training, monitoring outcomes, and continuous process improvement.
- Provide leadership coaching through structured 1:1s, team meetings, and performance evaluations to drive accountability and professional growth.
- Monitor caseloads, care plans, and outcomes to ensure member-centered care aligned with organizational mission and standards.
- Serve as a subject matter expert for case management systems, reports, and applications.
- Collaborate cross-functionally and with payers to support program initiatives, reporting requirements, and quality improvement efforts.
Supervisor, Case Management
Centene (formerly WellCare)
05.2019 - 06.2021
- Supervised 17 RN Case Managers supporting a Medicaid Managed Specialty Program serving 500+ members.
- Ensured compliance with regulatory reporting requirements, audits, and performance metrics across the case management team.
- Provided leadership in staff development, workflow optimization, and quality monitoring.
- Partnered with internal stakeholders to align clinical operations with state and payer expectations.
Case Manager
Centene (formerly WellCare)
07.2018 - 05.2019
- Managed a caseload of medically fragile pediatric Medicaid members.
- Coordinated multidisciplinary care including home health, DME, transportation, and care planning.
- Completed Enhanced Care Coordination reports submitted to AHCA.
Senior Nursing Supervisor, Case Management
Children’s Medical Services (Merged with WellCare)
01.2018 - 07.2018
- Supervised 8 Nurse Care Coordinators for a Medicaid managed specialty program.
- Served as QI Team Leader, supporting HEDIS measures and audit performance.
- Maintained strong audit outcomes through proactive monitoring and staff education.
- Functioned as Medical Foster Care On-Call RN; CMAT trained.
School Nurse
Helping Hands School
NY
05.2012 - 06.2016
- Provided nursing care for children with complex medical and behavioral health needs.
- Coordinated therapies and multidisciplinary services.
- Served as Medicaid Compliance Officer, supporting documentation and regulatory adherence.
Registered Nurse
Saratoga Hospital
NY
07.2011 - 05.2012
- Med-Surg / Post-Operative Care
Registered Nurse
Albany Medical Center
NY
09.2010 - 09.2011
- Pediatric Oncology / Hematology
Office Manager
PageOne Financial
NY
08.2000 - 01.2011
- Managed daily operations and supervised 10 staff members, including financial advisors.
- Oversaw audits, client accounts, and financial operations.
Education
Bachelor of Science in Nursing - Nursing
Russell Sage College
12.2010
Skills
- RN Case Management Leadership
- NCQA & Regulatory Audit Leadership
- Policy & Procedure Development and Revision
- Quality Measure & Performance Improvement Implementation
- Medicaid & Managed Care Programs
- Staff Supervision, Coaching & Development
- Complex Care & Population Health Management
- Cross-Functional & Payer Collaboration
- Compliance, Reporting & Metrics Oversight
- Training and mentoring
- Goal oriented
- Complex Problem-solving
- Strategic planning
Certification
- Registered Nurse (Compact License)
- Florida RN License #RN9432075
- New York RN License #641016
- Certified Case Manager (CCM) #4239925
Timeline
Supervisor, Case Management
Interwell Health / Fresenius
06.2021 - Current
Supervisor, Case Management
Centene (formerly WellCare)
05.2019 - 06.2021
Case Manager
Centene (formerly WellCare)
07.2018 - 05.2019
Senior Nursing Supervisor, Case Management
Children’s Medical Services (Merged with WellCare)
01.2018 - 07.2018
School Nurse
Helping Hands School
05.2012 - 06.2016
Registered Nurse
Saratoga Hospital
07.2011 - 05.2012
Registered Nurse
Albany Medical Center
09.2010 - 09.2011
Office Manager
PageOne Financial
08.2000 - 01.2011
Bachelor of Science in Nursing - Nursing
Russell Sage College