Edeleine Exavier
N. Lauderdale,USA
Summary
Experienced Case Management Supervisor with strong background in overseeing and guiding case management teams. Skills include strategic planning, team leadership, and problem-solving coupled with a solid grasp of regulatory compliance related to case management processes. Proven record of implementing effective strategies that improve client outcomes and streamline operations. Committed to fostering an environment of continuous learning and improvement for case managers.
Overview
12
12
years of professional experience
Work History
CRS Case Management Supervisor (Shift Manager Nights Call taker)
Henderson Behavioral Health
Lauderdale Lakes, FL
10.2020 - Current
- Developed and maintained relationships with external stakeholders to ensure successful case management outcomes.
- Provided leadership, guidance, and supervision for a team of caseworkers responsible for managing complex cases.
- Managed the daily operations of the case management department including developing policies and procedures.
- Conducted performance evaluations for caseworkers to assess progress and identify areas for improvement.
- Analyzed data from case management initiatives to measure effectiveness and develop strategies for improvement.
- Created reports on caseloads, service utilization, program trends, and other relevant metrics.
- Collaborated with community partners to provide resources and services to clients in need.
- Monitored caseworker activities to ensure compliance with agency policies and applicable laws and regulations.
- Assisted in identifying potential funding sources to support ongoing case management efforts.
- Facilitated trainings for staff members on best practices related to client care coordination.
- Defined and applied utilization review methods to guarantee conformance with medical coverage plans.
- Collaborated with multidisciplinary team to establish record of comprehensive patient care plans.
- Streamlined discharge planning to create efficient, patient-oriented care strategies.
- Worked with management to optimize every aspect of patient care from clinical and administrative perspectives.
Desk Adjuster-Calls
Idah
Fort Lauderdale, FL
06.2023 - 01.2024
- Reviewed, evaluated and adjusted claims to promote fair and prompt settlement.
- Negotiated and settled claims according to information presented through reports, research, and data verification.
- Completed required investigations on referred files within established timeframes.
- Identified and obtained evidence to ascertain claim value.
- Drafted statement of loss to summarize damages, payments and underlying policy coverage.
- Communicated with personnel and legal counsel on claims involving litigation.
- Interviewed claimants, medical specialists and employers to determine pertinent claim information.
- Investigated questionable claims to determine payment authorization.
- Discovered occurrences of insurance fraud or criminal neglect to avoid workplace liability.
- Coordinated with law enforcement and other agencies as needed for claims investigation.
- Participated in training and mentoring of new claims adjusters, sharing knowledge and expertise.
Social Services Program Manager
Salvation Army
Fort Lauderdale, FL
05.2022 - 05.2023
- Developed project plans, identified risks, set objectives and monitored progress towards completion.
- Completed thorough opening, closing, and shift change functions to maintain operational standards each day.
- Implemented quality control measures to uphold company standards.
- Analyzed business performance data and forecasted business results for upper management.
- Evaluated individual and team business performance and identified opportunities for improvement.
- Organized team activities to build camaraderie and foster pleasant workplace culture.
- Created and managed budgets for travel, training, and team-building activities.
- Mediated conflicts between employees and facilitated effective resolutions to disputes.
- Recruited and trained new employees to meet job requirements.
- Assigned work and monitored performance of project personnel.
- Held regular one-on-one meetings with employees to review performance and priorities and provide feedback.
- Interviewed prospective employees and provided input to HR on hiring decisions.
- Reviewed completed work to verify consistency, quality, and conformance.
- Remained calm and professional in stressful circumstances and effectively diffused tense situations.
- Provided leadership, insight and mentoring to newly hired employees to supply knowledge of various company programs.
- Directed the development and maintenance of comprehensive program documentation, including plans, reports, and presentations.
Care Coordinator Manager (Health Homes Project)
Atlantic Group Staffing, Project Hospitality
Staten Island, NY
12.2019 - 03.2020
- Coordinated with other health professionals to develop individualized plans of care for patients.
- Provided case management services to ensure the delivery of quality care.
- Monitored and evaluated patient progress, adjusting treatment plans as needed.
- Maintained accurate client records in accordance with agency policies and procedures.
- Collaborated with physicians, social workers, and other healthcare providers to provide comprehensive care for patients.
- Assisted in the development of discharge plans for clients transitioning out of care programs.
- Facilitated referrals to community resources such as housing, transportation, employment opportunities.
- Ensured compliance with state regulations related to healthcare service provision.
- Attended meetings with families and other members of the interdisciplinary team to discuss patient progress and plan for future interventions.
- Provided crisis intervention services when needed.
- Maintained records management system to process personnel information and produce reports.
Court Liaison/Hospital Evaluator
Henderson Behavioral Health
Lauderdale Lakes, FL
02.2019 - 11.2019
- Provided administrative support to the court staff, including answering phones and responding to inquiries.
- Maintained communication with court personnel regarding court proceedings and case updates.
- Prepared legal documents for filing in accordance with applicable laws and regulations.
- Organized documents for submission to the court, ensuring accuracy of all information provided.
- Coordinated meetings between attorneys, judges, and other parties involved in a case.
- Attended judicial proceedings as needed to provide assistance or take notes during testimony.
- Managed the document production process by preparing exhibits, motions, orders, pleadings.
- Assisted attorneys in researching legal issues pertaining to their cases.
- Generated reports detailing case status and progress for review by court personnel.
- Communicated effectively with clients regarding upcoming hearings or changes in their cases.
- Facilitated communication between opposing counsels to resolve disputes outside of court.
- Facilitated settlement negotiations between parties involved in a dispute.
- Tracked exhibits admitted during court hearings and updated documentation.
- Analyzed qualitative and quantitative data to identify trends, patterns or correlations.
Case Manager
Henderson Behavioral Health
Lauderdale Lakes, FL
04.2017 - 02.2019
- Assessed clients' needs, developed service plans and monitored progress towards goals.
- Facilitated communication between clients, families, caregivers, social services and other agencies to ensure client needs were met.
- Provided crisis intervention support for clients in emergency situations.
- Conducted home visits to assess the safety of living environments for clients.
- Developed individualized care plans with input from clients and their families.
- Maintained accurate case records and documentation according to agency guidelines.
- Attended court hearings as a representative of the organization when needed.
- Provided referrals to appropriate health care providers or other community resources.
- Monitored client progress through regular follow-up contacts.
- Educated clients about mental health conditions, medications and self-care techniques.
- Coordinated transportation services for clients who lacked access to reliable transportation.
- Assisted with applications for government benefits such as Medicaid or Social Security Disability Insurance.
- Developed trusting relationships with social services, health care providers and governmental agencies.
- Maintained logs and electronic client records following department and agency policies for effective monitoring.
- Evaluated program effectiveness and suggested improvements based on client outcomes.
Child Protection Investigator
State of Florida Department of Children and Families
West Palm Beach, FL
07.2012 - 09.2016
- Conducted comprehensive investigations into allegations of child abuse and neglect, including interviewing victims, witnesses, and suspects.
- Collaborated with law enforcement agencies to ensure the safety of children in high-risk situations.
- Facilitated protective orders when necessary to provide a secure environment for the child and family.
- Developed case plans with families to ensure that all safety needs are met on an ongoing basis.
- Assessed home environments to determine if they are safe and suitable for children.
- Monitored court proceedings related to cases involving children and their families.
- Participated in multidisciplinary team meetings with other professionals involved in the case process.
- Conducted background checks on all individuals associated with a case file.
- Reported any evidence of child abuse or neglect that was discovered during investigations.
- Prepared court documents such as affidavits, petitions, motions, subpoenas.
- Coordinated placements for children removed from unsafe living environments into more secure settings.
- Remained composed and calm when interacting with individuals, taking into account that children and families were involved in high-stress situations.
- Maintained confidentiality through stringent handling of charts and data.
- Used job-related software to compose or prepare correspondence, case notes and technical reports
Economic Self-Sufficient Specialist I (ESSI)
State of Florida Department of Children and Families
Fort Lauderdale, FL
07.2012 - 04.2015
- Coordinated with other departments to ensure efficient workflow processes.
- Provided technical support for customers in resolving complex issues.
- Assisted in developing strategies to increase customer satisfaction levels.
- Analyzed data from customer surveys to identify trends in customer behavior.
- Utilized document management system to organize company files, keeping up-to-date and easily accessible data.
- Maintained positive working relationship with fellow staff and management.
- Implemented strategies to take advantage of new opportunities.
- Organized client meetings to provide project updates.
Education
Certification in Accounting - Accounting
Devry University
Chicago, IL03-2025
Certified 6-20 Insurance Claims Adjuster -
Florida Insurance College
Fort Lauderdale, FL06.2023
Master of Business Administration - Human Resource Management
American Intercontinental University
Weston, FL03.2020
Bachelor of Science - Criminal Justice
American Intercontinental University
Weston, FL11.2007
Associate in Science - Criminal Justice
Florida Metropolitan University
Pompano Beach, FL11.2004
Skills
- Recruitment
- Interdisciplinary Collaboration
- Program Development
- Documentation proficiency
- Crisis Intervention
- Progress Evaluations
- Decision-Making
- Case Management Tracking
- Data Entry and Analysis
- Conflict Resolution
- Strong written communication skills
- Strong verbal communication skills
- Excellent organizational skills
- Solution-oriented mindset
- Attention to detail
- Cultural competence
- Team Management
- Performance Tracking
Timeline
Desk Adjuster-Calls
Idah
06.2023 - 01.2024
Social Services Program Manager
Salvation Army
05.2022 - 05.2023
CRS Case Management Supervisor (Shift Manager Nights Call taker)
Henderson Behavioral Health
10.2020 - Current
Care Coordinator Manager (Health Homes Project)
Atlantic Group Staffing, Project Hospitality
12.2019 - 03.2020
Court Liaison/Hospital Evaluator
Henderson Behavioral Health
02.2019 - 11.2019
Case Manager
Henderson Behavioral Health
04.2017 - 02.2019
Child Protection Investigator
State of Florida Department of Children and Families
07.2012 - 09.2016
Economic Self-Sufficient Specialist I (ESSI)
State of Florida Department of Children and Families
07.2012 - 04.2015
Certification in Accounting - Accounting
Devry University
Certified 6-20 Insurance Claims Adjuster -
Florida Insurance College
Master of Business Administration - Human Resource Management
American Intercontinental University
Bachelor of Science - Criminal Justice
American Intercontinental University
Associate in Science - Criminal Justice
Florida Metropolitan University
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