Emilie Bell

• Supported inpatient case management operations by ensuring accurate case entry, documentation, and care coordination activities in EZ-CAP.
• Tracked and obtained clinical records for hospital admissions, ensuring compliance with outreach and documentation protocols.
• Assisted with discharge planning by coordinating with hospitals, providers, and care teams to support safe and timely transitions of care.
• Secured discharge summaries from hospitals and ensured timely post-discharge documentation to promote continuity of care.
• Collaborated with Transition of Care (TOC) teams to document discharge information, coordinate primary care follow-up appointments, and address post-discharge needs.
• Conducted outbound outreach to members, providers, hospitals, and facilities to enhance care coordination and ensure adherence to documentation and quality standards.

· Coordinate any data extractions to support provider offices with gap closure in external quality platforms, i.e. Second Wave, Cozeva, etc.

· Communicated monthly reports to providers and staff on membership, AWE completion, STARS, and HEDIS measure scores, implementing plans to enhance scores as needed.

· STARS, HEDIS submission including but not limited to planning, preparation, data collection, clinical analysis, and care improvement initiatives.

· Educate providers regarding STARS, HEDIS.

· Provide all necessary reports, audit, and provider performance results to Client and Company's leadership team.

· Assist with timely supplemental data collection and Health Plan submission in the correct format with confirmation of receipt.

· Tracked data errors between provider EMR/paper charts, Ezcap, and Cozeva, reporting findings to team for resolution.

· Support Annual Wellness Claims process with risk adjustment coders.

· Contributed to improved patient experience and satisfaction through quality coordination efforts.

· Collaborated with other team members to enhance project outcomes.

Performs other duties as assigned