EMMA QUAYE
Lavon
Summary
Dedicated Care Manager with expertise in developing patient care plans and coordinating multidisciplinary teams. Proven ability to enhance patient outcomes through targeted assessments and personalized intervention strategies. Proficient in effective communication and problem-solving, fostering improved patient satisfaction and efficient care processes.
Overview
11
11
years of professional experience
1
1
Certification
Work History
Care Manager – RN
BlueCross BlueShield
12.2017 - Current
- Conduct comprehensive assessments to evaluate medical, functional, psychosocial, and environmental needs.
- Develop, implement, and monitor person-centered service plans in alignment with member goals and regulatory requirements.
- Assess patient medical records and treatment plans to ensure care is medically necessary, appropriate and cost effective
- Coordinate home and community-based services (HCBS), including personal care, DME, therapy, transportation, and behavioral health.
- Establishing short and long-term goals in collaboration with members, caregivers, and family.
- Collaborate with providers, social workers, caregivers, and community agencies to ensure continuity of care.
- Manages members with chronic illnesses, co-morbidities, and/or disabilities, to ensure cost-effective and efficient use of health benefits.
- Ensure compliance with state Medicaid guidelines, CMS regulations, and health plan policies.
- Maintain accurate documentation within EHR and case management systems.
- Track patient outcomes and manage discharge planning for a smooth transition to home or other care settings
- Managed case reviews to ensure compliance with regulatory requirements and quality standards.
Registered Nurse
Baylor Institute of Rehab
11.2016 - 12.2017
- Provided care for patients with chronic, complex, and co-morbid conditions.
- Conducted health risk assessments and supported care transitions post-hospital discharge.
- Educated patients and caregivers on disease management, medication adherence, and self-care.
- Utilized critical thinking skills to assess changes in patient conditions, recognize complications, and intervene appropriately.
Staff Registered Nurse
Epic Health Services: Pediatric Home Health
05.2015 - 12.2017
- Conduct initial & ongoing comprehensive assessments; develop, implement, & update individualized care plans.
- Teach self-care, disease management, medication use, and preventive strategies to the patient and family
- Maintain accurate, detailed records of care, assessments, interventions, and teaching in compliance and regulations
Education
Bachelor of Science in Nursing - BSN
University of Texas
Arlington, Texas12-2017
Associate of Science - Nursing
El Centro College
Dallas, Texas, TX05-2015
Skills
- Epic MCG Care Management Platforms
- Microsoft Office Suite
- Discharge planning
- Utilization management
- Patient Advocacy
- Interdisciplinary collaboration
- Multitasking
- Time Management
- Strong communication and Interpersonal Skills
- Care planning
- Service coordination
- HIPAA guidelines
Certification
- Registered Nurse (RN), State of Texas, 2017.
- CCM
Timeline
Care Manager – RN
BlueCross BlueShield
12.2017 - Current
Registered Nurse
Baylor Institute of Rehab
11.2016 - 12.2017
Staff Registered Nurse
Epic Health Services: Pediatric Home Health
05.2015 - 12.2017
Bachelor of Science in Nursing - BSN
University of Texas
Associate of Science - Nursing
El Centro College