Summary
Highly experienced healthcare worker whose outstanding performance led to a steady rise in responsibilities and promotions, and has positively impacted both health care organizations and the many patients served. Gifted with a calming and intelligent presence, a professional whose communication skills are equally effectively with encouragement or difficult messages to both team members and patients, enabling them to understand and benefit from the information. Committed to organizational improvement by introducing innovative management tools and methods that increase efficiency and effectiveness. A reliable, well-liked professional who adds significant value to every team and organization served. Skilled Patient Care Coordinator familiar with case management and care planning. 20+year history as Registered CNA working in busy healthcare settings prior to transitioning into administrative roles. Comprehensive understanding of care spectrum and processes for care coordination.
Overview
30
30
years of professional experience
Work History
Patient Care Advocate Coordinator
BJC HealthCare
03.2023 - Current
- Develop, implement, and oversee the hospital's patient advocacy program
- Establish and maintain policies and procedures to ensure effective advocacy for patients
- Monitor and evaluate the program's effectiveness and make necessary adjustments
- Recruit, train, and supervise a team of patient advocates
- Provide ongoing support, guidance, and professional development opportunities for team members
- Conduct performance evaluations and offer constructive feedback
- Serve as the primary point of contact for patients and families seeking assistance with healthcare-related concerns
- Ensure that patient complaints and grievances are addressed promptly and effectively
- Advocate on behalf of patients to resolve issues and improve their hospital experience
- Work closely with healthcare providers, administrators, and other hospital staff to address patient concerns and promote patient-centered care
- Facilitate communication between patients, families, and healthcare teams
- Participate in hospital committees and meetings to represent the patient perspective
- Develop and deliver training programs for hospital staff on patient rights, communication skills, and advocacy best practices
- Raise awareness about the patient advocacy program and its benefits to patients and staff
- Maintain accurate records of patient interactions, complaints, and resolutions
- Prepare regular reports on patient advocacy activities, trends, and outcomes
- Analyze data to identify areas for improvement and recommend solutions
- Ensure that patient advocacy activities comply with relevant laws, regulations, and hospital policies
- Stay current with changes in healthcare regulations and best practices related to patient advocacy.
Customer Service Representative/SME
Magellan Health
09.2021 - Current
- Handle a high volume of inbound calls related to prior authorization requests from healthcare providers and patients
- Verify insurance coverage and medical necessity for requested services
- Accurately document and track authorization requests in the system
- Maintain in-depth knowledge of prior authorization processes, insurance requirements, and medical guidelines
- Act as the go-to expert for complex inquiries and issues related to prior authorizations
- Provide detailed information and support to healthcare providers and patients regarding authorization status and requirements
- Ensure all prior authorization activities comply with relevant regulations and payer policies
- Maintain accurate and thorough documentation for all authorization requests and communications
- Develop and deliver training programs for new and existing team members on prior authorization processes and best practices
- Share insights and best practices with the team to improve efficiency and service quality
- Provide exceptional customer service to patients and healthcare providers, addressing their inquiries and concerns promptly and effectively
- Educate patients and providers on the prior authorization process and requirements
- Resolve escalated issues related to prior authorizations in a timely manner
- Identify recurring issues and suggest improvements to streamline the prior authorization process
- Collaborate with cross-functional teams to implement solutions and enhance operational efficiency
- Participate in the development and refinement of prior authorization protocols and procedures.
Patient Care Technician/Preceptor
Texas Health Resources
12.2019 - 06.2020
- Assist patients with activities of daily living, including bathing, dressing, grooming, and feeding
- Measure and record vital signs, such as blood pressure, temperature, pulse, and respiration
- Assist with mobility, including turning, positioning, and transporting patients
- Perform basic medical procedures, such as taking blood samples, inserting catheters, and providing wound care
- Monitor and report changes in patient condition to nursing staff
- Train and mentor new patient care technicians, providing guidance and support as they learn job duties
- Develop and deliver orientation programs and training sessions for new hires
- Demonstrate best practices in patient care and adherence to hospital protocols
- Evaluate the performance of new technicians, providing feedback and recommendations for improvement
- Foster a supportive learning environment that encourages questions and continuous learning
- Work closely with nurses, doctors, and other healthcare professionals to ensure comprehensive patient care
- Communicate effectively with patients and their families, providing information and reassurance
- Participate in team meetings and contribute to discussions about patient care and departmental improvements
- Maintain accurate and timely documentation of patient care activities and observations
- Complete necessary reports and logs as required by hospital policies
- Assist with data collection for quality improvement initiatives
- Adhere to hospital policies, procedures, and protocols to ensure patient safety and quality care
- Follow infection control guidelines and safety procedures
- Participate in mandatory training sessions and continuing education to stay current with best practices.
Patient Care Technician
Texas Health Presbyterian
03.2018 - 03.2020
- Assist patients with activities of daily living, including bathing, dressing, grooming, and feeding
- Measure and record vital signs, such as blood pressure, temperature, pulse, and respiration
- Assist with mobility, including turning, positioning, and transporting patients
- Perform basic medical procedures, such as taking blood samples, inserting catheters, and providing wound care
- Monitor and report changes in patient condition to nursing staff
- Train and mentor new patient care technicians, providing guidance and support as they learn job duties
- Develop and deliver orientation programs and training sessions for new hires
- Demonstrate best practices in patient care and adherence to hospital protocols
- Evaluate the performance of new technicians, providing feedback and recommendations for improvement
- Foster a supportive learning environment that encourages questions and continuous learning
- Work closely with nurses, doctors, and other healthcare professionals to ensure comprehensive patient care
- Communicate effectively with patients and their families, providing information and reassurance
- Participate in team meetings and contribute to discussions about patient care and departmental improvements
- Maintain accurate and timely documentation of patient care activities and observations
- Complete necessary reports and logs as required by hospital policies
- Assist with data collection for quality improvement initiatives
- Adhere to hospital policies, procedures, and protocols to ensure patient safety and quality care
- Follow infection control guidelines and safety procedures
- Participate in mandatory training sessions and continuing education to stay current with best practices.
Customer Service Associate
Teladoc Health
09.2018 - 01.2020
- Handle a high volume of inbound and outbound calls to schedule, reschedule, and cancel patient appointments
- Verify patient information and insurance details, ensuring accurate data entry into the scheduling system
- Coordinate appointments with various departments, providers, and facilities to optimize scheduling efficiency
- Maintain in-depth knowledge of the scheduling system, medical services offered, and provider availability
- Act as the go-to expert for resolving complex scheduling issues and answering advanced queries from patients and staff
- Provide detailed information to patients regarding appointment preparations, requirements, and follow-up procedures
- Deliver exceptional customer service by addressing patient inquiries, concerns, and complaints promptly and professionally
- Educate patients on the scheduling process and any relevant policies or procedures
- Resolve escalated issues related to scheduling in a timely and effective manner
- Assist in developing and delivering training programs for new and existing scheduling staff
- Mentor new team members, providing guidance and support as they learn scheduling procedures and best practices
- Share insights and best practices with the team to improve overall efficiency and service quality
- Identify recurring issues and suggest improvements to streamline the scheduling process
- Collaborate with cross-functional teams to implement solutions and enhance operational efficiency
- Participate in the development and refinement of scheduling protocols and procedures
- Maintain accurate records of all scheduling activities and communications
- Prepare and present reports on scheduling performance, trends, and areas for improvement to management
- Analyze data to identify patterns and recommend solutions to enhance scheduling processes.
Lab Assistant/Phlebotomist
Family Healthcare
10.2016 - 03.2018
- Perform venipunctures, finger sticks, and heel sticks to collect blood samples from patients of all ages
- Ensure proper identification of patients and labeling of specimens to maintain accuracy and traceability
- Apply infection control and safety protocols to prevent contamination and ensure patient safety
- Prepare and process blood samples for laboratory testing, including centrifuging and aliquoting as needed
- Ensure proper storage and transportation of specimens to maintain their integrity
- Perform basic laboratory tests and procedures under the supervision of a certified medical technologist or laboratory manager
- Greet patients warmly and verify their identity before collecting specimens
- Explain procedures to patients and address any questions or concerns to ensure their comfort and cooperation
- Provide post-procedure care, such as applying bandages and giving instructions for aftercare
- Maintain cleanliness and organization of the laboratory and phlebotomy area
- Monitor and restock supplies, ensuring all necessary equipment is available and in good working condition
- Perform routine maintenance and calibration of laboratory equipment as required
- Accurately document patient information, specimen details, and test results in the laboratory information system
- Report any discrepancies, unusual findings, or issues to the laboratory manager or supervisor
- Assist in the preparation of lab reports and ensure timely communication of results to healthcare providers
- Adhere to all laboratory protocols, safety guidelines, and regulatory requirements
- Participate in continuing education and training to stay current with best practices and advancements in phlebotomy and laboratory procedures
- Handle biohazardous materials and dispose of waste according to established protocols.
Regional Manager
Pinnacle Medical Management
12.2012 - 10.2017
- Oversee daily operations within the region to ensure efficiency and compliance with DOT regulations
- Implement and enforce company policies and procedures
- Ensure all testing sites within the region maintain high standards of service quality and accuracy
- Stay current with DOT regulations and ensure all regional activities comply with these standards
- Conduct regular audits and inspections to maintain compliance
- Provide training and support to staff on DOT regulations and company policies
- Recruit, train, and manage a team of supervisors and technicians
- Foster a positive and productive work environment
- Set performance goals, conduct evaluations, and provide ongoing feedback and development opportunities
- Build and maintain strong relationships with clients to understand their needs and ensure satisfaction
- Address client inquiries and resolve issues promptly and effectively
- Collaborate with the sales team to identify opportunities for new business within the region
- Prepare and manage the regional budget
- Monitor financial performance and implement cost control measures
- Generate reports on regional performance and present findings to senior management
- Identify and pursue opportunities to expand services and grow the client base within the region
- Develop and implement regional business strategies in alignment with company goals
- Monitor market trends and competitor activities to stay competitive
- Provide regular updates to senior management on regional performance, challenges, and opportunities
- Ensure effective communication within the region and with other departments
- Maintain accurate records and documentation for all regional activities.
Education
High school diploma or equivalent; completion of a state-approved nursing assistant training program. -
- Certified Nursing Assistant (CNA) or equivalent certification. Basic Life Support (BLS) certification required.
- EPIC
- Management
- CNA
- Dialysis
- EMR
- Cerner
- Excel
- Employee Orientation
- Laboratory Experience
- Customer Service
- Triage
- MEDICAL TERMINOLOGY
- Medical Office Experience
- Vital Signs
- Call Center
- MICROSOFT OFFICE
- EKG
- PCT
- Administrative Experience
- Injections
- Medical Records
- Customer Care
- Scheduling
- Patient Care
- Medical Terminology
- English
- Fluent CERNER
- Critical Care Experience
- Phlebotomy
- CSR
- Venipuncture
- CERNER
- Medicaid
- MICROSOFT OFFICE Microsoft office
- Hospital Experience
- Intoximeter
- Microsoft Word
- Epic
- Customer service
- Vital signs
- Physical examinations
- Microsoft Excel
- Supervising experience
- ICD-9
- ICD-10
- Minimum of 2 years of experience as a patient care technician or nursing assistant. Previous experience as a preceptor or trainer preferred.
Skills
- Customer-Centric: Passionate about providing exceptional customer service and enhancing the patient and provider experience
- Detail-Oriented: Strong attention to detail in documenting and processing prior authorization requests
- Team Player: Ability to work collaboratively with team members and other departments
- Adaptability: Flexibility to handle changing priorities and work in a fast-paced environment
- Integrity: Upholds the highest standards of professionalism and ethical behavior
- Documentation
- HIPAA Compliance
- Proficient in excel
- Proficient in microsoft excel
- Clinical Quality Program Standards
- Monitoring tools
- Organizational Skills
Certification
- ASCP Certification
- AED Certification
- Certified Phlebotomy Technician
- First Aid Certification
- CNA
- BLS Certification
- State Tested Nursing Assistant
- CPR Certification
Personal Information
Work Permit: Authorized to work in the US for any employer
Timeline
Patient Care Advocate Coordinator - BJC HealthCare
03.2023 - Current
Customer Service Representative/SME - Magellan Health
09.2021 - Current
Patient Care Technician/Preceptor - Texas Health Resources
12.2019 - 06.2020
Customer Service Associate - Teladoc Health
09.2018 - 01.2020
Patient Care Technician - Texas Health Presbyterian
03.2018 - 03.2020
Lab Assistant/Phlebotomist - Family Healthcare
10.2016 - 03.2018
Regional Manager - Pinnacle Medical Management
12.2012 - 10.2017
- High school diploma or equivalent; completion of a state-approved nursing assistant training program.,