Jessica Lee
Lynnwood,WA
Summary
Accomplished healthcare program professional with a focus on complex care management for Medicaid and Medicare populations. Specializes in developing individualized care plans, ensuring compliance with regulations, and enhancing member outcomes through effective interdisciplinary collaboration and community partnerships.
Overview
13
13
years of professional experience
Work History
Health Home Care Coordinator
Molina Healthcare of Washington
King County, WA
12.2023 - Current
- Manage a caseload of 45–50 Medicaid and Medicare members with complex chronic medical conditions, behavioral health diagnoses, and substance use disorders.
- Conduct comprehensive clinical assessments while ensuring compliance with Health Home program requirements, state regulations, and required assessment timelines.
- Develop individualized care plans and measurable member goals while coordinating transitions of care following emergency department visits and inpatient hospitalizations.
- Address social determinants of health through member education, resource coordination, strategic planning, and collaboration with internal and community partners.
- Serve as the Health Home Program subject matter expert during multidisciplinary care team meetings, providing guidance regarding program requirements, continuity of care, and care coordination best practices.
- Collaborate with providers, hospitals, caregivers, DME providers, housing agencies, transportation services, state agencies, and community organizations to improve healthcare outcomes.
- Analyze member needs, identify barriers to care, and coordinate interdisciplinary interventions that improve continuity of care and healthcare access.
Intensive Mental Health Case Resource Manager
Washington State Department of Social and Health Services Developmental Disabilities Administration
Snohomish County , WA
10.2022 - 08.2023
- Managed a complex caseload of 25 - 30 clients with developmental disabilities, behavioral health conditions, and significant mental health needs.
- Conducted comprehensive state assessments and developed individualized service plans while maintaining compliance with required regulatory timelines.
- Led interdisciplinary care coordination meetings involving hospitals, behavioral health providers, state agencies, caregivers, law enforcement, and community organizations to develop coordinated care strategies.
- Acted as resource on DDA program requirements, eligibility, waivers, and community partners to enhance client access to services.
- Collaborated with contracted providers to facilitate continuity of care and expedite access to essential services for clients.
- Audited and authorized provider payments while ensuring compliance with state policies and program requirements.
- Resolved complex care coordination challenges through proactive communication and conflict resolution, ensuring effective cross-functional collaboration.
Secondary Level Special Education Teacher
Mercer Island School District
01.2018 - 06.2022
- Implemented district-wide behavioral intervention program, enhancing educational outcomes and fostering inclusive learning environments.
- Collaborated with behavioral consultants and multidisciplinary teams, improving program implementation and serving as middle school subject matter expert.
- Case managed 20 - 25 students while developing legally compliant, data-driven Individualized Education Programs (IEPs).
- Facilitated multidisciplinary meetings involving families, administrators, therapists, and educational staff to coordinate services and ensure compliance with state and federal regulations.
- Supervised and trained paraeducators, coordinating schedules and instructional responsibilities to optimize student support.
- Participated in cross-functional initiatives to improve curriculum, behavioral interventions, and social-emotional learning.
Instructional Assistant
Overlake Hospital Specialty School
11.2015 - 08.2017
- Facilitated therapeutic educational services for K–12 students facing significant behavioral and mental health challenges.
- Implemented crisis intervention and de-escalation techniques, incorporating Cognitive Behavioral Therapy (CBT) and Dialectical Behavior Therapy (DBT) principles while collaborating with interdisciplinary care teams to enhance student support.
Certified Behavior Technician
Sum of Learning LLC
10.2013 - 08.2017
- Delivered Applied Behavior Analysis (ABA) therapy for pediatric patients in home and community settings.
- Collected, analyzed, and documented behavioral data to support individualized treatment plans and monitor patient progress.
- Prepared detailed written progress reports and collaborated with Board Certified Behavior Analysts (BCBAs), families, and multidisciplinary care teams.
- Trained newly hired Behavior Technicians on treatment protocols, documentation practices, and best practices for patient care.
Education
Masters in Teaching - Special Education & English Language Arts
Seattle Pacific University
Bachelor of Arts - Early Childhood and Family Studies
University of Washington
Skills
- Healthcare Program Management
- Case Management and Care Coordination
- Empathy and Patience
- Behavioral Health
- Cross-functional Collaboration
- Stakeholder Engagement
- Quality and Compliance
- Data Analysis and Documentation
- Training and Education
- Resource management
- Social work
Timeline
Health Home Care Coordinator
Molina Healthcare of Washington
12.2023 - Current
Intensive Mental Health Case Resource Manager
Washington State Department of Social and Health Services Developmental Disabilities Administration
10.2022 - 08.2023
Secondary Level Special Education Teacher
Mercer Island School District
01.2018 - 06.2022
Instructional Assistant
Overlake Hospital Specialty School
11.2015 - 08.2017
Certified Behavior Technician
Sum of Learning LLC
10.2013 - 08.2017
Masters in Teaching - Special Education & English Language Arts
Seattle Pacific University
Bachelor of Arts - Early Childhood and Family Studies
University of Washington