Juanita Stringer

Initial Seniority/Rehire Date: 02/08/2001.

• Performed telephonic consultations with DSNP members to facilitate service alignment and health risk evaluations.
• Formulated targeted questions, enabling Care Managers to create tailored care plans with members.
• Triaged misdirected calls to various departments as needed in a timely manner and with efficiency.
• Handled the management of high-volume inbound calls successfully while on the queue.
• Processed outbound, preview, and inbound calls with precision.
• Worked extensively with Outlook, Salesforce, and Med Compass software.
• Provided language support for members when necessary.
• Inquired about members' medical and functional status, healthcare services, medications, chronic conditions, pain management, living arrangements, and mental health.
• Executed tasks efficiently to fulfill daily audit and call metric goals.
• Utilized proficiency in customer relations and excellent computer skills to devise and implement effective solutions.

• Conducted authorizations via Dynamo, to include home health services, nursing facility admissions, and adult day care services.
• Transmitted approved service documentation to providers.
• Verified member eligibility via QNXT, VA DMAS portal.
• Utilized Daily Pro Fax and Dynamo for entering updates on member segments in the DMAS Medicaid system.
• Handled the management of high-volume inbound calls successfully while on the queue.
• Addressed inquiries from members and providers during calls.
• Efficiently routed phone calls to correct teams on time.
• Requested additional clinical information from home health providers, nursing homes, and skilled nursing facilities.
• Managed the daily Pro Fax assignment list in a timely manner.
• Assisted Transitional Care Coordinators with processing work for Hospice care, Nursing Facility and SNF admissions and discharges
• Proficiently managed tasks involving Cardinal Care Plus, Medallion, FIDE and DSNP programs.
• Maintained QuickBase tracking systems for CCC+ Waiver enrollments.
• Trained and guided newly recruited team associates.

• Provided administrative support to streamline case allocation in the Engagement Hub.
• Handled inbound calls for Medicare members in a dedicated queue line. Verified member eligibility with the plan.
• Utilized motivational interviewing techniques to engage members in the care management program.
• Managed emotionally sensitive members efficiently.
• Recorded detailed case data with precision and consistency.
• Collaborate with Community Care teams.
• Recognized improperly routed cases and escalated concerns to management.
• Managed benefit verification processes for CVS and Exxon Mobil employees.
• Processed and sent member-requested TPA and POA forms through the mailing platform.
• Assessed electronic records and routed to relevant regions.
• Utilized Med Compass, Clinical Engagement Console and Health Rules Payor system effectively.
• Aided in managing incoming referrals for case managers, Medical Directors, providers, and members.
• I precepted and shadowed new team associates to ensure a smooth transition.

• Gathered patient demographic data at registration.
• Secured eligibility, authorizations, precertification, and referrals for diagnostic evaluations.
• Facilitated pre-registration processes for patient admissions, surgeries, and onboarding.
• Transferred calls to corresponding departments as needed.
• Coordinated patient connections to financial counselors for essential assistance.
• Delivered support to diverse departments including ER, patient accounts, and registration.

• Secured accurate patient demographics along with confirming insurance coverage.
• Facilitated the acquisition of referrals, testing, medical records, and documentation from external sources.
• Acquired requisite authorizations from providers such as Medicare, Medicaid, managed care organizations, and more.
• Facilitated financial clearance for patients.
• Collected copayments and service payments in advance.
• Handled inbound calls efficiently on ACD line.