Myosha Milburn
Pearland,Texas
Summary
Medical management professional with comprehensive experience in coordinating healthcare services and optimizing patient care workflows. Skilled in utilizing medical software, analyzing data for quality improvement, and ensuring compliance with healthcare regulations. Strong focus on team collaboration, adaptability, and achieving measurable results. Known for effective communication, problem-solving abilities, and proactive approach to evolving healthcare needs.
Overview
8
8
years of professional experience
Work History
Medical Management Specialist II
Elevance Health
01.2023 - Current
- Company Overview: DSNP/Medicare
- Process hospital discharge to ensure timely and efficient transitions for patients
- Access and manage electronic medical records, maintaining accurate patient data
- Develop and implement complex discharge plans in collaboration with case managers
- Coordinate discharges between members and case managers, enhancing communication and workflow
- Collaborate with Independent Practice Associations (IPAs) to manage inpatient stays
- DSNP/Medicare
Medical Management Specialist II
Elevance Health
02.2020 - 01.2023
- Company Overview: MMP
- Managed a team of 6, focusing on performance improvement and staff development
- Approved Long-Term Services and Supports (LTSS), including various care services, ensuring compliance with regulations
- Trained associates for service approval processes, fostering a knowledgeable team environment
- Assisted case managers with comprehensive assessments, contributing to better care planning
- MMP
Clerical Support/Admin Assistant II
Harris Center
05.2018 - 02.2020
- Managed clinical flow by pulling charts, sorting and filing medical records, and organizing clerical resources
- Handled scheduling, reporting, and inventory management to support clinic operations
Customer Care Representative Team Lead
Conduent/Humana
09.2016 - 05.2018
- Led a team of 10-15 agents, providing training and mentorship to new associates
- Conducted retraining sessions for staff based on performance audits and improvement opportunities
- Resolved escalated issues and processed overrides on pharmacy claims
- Assisted members in coordinating their Medicare and pharmacy benefits
Education
Bachelor of Science - Health
Prairie View A&M University
Prairie View, Texas05.2016
Skills
- HIPAA compliance
- Healthcare analytics
- Microsoft office
- Patient care coordination
- Utilization review
- Teamwork and collaboration
- Multitasking Abilities
- Effective communication
- Adaptability and flexibility
- Electronic health records
Accomplishments
- Supervised a team of 6 staff members.
- Achieved excellent patient care through effectively helping with discharge follow-ups.
- Supervised team of [Number] staff members.
Timeline
Medical Management Specialist II
Elevance Health
01.2023 - Current
Medical Management Specialist II
Elevance Health
02.2020 - 01.2023
Clerical Support/Admin Assistant II
Harris Center
05.2018 - 02.2020
Customer Care Representative Team Lead
Conduent/Humana
09.2016 - 05.2018
Bachelor of Science - Health
Prairie View A&M University
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