Latosha Forrest
Upper Darby,PA
Summary
Compassionate Case Manager, hardworking and dedicated to achieving desired case outcomes. Professional with experience advocating for individuals. Skilled at providing support, guidance and assistance. Knowledge of community resources and passion for helping others.
Overview
12
12
years of professional experience
Work History
Drug/Alcohol Case Manager
PMHCC
03.2022 - Current
- Coordinated services with other agencies, community-based organizations, and healthcare professionals to provide useful benefits to clients.
- Assisted clients in navigating housing, legal services and public benefits to gain access to valuable resources.
- Contributed to team discussions and case conferences actively, sharing insights and expertise with colleagues to optimize client support strategies.
- Referred clients to appropriate team members, community agencies and organizations to meet treatment needs.
- Collaborated with community members to develop and implement service initiatives.
- Developed comprehensive discharge plans to transition clients to appropriate service providers in community.
Service Coordinator/Case Manager
Patient Care Coordination
09.2019 - 03.2022
- Provided Service Coordination per MCO (Managed Care Organization – Pa Health Wellness) and LTSS (Long Term Services and Supports) process for Philadelphia and surrounding counties for Medicaid eligible participants for the disabled or aging population
- Assisted Medicaid eligible participants with Home and Community Based Services such as in home care, life alert system, home delivered meals, home adaptations, durable medical equipment, skilled nursing and several others
- Created and implements Person Centered Service Plan (PCSP)
- Established in person and telephonic comprehensive clinical assessment by measuring and assessing participants range of medical, physical and mental abilities
- Created state critical incidents per LTSS process by using Department of Public Welfare website (HCSIS)
- Provided face to face and telephonic investigation per LTSS process for all critical incidents
- Collaborated with Adult Protective Services and Older Adult Protective Services regarding all critical incidents of abuse, exploitation and neglect allegations
- Communicated with MCO (Managed Care Organization – Pa Health Wellness) via zoom to help with point of care and care gaps for participants
- Completed in person and telephonic monitoring visits with participants
- Establishes rapport with home care agencies.
Service Coordinator
CARE 365 INC.
09.2018 - 08.2019
- Coordinated frequency, amount and duration of services with the home care agency
- Coordinated home modifications, medical equipment requests, incontinence supplies, Moms Meals/Meals on Wheels requests, Medical and Non-Medical transportation and life alert services for the consumer
- Completed initial intake over the phone and quarterly/yearly home visits, yearly Plan of Care assessments and Person Centered Service Plans as well as monthly phone call monitoring with the consumer
- Reviewed the consumer plan using HCSIS, SAMS, ELTSS and Envolve online portals
- Assisted the consumer with Home and Community Based Services
- Educated the consumer on available services and self-direction
- Verify state waiver program eligibility for Obra waiver, Act 150 waiver and Comm Care waiver
- Responsible for assisting consumer with Managed Care Organization eligibility and services provided by Keystone Community Health Choices, UPMC and PA Health and Wellness
- Monitor and document consumer health, safety and welfare
- Developed crisis plan, individual back-up plan, emergency back-up plan and individual service plan for the consumer by the direction of their needs
- Provided the consumer with HIPPA rights and responsibilities, freedom of choice and service provider choice information
- Collaborated with OLTL (Office of Long Term Living) to meet the needs of the consumer.
Enrollment Specialist
Amerihealthcaritas
06.2012 - 09.2018
- Ensured accurate and timely processing of enrollment files and eligibility reports
- Worked several lines of business daily by validating member Medicaid eligibility for Indiana, Pennsylvania, District of Columbia and Kentucky
- Managed the member account by assigning a primary care physician using the provider portals
- Reviewed and completed provider panel transfers
- Retrieved and sent daily discrepancy reports to Kentucky and District of Columbia managed care organization
- Created and completed service requests
- Processed invalid member claims and claims encounters
- Resolved multiple monthly financial reports
- Reconciled monthly billing
- Trained new hires
- Attended weekly conference phone calls regarding claims encounters
- Aided check unit department by creating service forms for plan checks and provider checks
- Examined claims, checks and remittance advice for check unit department
- Reached out to primary care providers for updated provider information
- Maintained performance and quality standards.
Education
Associate of Arts - Culture, Science, Technology
Community College of Philadelphia
Philadelphia, PA05.2012
High School Diploma -
Frankford High School
Philadelphia, PA06.2000
Skills
- Communication skills
- Ability to Multi task
- Microsoft Word, Outlook, Excel
- Written Communication Skills
- Ability to organize workload/caseload
- Ability to set priorities and work under deadlines
Activities
Serve and participate in church functions and community events.
Timeline
Drug/Alcohol Case Manager
PMHCC
03.2022 - Current
Service Coordinator/Case Manager
Patient Care Coordination
09.2019 - 03.2022
Service Coordinator
CARE 365 INC.
09.2018 - 08.2019
Enrollment Specialist
Amerihealthcaritas
06.2012 - 09.2018
Associate of Arts - Culture, Science, Technology
Community College of Philadelphia
High School Diploma -
Frankford High School
Similar Profiles
Elvira RiveraElvira Rivera
Enhance Case Management Supervisor at PMHCCEnhance Case Management Supervisor at PMHCC
ANTHONY R. KOAMANTHONY R. KOAM
Team Lead at PMHCCTeam Lead at PMHCC
Stacy LazaroStacy Lazaro
Psychiatric Registered Nurse at PMHCC- CTTPsychiatric Registered Nurse at PMHCC- CTT