Laura Perez-Garcia
Danielson,CT
Summary
Professional Case Manager experienced in coordinating care and advocating for social and economic well-being of individuals and families. Strong communicator with passion for helping others. Skilled at providing guidance, support and assistance. Excellent time management and problem-solving skills.
Overview
13
13
years of professional experience
Work History
Customer Service & Operations Manager
Voltage Styles
Worester, MA
05.2015 - Current
- Oversaw business budget planning and administration, purchasing, and bi-weekly payroll to include all financial needs.
- Scheduled employees for shifts, taking into account customer traffic and employee strengths.
- Recruited, hired, and managed personnel, while working to establish key internal functions and outline scope of positions.
- Supervised creation of exciting merchandise displays to catch customer's attention.
- Tracked employee attendance and punctuality, addressing repeat problems quickly to prevent long-term habits.
- Increased sales by 39% with special displays and promotions.
Bilingual Case Management Navigator
Fallon Health
Worcester, MA
03.2013 - 12.2019
- Provided case management and health services oversight to clients of senior, disabled, behavioral health, substance abuse, and homeless population of NaviCare program.
- Managed panel of 129-154 members needing case management services.
- Completed intake, needs/care assessment, crisis intervention, advocacy, referral, and monitoring of ongoing care.
- Partnered with physicians, social workers, activity therapists, nutritionists, and case managers to develop and implement individualized care plans and documented patient interactions and interventions in electronic charting systems.
- Identified care needs of individual patients and coordinated responses based on physician advice, insurance limitations, and procedural costs. of
- Coordinated care,community-based services, conducted telephonic and face-to-face health assessments to determine level of care needed by clients.
- Adhered to ethical principles and standards to protect clients' confidential information.
- Maintained up-to-date case records with case activity status.
- Communicated with social services agencies and community partners/key stakeholders, regarding client cases.
- Monitored clients' progress and tracked client services to provide crisis interventions.
- Collaborated with an interdisciplinary team to determine timely delivery of services
Bilingual Customer Service, Team Lead Support
Fallon Health
Worcester, MA
03.2011 - 05.2013
- Provided managed care and benefits information to members enrolled in Government Employees, Medicaid, or Medicare Advantage plans.
- Managed from 75 - 100 inbound/outbound calls daily.
- Researched from 50 - 70 claims or benefits-related cases daily.
- Investigated and resolved health plan members' inquiries, complaints, and claims issues in timely manner, while demonstrating empathy.
- Requested prior authorizations for outpatient and inpatient care.
- Followed up with members about resolved benefits or plan issues to maintain high standards of customer service.
- Cross-trained and provided backup support for organizational leadership.
- Trained new personnel regarding company operations, policies, and services.
Education
Bachelor of Arts - Human Services-Enrolled
Southern New Hampshire University
Hooksett, NHHigh School Diploma -
Richland Northeast High School
Columbia, SCAssociate of Arts - Human Services
Monroe College
The Bronx, NYSkills
- Community Outreach
- Client Advocacy
- Documentation and Reporting
- Crisis Intervention
- Excellent Verbal and Written Communication
- Care Coordination, Care Plan Creation, and Discharge Planning
- Home Visits and Health/Needs Assessments
- Emotional Awareness
- Progress Evaluations Understanding
- EMR / EHR (Epic)
- Bilingual English/Spanish
- Strong Leadership Skills
- Chronic Disease Management and HEDIS Outreach
- Regulatory Compliance
- Customer Service
- Problem-Solving
Timeline
Customer Service & Operations Manager
Voltage Styles
05.2015 - Current
Bilingual Case Management Navigator
Fallon Health
03.2013 - 12.2019
Bilingual Customer Service, Team Lead Support
Fallon Health
03.2011 - 05.2013
Bachelor of Arts - Human Services-Enrolled
Southern New Hampshire University
High School Diploma -
Richland Northeast High School
Associate of Arts - Human Services
Monroe College
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