Lauren Pickens
Little Rock,AR
Summary
Highly-motivated & operations-minded professional with strong work ethic, adaptability, exceptional communication skills seeking an organization that puts quality care first. Efficient operations and creative team building specialist to thrive in fast-paced and changing environments. Dedicated to sustaining operational accuracy and delivering results for optimal quality care and profitability.
Overview
13
13
years of professional experience
1
1
Certificate
Work History
Care Coordination Manager of Operations
CareSource
Little Rock, AR
06.2021 - Current
- Developed and implemented operational procedures to ensure quality standards are met.
- Monitored and improved efficiency of processes, team performance, and customer service.
- Directed care coordination and customer service staff by providing guidance, training, and support in order to meet company objectives.
- Produced SOPs to document workplace procedures and optimize productivity through standardization.
- Collaborated with team leaders on quality audits.
- Improved morale and management communication by creating employee recognition and rewards practices.
- Presented performance and productivity reports to supervisors.
- Coordinated with other departments including quality assurance, marketing, finance, human resources. to ensure efficient operations.
- Led cross-functional teams in problem-solving activities related to process improvements.
- Developed key performance indicators to measure effectiveness of operational processes.
- Implemented innovative strategies that reduced overall costs while maintaining high levels of customer satisfaction.
- Managed staffing needs through recruitment, selection, onboarding and training, disciplinary action as necessary.
- Supervised day-to-day workflow of employees in order to maximize productivity and maintain quality standards.
- Directed day-to-day operations by spearheading implementation of short-term and long-term strategies to achieve business plan and profitability goals.
- Built strong operational teams to meet process and production demands.
- Motivated and evaluated personnel for performance improvement and goal achievement.
- Developed initiatives for process improvement and reviewed and assessed ongoing operations.
- Anticipated and tracked operational and tactical risks to provide strategic solutions.
- Crafted operations best practices using audits and project management team feedback.
- Prepared staff work schedules and assigned team members to specific duties.
Director of Care Coordination Operations
Empower Healthcare Solutions
Little Rock, AR
01.2021 - 06.2021
- Developed and implemented operational plans to ensure efficient use of resources and effective service delivery across the area.
- Coordinated with internal stakeholders to develop policies, procedures, and strategies for improving operational efficiency.
- Monitored performance of care coordination and initial engagement teams to evaluate effectiveness of processes and identify areas for improvement.
- Conducted regular meetings with staff to review progress on goals and objectives.
- Identified training needs of staff members based on job roles and responsibilities.
- Ensured compliance with applicable laws, regulations, standards, policies, procedures and guidelines.
- Analyzed data related to performance metrics including customer satisfaction ratings and adherance to deadlines around ongoing contact and health assessments.
- Resolved conflicts between team members by providing constructive feedback.
- Performed regular audits of operations activities to identify potential issues or risks.
- Established key performance indicators for measuring success of care coordination and initial engagement teams.
- Established operational guidelines and identified opportunities for improvement.
- Assessed and evaluated business procedures and implemented structure to improve day-to-day operations.
- Recognized employees for demonstrating excellent service resulting in increased company morale.
- Communicated clear and consistent messages regarding departmental goals to produce desired results.
- Assessed reports and adjusted workflows to realign with targets.
- Successfully improved employment turnover through creating incentive and training programs.
- Delegated work to staff, setting priorities and goals.
Care Coordination Supervisor
Empower Healthcare Solutions
Little Rock, AR
04.2018 - 12.2020
- Supervised and evaluated care coordination staff in accordance with organizational policies and procedures.
- Developed and implemented strategies to ensure the highest quality of service delivery to clients.
- Assessed client needs, identified goals, developed plans of care, and provided supervision for implementation of services.
- Monitored staffing levels to ensure adequate coverage for clientele base.
- Conducted regular meetings with staff to discuss performance issues or changes in policy and procedures.
- Collaborated with other healthcare providers such as physicians and physical therapists to coordinate patient care activities.
- Provided orientation training for new employees on policies and procedures relevant to their job duties.
- Developed employee work schedules that ensured efficient utilization of personnel while meeting patient needs.
- Ensured compliance with applicable local, state and federal laws and regulations concerning care coordination of mental and physical healthcare services.
- Maintained a current knowledge of trends and developments in the field of healthcare.
- Evaluated employee performance regularly and provided feedback on areas needing improvement or reinforcement.
- Represented organization at professional conferences and meetings related to care coordination and mental health topics.
- Listened to customer feedback and responded to maintain or improve processes.
- Collaborated with staff members to plan training seminars and team-building events.
Utilization Management Specialist
Beacon Health Options
Little Rock, AR
06.2017 - 04.2018
- Performed concurrent reviews of inpatient admissions, ensuring appropriate level of care was provided.
- Conducted pre-certification reviews for elective services to ensure appropriateness of care.
- Collaborated with physicians, hospitals, and other providers to facilitate timely resolution of utilization management issues.
- Assessed requests for out-of-network services to determine if they meet medical necessity criteria.
- Prepared reports summarizing utilization patterns, outcomes, and quality measures.
- Participated in interdisciplinary meetings to discuss patient care plans and review medical records.
- Maintained accurate documentation of all utilization management activities.
- Reviewed claims for accuracy prior to submission for payment processing.
- Assisted with developing new strategies for improving workflow efficiency in the utilization management department.
- Collaborated with providers to obtain required clinical information, supporting prior authorization determinations and individual inquiries.
- Applied medical criteria and clinical judgement to researched cases to evaluate and establish determinations.
- Responded to emergency situations with speed, expertise and level-headed approaches to provide optimal care, support and life-saving interventions.
- Advocated for patient needs with interdisciplinary team and implemented outlined treatment plans.
- Referred patients to specialized health resources or community agencies to furnish additional assistance.
- Assisted in coordinating discharge planning for patients leaving acute care settings.
- Conducted follow up calls to assess the effectiveness of treatments and therapies prescribed by physicians.
- Facilitated collaboration between primary care physician, specialist, hospital staff and community resources to provide comprehensive patient care.
Care Coordinator
Beacon Health Options
Little Rock, AR
04.2015 - 06.2017
- Conducted initial assessments and evaluations of patient's needs.
- Provided care coordination services to ensure the coordination and delivery of quality care.
- Coordinated with other health professionals to develop individualized plans of care for patients.
- Monitored and evaluated patient progress, adjusting treatment plans as needed.
- Maintained accurate client records in accordance with agency policies and procedures.
- Assisted in the development of discharge plans for clients transitioning out of care programs.
- Facilitated referrals to community resources such as housing, transportation, employment opportunities.
- Ensured compliance with state regulations related to healthcare service provision.
- Attended meetings with families and other members of the interdisciplinary team to discuss patient progress and plan for future interventions.
- Educated clients on available resources and services within their communities.
- Provided crisis intervention services when needed.
- Scheduled appointments for clients with appropriate medical specialists.
- Provided emotional support to patients dealing with difficult health issues.
- Maintained communication between the family and caregiver and other involved parties regarding the patient's condition.
- Actively participated in staff meetings discussing best practices in patient care coordination.
- Investigated and reported issues relating to patient care and conditions which might hinder patient well-being.
- Improved patient outlook and daily living through compassionate care.
Therapist
Bridgeway Hospital
Little Rock, AR
08.2012 - 04.2015
- Provided psychotherapy services to individuals, couples, and families.
- Conducted initial assessments of clients to determine presenting issues and develop treatment plans.
- Facilitated group therapy sessions for clients with similar issues or diagnoses.
- Created documentation including assessment notes, treatment plans, progress notes, discharge summaries and referrals.
- Maintained accurate records of clinical activity in accordance with HIPAA guidelines.
- Developed individualized therapeutic interventions based on diagnosis and best practices in the field of mental health counseling.
- Assisted clients in developing coping skills to better manage symptoms of mental illness or emotional distress.
- Utilized a variety of techniques such as cognitive-behavioral therapy and mindfulness practices during sessions.
- Collaborated with multidisciplinary teams to ensure continuity of care for each client.
- Engaged in outreach activities within the community to increase awareness about available resources for mental health support.
- Identified environmental factors that may be contributing to client's symptoms and collaborated with them to create an action plan for change.
- Facilitated relapse prevention groups focusing on coping skills, problem solving, and stress management techniques.
- Coordinated referrals to external service providers when necessary.
- Participated in staff meetings to discuss difficult cases or new developments within the field.
- Educated patients on detox and withdrawal, medications, addiction, recovery, coping skills and community resources.
Education
Master of Social Work -
University of Arkansas at Little Rock
01.2010
Bachelor of Arts: Writing -
University of Central Arkansas
01.2008
TF-CBT Trained -
01.2012
Skills
- Organizational Management
- Performance Monitoring
- Performance Reporting
- Process Improvement
- Data Analysis
- Workflow Optimization
- Customer Service
- Planning and Implementation
- Continuous Improvements
- Microsoft Office Suite Expert
- Cross-Functional Communication
- Workforce Management
- Work Flow Planning
- Policies and Procedures Implementation
- Performance Management
- Solutions Development
- Operations Management
- Goal Attainment
- Staff Retention
- Team Building/Leadership
Accomplishments
- Boosted customer engagement ratings by 40% in under two months.
- Reduced projected revenue by loss by 10% during PHE Unwind by spearheading PHE Unwind process and tracking.
- Improved patient outcomes by spearheading implementation of Animal Assisted Therapy Program.
- Spearheaded "Member Stories and Jellyfish Awards" marketing initiative which significantly improved company reputation, team morale and led to increase in member attributions.
Timeline
Care Coordination Manager of Operations
CareSource
06.2021 - Current
Director of Care Coordination Operations
Empower Healthcare Solutions
01.2021 - 06.2021
Care Coordination Supervisor
Empower Healthcare Solutions
04.2018 - 12.2020
Utilization Management Specialist
Beacon Health Options
06.2017 - 04.2018
Care Coordinator
Beacon Health Options
04.2015 - 06.2017
Therapist
Bridgeway Hospital
08.2012 - 04.2015
Master of Social Work -
University of Arkansas at Little Rock
Bachelor of Arts: Writing -
University of Central Arkansas
TF-CBT Trained -
Certification
- Advanced Social Work Care Manager Certification - 2015
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