Summary
Overview
Work History
Education
Skills
References
Websites
References
Timeline
Generic

LISA HAYES

Columbus,OH

Summary

Healthcare professional with extensive CVS experience, specializing in case management and team leadership. Demonstrated success in enhancing service delivery through critical thinking and effective communication. Expertise in implementing process improvements that increase operational efficiency and promote collaboration among interdisciplinary teams. Dedicated to empowering clients with education and resources for informed health decisions.

Overview

35
35
years of professional experience

Work History

Field Case Manager, Accountable Care

CVS
Columbus, Ohio
11.2023 - 05.2025
  • Coordinated care plans for clients with complex health needs to enhance service delivery.
  • Conducted assessments to evaluate client eligibility for various services.
  • Collaborated with healthcare providers to ensure comprehensive support across disciplines.
  • Monitored client progress, adjusting care plans as necessary to meet changing needs.
  • Educated clients regarding available resources and support services to promote informed choices.
  • Facilitated communication among clients, families, and interdisciplinary teams to improve collaboration.
  • Established referrals to community resources, including housing and employment assistance programs.
  • Provided in-person consultations at OSU PCP offices to explain Accountable Care case management.

Supervisor, Clinical Health Services

Aetna- a CVS Health Company
New Albany, OH
05.2017 - 05.2025
  • Oversaw team of RN Case Managers to implement healthcare management services for Medicare members while ensuring adherence to NCQA standards and company policies.
  • Fostered positive work environment through effective communication via email, team meetings, and one-on-one discussions.
  • Conducted ongoing performance evaluations of Case Managers through audits, report reviews, and formal assessments.
  • Participated in Provider Collaboration meetings and contributed to Process Improvement initiatives.
  • Supervised daily operations and workflows to enhance team productivity and efficiency.
  • Ensured compliance with industry regulations and internal policies throughout all operations.
  • Implemented process improvements that increased operational effectiveness across the organization.
  • Moderated weekly interdisciplinary clinical rounds with the medical director to foster care coordination and offer suggestions for implementation of interventions to address concerns regarding complex cases.

Medicare Nurse Case Manager

Aetna
New Albany, OH
03.2014 - 05.2017
  • Telephonic case management of Ohio Retirees using a holistic approach to healthcare to identify and address risks, develop a rapport with members and create member-centric goals.
  • Attended multidisciplinary rounds and collaborated with Social Work, Pharmacy, Behavioral Health and Medical Directors.
  • Spoke at high level meetings with customers representing Case Management.
  • Collaborated with a Provider Group as a partially embedded case manager. Worked with their Quality Team and Care Coordinators to close Stars gaps, provide home visits and reconcile medications for members.

Clinical Manager

Alere Health Services
Worthington, OH
12.2011 - 11.2013
  • Managed a team of perinatal clinicians in the referral department including intake, insurance authorization, consultation with pharmacists and communication with sales staff and patient educators.
  • Interviewed, hired and trained staff within my department and cross-trained staff.
  • Collaborated with multidisciplinary team including Sales, Pharmacy, Insurance Case Managers, Authorizations, Patient Educators and Providers.
  • Assisted with preparation for JCAHO inspections, participated in update of documentation and policies and procedures.
  • Initiated process improvements and ongoing training and management of staff.

Office Nurse

WomanKind Obstetrics and Gynecology
Columbus, OH
12.2006 - 12.2011
  • Conducted telephonic triage for OB and GYN patients to assess needs effectively.
  • Assisted with office-based surgical procedures, ensuring patient comfort and safety.
  • Facilitated transition to electronic medical records, improving data accessibility.
  • Performed OB and surgical consults to evaluate for risks and educate patients about upcoming
  • Maintained accurate records of patient assessments, treatments and medications administered.
  • Responded quickly to medical emergencies within the office setting.
  • Prepared and administered vaccines, medications, controlled substances and narcotics as prescribed and sterilized and stored instruments, equipment and supplies.
  • Educated patients in regards to office policies, medical procedure steps, recovery measures and medication instructions.
  • Coordinated surgery scheduling for multiple doctors across Central OH facilities, managing logistics with surgeons and equipment representatives.
  • Oriented new staff members to enhance team integration and performance.
  • Served as Clinical and Office Manager during absences, maintaining operational continuity.

Perinatal Clinician/Referral Nurse

Matria Healthcare
Columbus, OH
06.1999 - 12.2006
  • Conducted telephonic assessments to customize education for high-risk OB patients.
  • Generated status reports to inform physicians of treatment responses and condition changes.
  • Mentored new staff on computer training and prioritization of tasks.
  • Coordinated referral processes, including intake and insurance authorization.
  • Prepared documentation for JCAHO inspections to ensure compliance.
  • Collaborated with sales staff and patient educators to facilitate effective referrals.
  • Provided tailored support to enhance understanding of patient care among high-risk populations.
  • Participated in policy updates to maintain adherence to healthcare standards.

Staff Nurse-Labor & Delivery

Mt. Carmel Medical Center
Columbus, OH
11.1990 - 06.1999
  • Provided care for antepartum, intrapartum, postpartum and newborn patients.
  • Frequently assisted in care of high-risk patients.
  • Functioned in role of charge nurse, gave staff assignments, continually reassessing and updating patient load, providing assistance as needed.
  • Precepted new staff. Taught clinical skills, documentation and fostered critical thinking. Coordinated preceptor program.
  • Participated on committee to revamp and coordinate documentation with affiliated hospitals.
  • Assisted in readying unit for JCAHO and OSHA inspections.
  • Maintained accurate documentation of patient interactions and medical histories.
  • Monitored patient vitals post-surgery, managed medical equipment, and administered medications and IVs.
  • Assessed patients to determine their physical condition, health status and needs.
  • Managed multiple tasks simultaneously while maintaining quality standards of care.
  • Demonstrated effective communication skills while interacting with patients, families, physicians and other healthcare staff members.

Staff RN Mother/Infant

Mt. Carmel Medical Center
Columbus, OH
06.1990 - 11.1990
  • Assessment and care of antepartum, postpartum and newborn patients.
  • Taught breastfeeding, newborn care and self-care to antepartum and postpartum patients.
  • Administered medications and treatments according to physician's orders.
  • Educated patients and families on health management and care plans.

Education

Bachelor of Science - Nursing

The Ohio State University
Columbus, OH
01.1990

Skills

  • Registered nurse
  • Critical thinking
  • Effective communication
  • Epic experience
  • Patient education
  • Multitasking
  • Teaching and training
  • Leadership and management
  • Team collaboration
  • Public speaking
  • Care coordination
  • Process improvement
  • Problem-solving
  • Adaptability

References

References upon request.

Websites

References

References available upon request.

Timeline

Field Case Manager, Accountable Care

CVS
11.2023 - 05.2025

Supervisor, Clinical Health Services

Aetna- a CVS Health Company
05.2017 - 05.2025

Medicare Nurse Case Manager

Aetna
03.2014 - 05.2017

Clinical Manager

Alere Health Services
12.2011 - 11.2013

Office Nurse

WomanKind Obstetrics and Gynecology
12.2006 - 12.2011

Perinatal Clinician/Referral Nurse

Matria Healthcare
06.1999 - 12.2006

Staff Nurse-Labor & Delivery

Mt. Carmel Medical Center
11.1990 - 06.1999

Staff RN Mother/Infant

Mt. Carmel Medical Center
06.1990 - 11.1990

Bachelor of Science - Nursing

The Ohio State University

Similar Profiles

CREATE PROFILE