MARTHE HIPPOLYTE
Rosedale
Summary
Obtain a challenging and responsible position as a Healthcare Manager with proven ability to provide leadership, company goals, and project deadlines. To seek and maintain full-time position that offers professional challenges utilizing interpersonal skills, excellent time management and problem-solving skills.
Overview
29
29
years of professional experience
Work History
Multilingual Psychotherapy
Targeted Case Management
01.2018 - Current
- Admit new clients by assessing the needs of the clients with underlying mental health disorder
- Determine clients' requirements by completing intake; determining need for therapeutic medical, psycho-social, and psychiatric evaluations
- Establish treatment programs by setting schedules and routines; coordinating services being provided; arranging resources, including transportation
- Monitor cases by verifying clients' attendance to providers; observing and evaluating treatments and responses; advocating for needed services in the community; obtaining additional resources
- Maintain clients' records by reviewing case notes; and service plan reviews
- Communicate clients' progress by conducting monthly home visits and phone calls; observes barriers
- Prepare clients' discharge by reviewing and amplifying discharge plans; coordinating discharge and post-discharge requirements
- Work on operational process improvement for the sales department by preparing monthly reports of business renewals, contract terminations and reinstatements
- Perform work duties on various healthcare systems & enrollment platforms
- Work cross-functionally with various internal and external teams on necessary components of business sales to ensure timely and accurate budget eligibility
Targeted Case Management
Community Partner
01.2018 - Current
- Provide case management functions including those of coordination of service planning, facilitation of linkages with community and center resources, monitoring of overall service delivery and referrals of the person served to sources providing assistance
- Coordinate patient care: responsible for an assigned caseload of individuals and guides the overall plan of care by assessing needs, developing, implementing and reviewing service plans, monitoring patient progress, adjusting treatment plans as necessary and working collaboratively with the health care team and with other community resources in meeting and/or achieving individual service needs
- Meet with clinical team to reports frequent ER visit in order to help decrease cost
- Coordinate hospital discharge through referral and linkage to care resources
- Provide care management with the interdisciplinary team to ensure that the member progresses through the continuum of care
- Perform daily field visit in order to locate and link UCC members and long-term care clients to services
- Coordinate the integration of care management functions into treatment plans with other internal and external providers.
Road to Recovery Treatment Center
Case Management
01.2015 - 01.2018
- Admit new clients by reviewing records and applications; conducting orientations
- Determine clients' requirements by completing intake interviews; determining need for therapeutic medical, psycho-social, and psychiatric evaluations; reviewing therapist evaluations, treatment objectives, and plans
- Establish treatment programs by setting schedules and routines; coordinating services being provided; arranging resources, including transportation and escort
- Monitor cases by verifying clients' attendance; observing and evaluating treatments and responses; advocating for needed services and entitlements; obtaining additional resources; intervening in crises; providing personal support
- Maintain clients' records by reviewing case notes; logging events and progress
- Communicate clients' progress by conducting weekly interdisciplinary meetings and evaluations; disseminating results and obstacles to therapeutic team and family; identifying treatment influences
- Prepare clients' discharge by reviewing and amplifying discharge plans; coordinating discharge and post-discharge requirements; orienting and training family members; providing resources
- Improve staff competence by providing educational resources; balancing work requirements with learning opportunities; evaluating the application of learning to changes in treatment results
- Improve financial status by analyzing results; monitoring variances; identifying trends; recommending actions to management
- Meet budget by monitoring expenses; implementing cost-saving actions
- Prepare reports by collecting, analyzing, and summarizing treatment and results data and trends; compiling statistics; completing grant and subsidy applications
- Update job knowledge by participating in educational opportunities; reading professional publications; maintaining personal networks; participating in professional organizations
- Enhance department and organization reputation by accepting ownership for accomplishing new and different requests; exploring opportunities to add value to job accomplishments.
AMERIROUP
Provider Relations Representative
10.2013 - 04.2016
- Educate, monitor, analyze, document and interact with providers to ensure provider cooperation, understanding and effective participation in Anthem BCBS products
- Assist Management, Finance and Medical Leadership analyzing potential contracting arrangements and rate negotiations to ensure the delivery of cost effective, quality service
- Establish strong, solid relationships with physicians/administrators at key provider offices within assigned territory
- Coordinate with other members of the Provider Relations team and representatives from appropriate areas to effectively troubleshoot complex claim situations, program/policy disputes, executive, and VIP and regulatory inquiries
- Participate in the planning, organizing and presentation of seminars, conventions, speeches, etc
- To various providers, billing service, medical society and internal groups
- Evaluate and identify opportunities for implementation of the various electronic initiatives and other key enterprise initiatives, available to assist providers with their daily interactions with Anthem BCBS
- Work closely with Medical Leadership and network physicians to facilitate significant practice patterns and cost effective healthcare delivery initiatives
- Develop time and cost effective territory management programs that comply with department and enterprise goals
- Maintain a thorough knowledge of healthcare industry trends and developments through the review of industry publications, newsletters and formal training
- Perform other assignments/projects as assigned by Management.
Enrollment Specialist
Health First
02.1995 - 09.2001
- Updated, entered, and reviewed customer data.
- Communicated effectively via telephone, email, and in person with prospective customers.
- Enhanced customer service by promptly addressing inquiries and resolving issues in a timely manner.
- Conducted comprehensive applicant interviews to determine eligibility and fit for specific programs.
- Streamlined the enrollment process for increased efficiency and enhanced user experience.
- Understood and thoroughly explained services provided to customers and potential customers.
- Developed training materials for new Enrollment Specialists, enhancing departmental performance and consistency in processes.
- Enhanced team productivity through effective time management and prioritization techniques during peak enrollment periods.
Education
Master of Science- Public Health, MPH -
Florida International University-Florida
Bachelor of Science- Human Services, BA -
Pace University- New York
TCM certification (CBHCM)
Skills
- Friendly, Positive Attitude
- Teamwork and Collaboration
- Customer Service
- Problem-Solving
- Time Management
- Attention to Detail
- Flexible and Adaptable
- Dependable and Responsible
- Multitasking
- Multitasking Abilities
- Critical Thinking
- Computer Skills
- Organizational Skills
- Excellent Communication
- Calm Under Pressure
- Organization and Time Management
- Active Listening
- Problem Resolution
- Decision-Making
- Verbal Communication
Languages
French
Catalan
Timeline
Multilingual Psychotherapy
Targeted Case Management
01.2018 - Current
Targeted Case Management
Community Partner
01.2018 - Current
Road to Recovery Treatment Center
Case Management
01.2015 - 01.2018
AMERIROUP
Provider Relations Representative
10.2013 - 04.2016
Enrollment Specialist
Health First
02.1995 - 09.2001
Master of Science- Public Health, MPH -
Florida International University-Florida
Bachelor of Science- Human Services, BA -
Pace University- New York
TCM certification (CBHCM)
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