MELISSA CHRISTOPHER, MSW, LCSW-QS
Boca Raton,FL
Summary
Dynamic case management leader with 18 years of experience in strategic management and team collaboration within, recognized for cultivating a high-performance culture and adapting to the evolving needs of organizations. Expertise in operational planning, financial oversight, and stakeholder engagement drives impactful outcomes through innovative problem-solving and effective communication. Committed to accountability and resourcefulness, with a strong emphasis on patient wellness, quality metrics, fiscal outcomes, and ensuring safe transitions of care. Proven ability to deliver results that align with organizational goals while fostering a culture of continuous improvement.
Overview
17
17
years of professional experience
1
1
Certification
Work History
Group Director - Case Management
Tenet Healthcare, Palm Beach Health Network
Delray Beach, FL
09.2023 - Current
- Directed strategic initiatives to enhance operational efficiency across six hospitals, including two trauma sites.
- Led cross-functional teams in implementing process improvements, resulting in streamlined patient care delivery and improved throughput efficiencies.
- Collaborated with executive CM leadership to develop and execute long-term organizational strategies.
- Collaborated with and developed a market contract agreement with The Salvation Army to expand services for medical respite, shelter and case management services for our homeless population. This partnership was featured on the local news.
- Oversaw compliance with healthcare regulations, ensuring adherence to industry standards and best practices.
- Mentored and developed management teams, fostering a culture of continuous improvement within the organization.
- Managed budgetary allocations and resource optimization for enhanced financial performance via O/E & LOS reduction initiatives.
- Facilitated stakeholder engagement initiatives to strengthen partnerships and improve community health outcomes.
- Continual collaboration with Utilization teams and Physician Advisor/CMO to escalate issues related to appropriate medical necessity, LOC, P2P and reduce clinical denials/appeals.
- Ongoing reviews/auditing for CDI/Coding opportunities to help improve DRG/CMI documentation and improve reimbursements.
Director of Case Management
Baptist Health - Boca Raton Regional Hospital
Boca Raton, FL
06.2022 - 09.2023
- Directed case management initiatives to enhance patient care and optimize resource allocation with 30+ FTE's
- Implemented evidence-based practices to improve clinical outcomes across multidisciplinary teams.
- Led training programs for staff on best practices in case management and regulatory compliance.
- Facilitated interdisciplinary meetings to ensure comprehensive care planning and coordination of services.
- Provided leadership, guidance and support to staff members.
- Conducted regular performance evaluations to identify strengths, areas for improvement, and opportunities for growth among team members.
Director of Case Management
St. Mary's Medical Center & Palm Beach Children's
West Palm Beach, FL
07.2020 - 06.2022
- Structured & standardized case management processes to comply with regulatory agency statutes and standards.
- Developed and administered budgets, authorized expenditures and monitored financial indicators to improve profitability.
- Fostered professional networks and relationships with service and resource providers to promote continuity and quality of care for patients.
- Collaborated with multidisciplinary teams to facilitate patient care and reduce case management barriers.
- Implemented data-driven strategies for continuous improvement in case management performance metrics.
- Developed strong relationships with community partners to facilitate comprehensive support services for patients and families.
- Proactively addressed complex cases or escalated issues, working closely with stakeholders to devise effective resolution strategies.
- Analyzed trends and data to inform decision-making and program development.
- Conducted regular performance evaluations to identify strengths, areas for improvement, and opportunities for growth among team members.
- Streamlined, standardized and implemented case management processes and techniques to maximize revenue cycle.
Clinical Care Coordinator
Unitedhealthcare
Miramar, FL
02.2020 - 07.2020
- Providing care coordination services to UHC Commercial members (Virtual ACO working collaboratively with smaller PCP's in Tri-County Area)
- Managing 10 PCP practices, including 2 large IPA's
- Populations managed: Recently discharged from ED/IP, high risk (projected UR use/scoring models) and unattributed members
- Working collaboratively with PCP offices to re-engage members and re-direct care to PCP's office
- Reaching out to new PCP practices using target lists. Presenting Spectrum to grow program member attribution
- Tracking, analyzing and managing program data- various programs
- Assisting with build-out & integration of documentation tool/system
Psychotherapist
Arvon & Associates in Counseling
Aventura, FL
02.2019 - 01.2020
- Independently managed caseload of 26 clients
- Conducted client psycho-social assessments and developed treatment plans
- Utilized CBT/DBT, motivational interviewing and education to support clients in meeting therapeutic goals
- Provided diagnosis and supporting documentation for billing
Manager- Case Management & Social Services
Memorial Hospital Pembroke
Pembroke Pines, FL
02.2017 - 04.2019
- Oversight of daily department operations, hospital census and staff scheduling (RN's & MSW/LCSW's)
- Partner with Centralized Utilization to reduce Inpatient days/Observation hours
- Attendance/participation at system meetings: Transitions-of-Care, SNF Alliance, Clinical Efficiency, Post-Acute Strategic Partnership (Bundled Payment Care Improvement & Population Health)
- Monthly meetings with various managed care companies to ensure efficient/safe/cost-effective care
- Completion/review of reports/data for MHS Monthly Operating Report
- Length-of-stay variance reports for CFO
- Annual Reviews/Staff Counseling/Discipline
- Ensure compliance with regulatory standards
- Routine internal auditing/monitoring of data/trends
- Assisted Director of department with monthly reports and presentation of results at quarterly meetings. Provided coverage for Director, when needed
Supervisor- Case Management & Social Services
Memorial Hospital Pembroke
Pembroke Pines, FL
06.2015 - 02.2017
- Completion of six month and annual performance evaluations of all staff.
- Developed and organized staff development and orientation programs for new social workers and nurse case managers.
- Regularly evaluated employee performance, provided feedback and assisted, coached and enacted disciplinary actions , as needed.
- Supervising and mentoring MSW graduate level interns from FIU since 2013.
Social Worker
Memorial Hospital Pembroke
Pembroke Pines, FL
10.2012 - 06.2015
- Performed discharge planning, family conference attendance/participation, interdisciplinary rounding, documentation of clinical interventions, communication with physicians, nurses, patients and families regarding plans for discharge from hospital to next level-of-care
- Experience in various units: Medical/Surgical, Telemetry, Medical Stabilization, Emergency Room, ICU/IMCU, and Outpatient
Social Worker
Memorial Hospital Miramar
Miramar, FL
09.2009 - 10.2012
- Responsible for discharge planning, family conference attendance/participation, interdisciplinary rounding, documentation of clinical interventions, communication with physicians, nurses, patients and families regarding plans for discharge from hospital to next level-of-care
Education
MSW - Clinical Social Work
Florida International University
Miami, FL2009
BSW - Social Work
Florida Atlantic University
Boca Raton, FL2007
Skills
- Case Management/Discharge Planning
- Social Services Management
- Utilization Review/LOS Reduction
- Coding/CDI Improvement
- Care Coordination/Transition-of-Care
- Annual Performance Reviews
- Relationship & Team Building
- Crisis Intervention
- Staff Training & Development
- Revenue Cycle Planning & Presentation
- Auditing & Data Analysis
- Regulatory Knowledge (CMS, AHCA, Joint Commission, DCF)
Languages
Spanish
Native or Bilingual
Licenses
Licensed Clinical Social Worker
Qualified Supervisor - CSW
State of Florida License #SW14041
Expiration: 03-31-2027
Affiliations
ACMA (American Case Management Association
-National Public Policy Committee Member (2026)
Certification
- Florida Department of Health - Qualified Supervisor for LCSW Interns
- Certification: NASW- (Supervisory Leaders in Aging) Program- April 2016
Timeline
Group Director - Case Management
Tenet Healthcare, Palm Beach Health Network
09.2023 - Current
Director of Case Management
Baptist Health - Boca Raton Regional Hospital
06.2022 - 09.2023
Director of Case Management
St. Mary's Medical Center & Palm Beach Children's
07.2020 - 06.2022
Clinical Care Coordinator
Unitedhealthcare
02.2020 - 07.2020
Psychotherapist
Arvon & Associates in Counseling
02.2019 - 01.2020
Manager- Case Management & Social Services
Memorial Hospital Pembroke
02.2017 - 04.2019
Supervisor- Case Management & Social Services
Memorial Hospital Pembroke
06.2015 - 02.2017
Social Worker
Memorial Hospital Pembroke
10.2012 - 06.2015
Social Worker
Memorial Hospital Miramar
09.2009 - 10.2012
BSW - Social Work
Florida Atlantic University
MSW - Clinical Social Work
Florida International University