Melissa Herron

• Aligned corporate strategy with long-term growth goals, enhancing market position.
• Set leadership expectations to improve accountability and cross-functional execution.
• Reviewed operational risks and took corrective action to support business stability.
• Assessed operational risks and implemented corrective actions to ensure business stability.
• Developed and implemented foundational processes that streamlined business operations.
• Explained health and life insurance options, coverage details, and policy benefits to clients.
• Assessed customer needs and recommended plans aligned with budget and protection goals.
• Maintained detailed records of leads, applications, and customer interactions for efficient tracking. for leads, applications, and customer interactions.
• Established rapport with clients through active listening and personalized recommendations. with prospects through active listening and tailored coverage recommendations.
• Stayed current on industry trends and regulatory changes to provide accurate client guidance.
• Expanded product knowledge through training sessions, seminars, and workshops focused on health and life insurance offerings.
• Used time management methods to handle multiple client accounts while maintaining high service standards.

· Supervised individuals to achieve and sustain productivity and NCQA compliance above 90%.

· Established and maintained effective communication with individuals, staff, physicians and community organizations to promote high quality member centered care.

· Ensured the safety and quality of care of individuals within the community.

· Established and maintained effective communication with individuals, staff, physicians and community organizations to promote high quality member centered care.

· Ensured safety and quality of care for individuals in the community.

• Reviewed referrals and service requests to support appropriate care plan navigation.
• Coordinated care management activities, ensuring accurate documentation and timely member outreach.

· Guided clients in developing self-advocacy skills, enhancing their independence and confidence in navigating social services.

· Assisted clients in achieving greater independence by providing guidance on developing self-advocacy skills.

· Ensured regulatory compliance by staying current on relevant federal, state, and local policies and procedures affecting IRIS consultant responsibilities.

Promoted clients' rights during meetings with social services stakeholders. within the larger social services system by participating in meetings, conferences, or other professional gatherings where decisions impacting supported individuals were made.

· Maintained detailed records to ensure compliance with agency standards and regulations, supporting quality care delivery.

Acted as a liaison between patients, families, physicians, insurance providers, and other healthcare professionals to facilitate care coordination.

· Educated clients and families on community resources and treatment options, empowering them to effectively manage health conditions.

· Managed complex caseloads, facilitating timely assessments and interventions to enhance care outcomes.

• · Conducted thorough assessments of clients' needs to determine appropriate support services and referrals.
• · Collected and analyzed quantitative and qualitative data on client details to ensure tailored service delivery.
• · Built strong relationships with aid recipients, assessing goals to effectively address individual needs and customize support services.
• · Explained procedures, requirements, and benefits to clients, enhancing their understanding of available services.
• Completed intake screenings, gathered eligibility details, and routed cases to appropriate support programs.
• Conducted information and assistance interviews, identified client needs, and connected individuals to aging and disability resources.

• · Maintained accurate records to ensure compliance with state regulations on documentation guidelines for patient assessments and critical incident reports, effectively managing a complex caseload.
• · Developed and updated policies and procedures, maintaining compliance with guidelines relating to HIPAA, benefits administration and general liability.
• · Educated and evaluated clinical and support staff on care quality management regulations and standards of care to enhance team competency.
• Educated clients and families on community resources, treatment options and health care services to better manage conditions.
• Reviewed case documentation for accuracy, compliance, and continuity of services.
• Monitored care transitions and follow-up activities to reduce gaps in member support.
• Arranged transportation and documented details of discharge transition plans.
• Coordinated assessments, referrals, and service authorizations to facilitate timely access to care for clients.
• Led person-centered care planning across multidisciplinary teams to align services with member needs and goals.