Open To Work
Mia Middleton
Healthcare and Customer Service
Phenix City,AL
Summary
Dynamic care manager with extensive experience in patient care coordination and chronic condition management at Caremaster Medical Services. Proven track record in HEDIS compliance and medical records management, demonstrating strong communication skills and a commitment to quality improvement. Skilled in building relationships with patients and families to enhance care outcomes.
Overview
29
29
years of professional experience
3
3
Certifications
Work History
Care Manager
Caremaster Medical Services
Griffin
04.2017 - 12.2018
- Managed private duty patient care in the home
- Home health and private duty nurse
- Lab Draws
- Coordinated care plans for patients with chronic health conditions.
- Developed strong relationships with patients and their families for effective communication.
HEDIS Chart Abstractor
Altegra Health
01.2014 - 05.2016
- Implemented quality improvement by chart abstracting using HEDIS Core Measures, maintained 96-100% accuracy entering info into the database.
- Used various forms of software(i.e. Quality Reporter, Excel, Word, Microsoft Office Suite) to support HEDIS operations and remote communication.
- Working knowledge of NCQA HEDIS abstracting guidelines
Nursing Supervisor
H.A.N.D.S Adult Daycare
01.2011 - 01.2014
- Nurse supervisor and Marketing Director who also prepared monthly reports for state and federal regulations and payment
- Organized and led support groups, activities and field trips
- Liaised between clients, family members, and providers
Home Health LPN
Me and My Nana
09.2010 - 02.2012
- Home health nurse for pediatrics providing 24/7 on-call for my caseload
Admissions and Marketing Director
Holly Springs Rehabilitation and Healthcare
06.2003 - 05.2005
- Community and provider liaison, organized and conducted health awareness fairs
- Managed employee in-service program, conducted new hire orientation and coordinated QIA's to identify performance areas for improvement
- Increased occupancy from 30% to 100% within my first 3 months of becoming Marketing Director and maintained 96-100% occupied during employment
- Holly Springs, MS
Contract LPN
Primecare Staffing
08.1999 - 05.2005
LPN and Asst. Case Manager
Doctor's Hospital
01.1996 - 01.1999
- Staff nurse on M/S and Psych units
- As Asst. Case Manager worked on M/S and Psych case management, concurrent review and discharge planning
- Obtained Prior-Authorizations
Instructor
Meadows College
01.1994 - 01.1997
- Class and Clinical Instructor for the Medical Assistant and Medical Office Services programs
- Developed syllabus for each course taught
LPN Charge Nurse
Canterbury Health Care
Phenix City
01.1994 - 01.1996
- Charge nurse for Alzheimer's unit managing an average of 10-15 employees, made patient assignments, monitored care, and medication passes
- Provided nursing care for 25-35 patients per shift
- Supervised nursing staff to ensure quality patient care and adherence to protocols.
- Coordinated patient admissions, discharges, and transfers efficiently within the facility.
Billing and Coding Specialist; Customer Service Rep
Blue Cross Blue Shield of Georgia
01.1990 - 01.1992
- Billing and coding for all special line accounts
- Inbound and outbound CSR for the Federal Employee Program handling calls and written correspondence
Education
Tecnical Diploma - Nursing
Southern Union State Community College
Wadley, AL09-1993
None - Health Promotion
Auburn University
Auburn, AL05.1987
Skills
- Medical records management
- Managed care expertise
- BLS and first aid certification
- Alzheimer's and dementia care
- Vital signs monitoring
- HEDIS compliance
- Medication administration
- Employee orientation and training
- Patient care services
- Nursing practices
- Medical coding proficiency
- HIPAA compliance
- Laboratory skills
- Case management strategies
- Medical office operations
- ICD-9 and ICD-10 coding
- Computer proficiency
- Caregiving techniques
- Hospital experience and support
- CPT coding knowledge
- Insurance verification processes
- IV therapy certification
- Strong work ethic and organization
- Time management skills
- Effective communication
Personal Information
- Willing To Relocate: Anywhere
- Authorized To Work: US for any employer
Certification
Multi-state LPN license
Timeline
Care Manager
Caremaster Medical Services
04.2017 - 12.2018
HEDIS Chart Abstractor
Altegra Health
01.2014 - 05.2016
Nursing Supervisor
H.A.N.D.S Adult Daycare
01.2011 - 01.2014
Home Health LPN
Me and My Nana
09.2010 - 02.2012
Admissions and Marketing Director
Holly Springs Rehabilitation and Healthcare
06.2003 - 05.2005
Contract LPN
Primecare Staffing
08.1999 - 05.2005
LPN and Asst. Case Manager
Doctor's Hospital
01.1996 - 01.1999
Instructor
Meadows College
01.1994 - 01.1997
LPN Charge Nurse
Canterbury Health Care
01.1994 - 01.1996
Billing and Coding Specialist; Customer Service Rep
Blue Cross Blue Shield of Georgia
01.1990 - 01.1992
Tecnical Diploma - Nursing
Southern Union State Community College
None - Health Promotion
Auburn University