Molly Dressler
DuBois,United States
Summary
My career objective is to work positively in collaboration with management and other organization leaders to support staff, meet organizational outcomes and objectives while making a positive impact on staff and the people we serve.
Overview
9
9
years of professional experience
Work History
Compliance and Incident Management Analyst
SAM, Inc
04.2023 - Current
- Comparison reports for MCO’s to ensure census of participants is accurate
- Long Term Service and Supports Subject Matter Expert
- · Ensure compliance with program and contractual requirements
- Value based payment criteria for Pa Health and Wellness, research, collaboration with payer for exceptions, identification of trends for remediation
- Assist with critical incidents to ensure timeliness of submission is achieved consistently for payer
- Assist director of program with preparation of daily, weekly and monthly reporting for Amerihealth and Pa Health and Wellness
- OPS 29 Audits of service coordination staff submitted work for compliance and accuracy
- Privacy officer, expert on compliance and HIPPA concerns
- HEDIS auditing and reporting to payers
- Evaluated current processes to develop improvement plans.
- Produced detailed and relevant reports for use in making business decisions.
- Conducted thorough reviews of operations to devise and deploy improvement strategies.
- Compiled research data and gave professional presentations highlighting finds and recommended optimizations.
Onboarding, Outreach and Quality Supervisor
SAM, Inc
02.2022 - 03.2023
- Training Onboarding service coordinators for Community and Nursing Home Service Coordination working with PA Health and Wellness
- Long Term Service and Supports Subject Matter Expert
- Supervision of onboarding staff for first 90 days
- Monitored activities and supporting systems in C2S, HCSIS, Tru Care, LMS settings to check compliance with all institutional and regulatory requirements
- Development of trainings for all staff working with PA Health and Wellness
- Assists with the development and management of policies and procedures, ensuring alignment with State and Federal Requirements and NCQA standards
- Monitoring Quality of SC’s work submitted to PA Health and Wellness
- TruCare
- HHA exchange
- HCSIS Enterprise Incident Management
- Interviewing of potential new staff members
SC Supervisor CW2SP
SAM, Inc
03.2020 - 02.2022
- Supervision of Case Managers of Home and Community Based services
- SAM, Inc program outcomes
- Corporate compliance procedures
- SAM, Inc policy and procedures
- Time management, case review and productivity standards
- OLTL Act 150 and OBRA Waiver and PA Health and Wellness procedures related to Medicaid funded services
- Creative problem solving
- NFI project
- Interviewing of potential new staff members
- Applied strong leadership talents and problem-solving skills to maintain team efficiency and organize workflows.
- Evaluated staff performance and provided coaching to address inefficiencies.
- Created and managed project plans, and timelines
Service Coordinator OLTL
SAM, Inc
01.2016 - 03.2020
- Development of person centered service plans and ISP’s
- Inter RAI completion to meet the standards of PA Health and Wellness
- OBRA and Act 150 SC supervisor
- Coordination of all support services both waiver and non-waiver
- Location of supports from community providers
- Medicaid oversite to prevent fraud
- Completion of incident reporting for Adult Protective Services
- Timely follow up for all service requests
- Monthly monitoring for health and safety
- HCSIS and SAMS for OLTL waiver consumers
- Maintaining files for participants to insure OLTL quality measures are being met
- Mentoring of new SC’s in CW2SP program
- Creative problem solving
Education
Bachelor of Science - Liberal Studies, Business Administration
Penn West Clarion
Clarion, PA05.2015
Skills
- Business process improvement
- Requirement gathering and analysis
- Policy analysis
- Client relationship management
- Goal setting
- Analyze data
- Effective communication
- Organizational management
Leadership Experience
- 2021-2025, SAM, Inc Master Supervisor Credential
- 2017, Strengths Based Family Worker Credential
- 2001, Organizer of Toys for Tots campaign with partnership of WOWQ radio station
- 2023, Lions Club Marketing and Service Chairperson
Communication Skills
- 2022, Presenter National Association of Case Managers Conference, Atlantic City
- 2019-2023, Media Liaison, DuBois Lions Club
- 2017, Speech presenter at Strengths Based Family Worker of Temple University ceremony
Timeline
Compliance and Incident Management Analyst
SAM, Inc
04.2023 - Current
Onboarding, Outreach and Quality Supervisor
SAM, Inc
02.2022 - 03.2023
SC Supervisor CW2SP
SAM, Inc
03.2020 - 02.2022
Service Coordinator OLTL
SAM, Inc
01.2016 - 03.2020
Bachelor of Science - Liberal Studies, Business Administration
Penn West Clarion
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