Morgan Graham
North Las Vegas,NV
Summary
Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals.
Overview
11
11
years of professional experience
Work History
Care Management Associate
CVS Health Company
12.2021 - Current
- Identifies principal reason for admission, facility, and member product to correctly apply intervention assessment tools
- Communicated with patients and family members to assist with information, provide literature and direct to community resources.
- Monitors non-targeted and targeted cases for entry of appropriate discharge date and disposition.
- Identifies triggers for referral Case Management, Disease Management, and other Programs.
- Performs non-medical and medical research pertinent to the establishment, maintenance, and closure of open cases using systems such as Dynamo, QNXT, MedCompass, Sales Force and PeopleSafe.
- Successfully completed 30 incoming and outgoing calls daily; answering questions, completing assessments, and responding to inquiries.
- Obtained case history by completing needed assessments and gathered triage information to determine appropriate avenue for care.
Community Care Coordinator
Caidan, Meridian Health Plan
01.2016 - 11.2021
- Conducted complete, timely and accurate Health Risk Assessments and Care Plans (face-to-face) and ongoing outreach and maintained contractual compliance indicators for a case load of 210
- Maintained case record documents and documented case notes daily using TruCare, and coordinated follow-up for seamless case management.
- Facilitated interdisciplinary care team (ICT) meetings with medical teams, patients and families to implement effective treatment plans.
- Completed post hospital discharge follow-up and coordination of care
- Conducted reviews to determine eligibility and functional needs..
- Delivered social work services to LTSS & MLTSS in Assisted Living, Nursing home and Home settings.
Program Coordinator
Centene Corporation, County Care/Illinicare
01.2015 - 12.2016
- Initiated authorization requests for output or input services in keeping with the prior authorization list
- Maintained a case load of 600 Low risk members using EHR TruCare
- Utilize Impact Pro, Tru Care and varies other programs to screen members by priority for case management (CM) assessment and to perform HEDIS measures
- Research claims inquiry specific to the department and responsibility
- Perform tasks necessary to promote member compliance such as verifying appointments, obtaining lab results.
Medical Assistant
Advocate Health Care
05.2012 - 09.2014
- Maintain clean examination areas by setting up rooms, cleaning instruments and maintaining GI diagnostic equipment
- Performed venipunctures and skin punctures
- Called and faxed pharmacies to submit prescriptions and refills.
- Completed clinical procedures and gathered patient data for interpretation by physician.
- Collaborated with medical and administrative personnel to maintain patient-focused, engaging and compassionate environment.
- Documented vital signs and health history for patients in clinics such as Gastroenterology, Family Practice, OB/GYN, PEDS and Varies Procedures
Education
Associate Degree - Applied Science
Robert Morris University
Skills
- Organization and Time Management
- Medical Recordkeeping
- Adaptable and Flexible
- Administering Medications
- Scheduling Tests and Procedures
- Medical Report Preparation
- Patient Health Information Access
- Data Entry Software
- Case Management Software
- Clinical Documentation
- Care Planning and Management
Timeline
Care Management Associate
CVS Health Company
12.2021 - Current
Community Care Coordinator
Caidan, Meridian Health Plan
01.2016 - 11.2021
Program Coordinator
Centene Corporation, County Care/Illinicare
01.2015 - 12.2016
Medical Assistant
Advocate Health Care
05.2012 - 09.2014
Associate Degree - Applied Science
Robert Morris University
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