Summary
Overview
Work History
Education
Timeline
Generic

Pamela Godfrey

Summary

Results-driven management professional with proven ability to lead teams to success. Strong focus on team collaboration, operational efficiency, and achieving measurable outcomes. Adept at process improvement, and fostering culture of accountability and excellence. Known for adaptability and consistently meeting changing organizational needs.

Overview

19
19
years of professional experience

Work History

Manager II, Medical Management

Elevance Health
02.2023 - Current
  • Provide leadership to a team of nurses and support staff to ensure the success of the Complex Discharge Planning Program
  • Responsible for process improvement, quality assurance and adherence to policies and procedures.
  • Responsible for hiring, training, coaching, and evaluates performance of staff.
  • Responsible for reporting and cost of care for Complex Discharge Planning program.


Director PAC-IM

MyNEXUS
04.2022 - 02.2023
  • Instrumental in the development and implementation the Post-Acute program to include creating procedure guides, processes, hiring and training new staff.
  • Responsible to ensure adherence to Medicare guidelines and member benefits in providing services that are medically appropriate and cost effective.
  • Monitored day to day operations to ensure compliance
  • Developed high-performing team by providing mentorship, guidance, and opportunities for professional growth.
  • Enhanced team collaboration through regular communication, goal setting, and performance evaluations.

Manager I/II Medical Management

Anthem BC/BS
07.2012 - 04.2022
  • Provided leadership for a team of nurses and support staff that completed prospective, concurrent and retrospective reviews for post-acute level of care.
  • Monitored day to day operations to ensure compliance to CMS policy
  • Lead workgroups for process improvement activities
  • Interviewed, hired, and onboarded new associates.
  • Ongoing training of associates to include coaching, counseling and evaluating performance.
  • Strong knowledge of Medicare guidelines and regulatory requirements.
  • Instrumental in the development and implementation of CareMore Essentials to include creating training materials, hiring and training new staff, and overseeing the program.

Medical Management Team Lead

Anthem BC/BS
08.2010 - 07.2012
  • Monitored day to day operations, productivity, daily case loads and generate reports.
  • Assisted in training new team members by relaying information on company procedures and policies.
  • Responsible for completing team audits and providing feedback.
  • Supported manager as needed.
  • Served as a role model for the team by demonstrating commitment to excellence, professionalism, and adherence to company values.
  • Coached team members in techniques necessary to complete job tasks.

Utilization Management Nurse

Anthem BC/BS
09.2005 - 08.2010
  • Conducted prospective, concurrent, and retroactive reviews for post-acute level of care.
  • Contributed to team success by consistently meeting productivity goals while maintaining high-quality standards in job performance.
  • Determined medical appropriateness for benefits of health services


Education

Associate of Applied Science - Nursing

Edison Community College
Piqua, OH
05-1994

Timeline

Manager II, Medical Management

Elevance Health
02.2023 - Current

Director PAC-IM

MyNEXUS
04.2022 - 02.2023

Manager I/II Medical Management

Anthem BC/BS
07.2012 - 04.2022

Medical Management Team Lead

Anthem BC/BS
08.2010 - 07.2012

Utilization Management Nurse

Anthem BC/BS
09.2005 - 08.2010

Associate of Applied Science - Nursing

Edison Community College

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Pamela Godfrey