Patience Montgomery
Obetz,Ohio
Summary
Care Management Leader with 11 years of Medicaid care management experience and 5 years of team leadership, driving improved health outcomes, coordinated care delivery, and operational efficiency. Proven ability to oversee complex clinical and non-clinical initiatives, analyze care management trends, and translate data insights into strategic population health solutions. Adept at cross-functional collaboration, regulatory alignment, workflow design, and developing programs that support quality, cost containment, and compliance with state and federal standards.
Overview
11
11
years of professional experience
1
1
Certification
Work History
Lead Care Manager – Medicaid Managed Care
Buckeye Health Plan
11.2014 - Current
- Strategic Population Health Leadership
- Led operational initiatives supporting population health strategy, aligning care management workflows with organizational priorities and state regulatory requirements.
- Oversaw queue management for referrals, transitions of care, alerts, and specialty tasks, enabling timely interventions for high-risk and rising-risk member populations.
- Analyzed care management activity, trends, and alert data to support early identification of complex members and inform strategy discussions with senior leadership.
- Program & Process Improvement
- Provided insights and operational recommendations to leadership to enhance care coordination, reduce inefficiencies, and support cost management goals.
- Managed transportation program oversight, identifying misuse trends, ensuring proper utilization, and contributing to program-level improvements.
- Streamlined Care Coordination Portal processes, improving user access, reducing workflow delays, and ensuring system integrity through training and troubleshooting.
- Cross-Functional & External Collaboration
- Collaborated with senior leaders, provider partners, and Medicaid agencies through CPC initiatives and multi-MCO quality forums.
- Partnered with Partners for Kids (PFK) to support complex case needs, incident reporting, grievance and appeals responses, and data requests.
- Supported delegated vendor oversight through quarterly evaluations, outreach outcome reviews, and alignment with performance expectations.
- Data Analysis, Reporting & Strategic Support
- Conducted high-level research, demographic analyses, and family group assessments for medical directors and utilization management teams.
- Synthesized outcomes and participation trends across programs, closing or escalating cases based on engagement and clinical need.
- Supported organizational readiness for NCQA, state mandates, and contract compliance through accurate documentation and reporting.
- Leadership, Team Development & Operational Continuity
- Provided leadership coverage during other leads’ absences, ensuring continuity in operations and staff performance.
- Delivered system training, workflow support, and mentorship to staff to strengthen team capability and compliance.
- Completed cross-functional responsibilities to support strategic initiatives and evolving organizational priorities.
Education
Bachelor of Science - Nursing
Shawnee State University
Portsmouth, OhioSkills
- Care Coordination Platforms
- Medicaid Care Management Systems
- Analytics & Reporting Tools
- Microsoft Office Suite
Certification
Certified Case Manager (CCM)
Timeline
Lead Care Manager – Medicaid Managed Care
Buckeye Health Plan
11.2014 - Current
Bachelor of Science - Nursing
Shawnee State University
Core Competencies
- Care Coordination Optimization
- Data Trends, Reporting & Analytics
- Quality Improvement & Outcome Measurement
- Regulatory Compliance (State, Federal, NCQA)
- Cross-Functional Leadership & Collaboration
- Clinical & Non-Clinical Program Oversight
- Strategic Planning
- High-Risk Population Support & Identification
- Interdisciplinary Rounds & Clinical Integration
- Provider, Vendor & Delegated Entity Management
- Training, Coaching & Team Development