ROSEMARIE ARREDONDO KIDD
Registered Nurse Leader
Hampton,Virginia
Summary
Healthcare leader with extensive experience at Sentara Health Plan, specializing in care management and team supervision. Demonstrated success in developing innovative programs that enhance operational efficiency. Expertise in regulatory compliance and strategic planning, with a focus on staff training and relationship building to improve quality outcomes in Medicaid services.
Overview
20
20
years of professional experience
Work History
Manager Government Services
Optima Health /Sentara Health Plans Community Care
Norfolk, VA
11.2022 - Current
- Manage teams 6 to 75 plus care coordinators, supervising various teams including Tidewater Regional team, HRA Field Team, Brain Injury Services, Chronic Care Management/ UM Team, MCOD Telephonic Team.
- Developed specialty team, HRA Field Team- Specializing in assessments for the CCC Plus Program and Cardinal Care Contract for all populations, NF, Waiver, Peds, Adult, PDN, and others as requested. Used Microsoft Teams to track KPI for these team members. One RN per region for the state of Virginia Cardinal Care Contract with DMAS.
- PPED Wave Initiative- Co-Chair for this initiative since 2022- developed educational materials as needed for PPED education for members and providers; participate in provider education with Network Team.
- Assist with various Wave initiative sub-committees; PPA, PPR, developed educational materials as directed by chairs of these committees.
- Nine Box Project- Developed Virtual Manual for the Medicaid team, with technical assistance from analytic team members and education team. Also, assisted in coordinating Medicaid teams required training per the Cardinal Care DMAS contract 2024/2025.
- Subcommittee member for the Diabetic CPI committee for GIC project.
- Participating in the education department’s preceptor training program as developer/team member.
- Assist quality teams as requested in special projects such as HSAG PIP for PPED 2022-2024; New HSAG initiative for 2025-2027 will be Blood Pressure focus.
Team Coordinator
Optima Health Community Care
Norfolk, VA
06.2017 - 11.2022
- Direct leadership for Long Term Services and Support Program Commonwealth Coordinated Care Plus (CCC Plus) Medicaid plan for the Tidewater Region of Virginia.
- Serving members in managed care Medicaid program for the state of Virginia Department of Medicaid Assistance Services, focusing on children and adults with disabilities which includes 15,000 members in the Tidewater region.
- Supervise, educate and mentor staff and members of the program for Tidewater including identifying team training needs, provide performance evaluation, analyzing data and behaviors to prescribe appropriate learning solutions.
- Provides supervision and direction to Nurse and Non-RN clinicians participating in the member’s case in accordance with applicable state law and contract.
- Responsible for face-to-face clinical assessments for the identification, evaluation, coordination and management of member’s needs, including physical health, behavioral health, social services and long-term services and supports.
- Identifies members for high-risk complications and coordinates care with the member and the health care team.
- Manages members with chronic illnesses, co-morbidities, and/or disabilities, to ensure cost effective and efficient utilization of health benefits.
- Obtains a thorough and accurate member history to develop an individual care plan with care coordinators assigned to individual members.
- Establishes short- and long-term goals in collaboration with the members, caregivers, family, natural supports, physicians, including helping to identify members that would benefit from alternative care or other waiver programs.
- May assist with the implementation of member care plans by facilitating authorizations/referrals for utilization of services, as appropriate, within benefits structure or through extra-contractual arrangements.
- Interfaces with Medical Directors, Physician Advisors and/or Inter-Disciplinary Teams on the development of care management treatment plans.
- Directs and supervise LPN/LVN, LSW, LCSW, LMSW, and other licensed professionals in coordinating services for the members including assigning appropriate tasks, verifying and interpreting member information obtained by these individuals, conducting additional assessments, and more.
- Supervise Clinical Care Technicians.
Education
Doctorate - Healthcare Administration
University of Phoenix
Tempe, AZ03-2026
Masters - business administration, Minor in healthcare administration
University of Phoenix
03.2009
Baccalaureate - Nursing
University of Phoenix
02.2006
Certificate - Healthcare Management
Old Dominion University
04.2002
diploma -
De Paul Medical Center School of Professional Nursing
Norfolk, Virginia05.1990
Skills
- Care management and healthcare administration
- Medicare and Medicaid expertise
- Supervision and leadership
- Registered nursing
- Long-term services and supports
- Multi-generational population care
- Regulatory compliance and standards
- Microsoft Office proficiency
- Advanced internet skills
- Marketing strategies
- Revenue and budget management
- Safety procedures implementation
- Business administration skills
- Complex problem-solving abilities
- Trend analysis and project planning
- Strategic planning and resource allocation
- Staff training and development
- Operations management expertise
- Work prioritization techniques
- Employee onboarding processes
- Cross-functional team leadership
- Project management skills
- Customer relationship management (CRM)
- Documentation and reporting practices
- Key performance indicators (KPIs) tracking
- Financial management strategies
- Relationship building techniques
- Coaching and mentoring
References
Available upon request.
Area Of Expertise
- Care Management
- Medicare & Medicaid
- Supervision & Leadership
- Registered Nurse
- Long-term Services and Supports
- Multi-generational populations
- Healthcare Administration
- DMAS, CMS & Sentara Compliance
- SDOH
- NCQA Standards
- Cardinal Care
Timeline
Manager Government Services
Optima Health /Sentara Health Plans Community Care
11.2022 - Current
Team Coordinator
Optima Health Community Care
06.2017 - 11.2022
Doctorate - Healthcare Administration
University of Phoenix
Masters - business administration, Minor in healthcare administration
University of Phoenix
Baccalaureate - Nursing
University of Phoenix
Certificate - Healthcare Management
Old Dominion University
diploma -
De Paul Medical Center School of Professional Nursing
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