Sally Ingeno
Boynton Beach,FL
Summary
A dedicated and results-driven healthcare and social services professional with over 20 years of experience in case management, staff supervision, and regulatory compliance. Holds an Interprofessional Graduate Certificate in Gerontology and a Bachelor of Science in Rehabilitation and Human Services. Expertise includes overseeing clinical appeals, managing interdisciplinary teams, and ensuring compliance with federal, state, and contractual guidelines. Proven track record in optimizing case management processes, improving service delivery, and enhancing member satisfaction. Skilled in preparing and presenting appeals for Medicaid fair hearings, coordinating care plans, and providing education to clients and caregivers. Strong communicator with a passion for advocating for vulnerable populations and driving positive outcomes in healthcare and social services settings.
Knowledgeable [Desired Position] known for effectively leading case management teams and implementing process improvements. Adept at coordinating care plans and fostering strong relationships with healthcare providers. Demonstrated ability in strategic planning and conflict resolution.
Overview
25
25
years of professional experience
Work History
Clinical Appeals Specialist
FCC
06.2022 - Current
- Review enrollee medical records, using clinical and regulatory expertise to determine the reasons for case denials and whether an appeal is warranted
- Utilize pre-existing criteria, resources, and clinical evidence to develop strong, supported appeal arguments
- Act as the liaison between the AHCA Office of Fair Hearings and FCC, preparing and submitting evidence, and providing testimony during Medicaid fair hearings
- Maintain compliance with federal and state regulations, as well as contractual agreements related to appeals and fair hearings
- Schedule and run appeal meetings with the medical director, and case management staff as needed
- Complete all AHCA related statutory reporting and audit-related correspondence, and other administrative duties as required
Care Manager Supervisor
FCC
11.2019 - 06.2022
- Manage a team of case managers, including hiring, training, scheduling, workload monitoring, and performance evaluation
- Ensure compliance with federal and state regulations and contractual agreements
- Facilitate communication between case management staff, interdisciplinary teams, and providers to foster cooperation
- Oversee staff production metrics and audit assessments and care plans to meet policies, procedures, and contractual guidelines
- Coordinate and present information for administrative hearings and state reviews when applicable
Care Manager
FCC
12.2018 - 11.2019
- Conduct initial and annual assessments using the Florida 701B assessment
- Develop and review care plans in collaboration with clients and their representatives
- Link members to appropriate services and coordinate service delivery
- Maintain and document member records in compliance with AHCA contracts
- Provide education and training to members and caregivers
LTC Case Manager
Aetna
10.2016 - 12.2018
- Complete initial and annual assessments using the Florida 701B assessment
- Develop and review care plans in collaboration with clients and their representatives
- Coordinate the delivery of services and link members to appropriate resources
- Maintain member records and ensure ongoing documentation in accordance with AHCA contracts
- Provide education and training to members and caregivers
Patient Care Coordinator
Caregivers of America
02.2008 - 04.2010
- Company Overview: Lauderhill, FL
- Manage client intake for home healthcare services and determine eligibility for care
- Coordinate scheduling and supervise the delivery of care
- Ensure compliance with state, federal regulations, and accrediting agency requirements
- Oversee the completion of Home Health Aides/Homemaker and companion personnel requirements
- Facilitate case conferences with the Director of Nursing and Administrator to update patient care plans
- Address problems and complaints, identifying and implementing corrective action plans
- Lauderhill, FL
Family Case Manager
Neighbor to Family
09.2007 - 02.2008
- Company Overview: Orlando, FL
- Assess the needs of minors placed in care by DCF due to abuse or neglect
- Conduct safety assessments, family assessments, and coordinate service delivery
- Develop and monitor case plans, reporting progress to supervisors and court
- Provide specialized services, including ICPC requests, home studies, and court reports
- Orlando, FL
Adoption Caseworker
The Maine Children’s Home for Little Wanderers
01.2007 - 07.2007
- Company Overview: Waterville, ME
- Provide guidance to families pursuing in-state, interstate, and international adoption
- Oversee the care of infants placed in foster care and update prospective adoptive parents
- Provide post-adoption services, including post-placement supervision in compliance with laws
- Waterville, ME
Habilitation Specialist II
Assistance Plus
01.2007 - 07.2007
- Company Overview: Benton, ME
- Supervise and train Habilitation Specialist I staff, developing service plans and ensuring implementation
- Lead a team of approximately 14 staff providing in-home habilitation services to individuals with intellectual disabilities and mental health disorders
- Provide behavioral modification/management and promote physical and social development
- Benton, ME
Case Management Supervisor
Assistance Plus
02.2004 - 10.2006
- Company Overview: Benton, ME
- Manage all case management staff, including hiring, training, and scheduling
- Act as liaison with the State of Maine to ensure compliance with state and federal laws
- Review staff performance and recommend appropriate personnel actions
- Develop and implement program-wide changes and establish policies and goals to enhance service quality
- Benton, ME
Case Manager
Assistance Plus
08.2000 - 10.2006
- Company Overview: Benton, ME
- Provided case management for children and young adults with behavioral health issues, intellectual disabilities, and severe medical conditions
- Completed comprehensive assessments and developed service plans based on individual needs
- Coordinated services such as respite care, Medicaid, OT/PT/SLP, educational programming, and crisis services
- Oversaw placements in treatment facilities, crisis services, and foster care, providing advocacy and coordination of services
- Benton, ME
Behavioral Specialist I
Assistance Plus
09.1999 - 09.2000
- Company Overview: Benton, ME
- Provided 1:1 behavioral health services for children with autism and mental health diagnoses in home and community settings
- Followed individualized treatment plans and participated in team meetings and trainings
- Benton, ME
Education
Interprofessional Graduate Certificate - Gerontology
The University of Maine
Orono, MEBachelor of Science - Rehabilitation and Human Services
University of Maine at Farmington
Farmington, ME01.2000
Skills
- Clinical and regulatory knowledge
- Case management
- Staff supervision
- Appeals preparation
- Fair hearings
- Medical record review
- Care coordination
- Communication
- Collaboration
- Effective communication
- Strong analytical skills
- Negotiation techniques
- Problem-solving capacity
- Time management
- Attention to detail
Timeline
Clinical Appeals Specialist
FCC
06.2022 - Current
Care Manager Supervisor
FCC
11.2019 - 06.2022
Care Manager
FCC
12.2018 - 11.2019
LTC Case Manager
Aetna
10.2016 - 12.2018
Patient Care Coordinator
Caregivers of America
02.2008 - 04.2010
Family Case Manager
Neighbor to Family
09.2007 - 02.2008
Adoption Caseworker
The Maine Children’s Home for Little Wanderers
01.2007 - 07.2007
Habilitation Specialist II
Assistance Plus
01.2007 - 07.2007
Case Management Supervisor
Assistance Plus
02.2004 - 10.2006
Case Manager
Assistance Plus
08.2000 - 10.2006
Behavioral Specialist I
Assistance Plus
09.1999 - 09.2000
Bachelor of Science - Rehabilitation and Human Services
University of Maine at Farmington
Interprofessional Graduate Certificate - Gerontology
The University of Maine
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