Sarah Fitzpatrick
Greenville,SC
Summary
Licensed social worker with extensive experience in healthcare including assessment, case management, and managed care. Proven leader and recognized top performer who is passionate about improving quality of care.
Quality professional with proven track record in leading cross-functional teams and driving project success. Skilled in strategic planning, risk management, and resource allocation. Known for adaptability, problem-solving, and fostering collaboration to achieve results. Proficient in optimizing processes and aligning initiatives with organizational objectives.
Overview
16
16
years of professional experience
1
1
Certification
Work History
Clinical Quality Program Manager
Elevance Health
08.2023 - Current
- Leads a team of 8 clinicians
- Responsible for overseeing quality of care investigations in multiple states
- Leads the Member Safety Committee
- Clinical data reporting and presentations
- Responsible for overseeing state and client contract obligations
- Created onboarding orientation structure
- Completes all high profile Quality of Care Reviews.
- Responsible for all new policy creation and annual review of all policy
- Project manager for departmental initiatives.
Training Specialist
Elevance Health
12.2019 - 08.2023
- Responsible for company wide department training
- Supports all staff with daily tasks
- Managed a full quality of care review caseload
- Conducted internal and external audits
- Created team structure
Quality Management Specialist II
Beacon Health Options
10.2018 - 12.2019
- In depth knowledge of the HEDIS follow up after hospitalization measure
- Manages the Nonstandard Supplemental Data collection process for government lines of business
- Conducts inpatient facility audits for HEDIS FUH compliant discharge planning and educates providers on process improvements
- Completed 2018 audit to ensure compliance with the Aftercare Follow up Workflow and New Jersey Corrective Action Plan
- Presented findings in an internal meeting with the clinical director
- Performs monthly case-by-case root cause analysis of members not meeting FUH compliance to identify claims processing issues impacting HEDIS performance and communicate findings in customer, provider, and internal meetings
- Assist with behavioral health facility audits to ensure compliance with agreed upon Corrective Action Plan measures to reduce Quality of Care concerns
- Participate in facility meetings to review audit outcomes and opportunities for improvement
- Assist with outpatient provider record review audits
- Active member of Beacon Project ECHO
Clinical Care Manager
Beacon Health Options
05.2014 - 09.2017
- Lead clinician for the Out of Area Substance Abuse Initiative: improved workflows, facilitated rounds, trained clinicians on the initiative and documentation requirements
- Trained and provided ongoing support for new hires for the IOP/PHP concurrent team
- Utilization review for ABA, IOP, PHP
- Responsible for member customer service experience for the ASD population: explanation of benefits, referrals, and complaint de-escalation
- Developed and coordinated the interdepartmental ABA claims workgroup
- Mount Laurel, NJ
Hospital Social Worker
Deborah Heart And Lung Center
10.2011 - 05.2014
- Case Management and discharge planning
- Participation in hospital work groups
- Provided emotional support to family members during emergency codes
- Trained interns and new employees under the supervision of management
- Provided emotional support to patients coping with chronic illness
- Active participant in treatment planning via interdisciplinary rounds
- Participated in family meetings
- Obtained prior authorizations for all after care services
- Browns Mills, NJ
Inpatient Psychiatric Social Work Intern
Lourdes Health System
09.2012 - 05.2013
- Performed all evening Bio-Psycho-Social Multi-Axial Assessments
- Facilitated Psycho-Educational groups with a focus on coping skills
- Participated in family meetings
- Assisted treatment team with discharge planning for the geriatric population
Community Educator
Light House Hospice
03.2010 - 09.2010
- Established and maintained public relations efforts to increase community understanding of hospice and improve relationships with referral sources
- Conducted market assessment in assigned territories for recruitment
- Communicated referral, admission, and census statistics to the Director of Education and Quality
- Acted as a liaison for physicians, nursing facilities, hospitals, assisted living homes for resolving complaints.
Director of Marketing and Admissions
Spring Oak Assisted Living
08.2008 - 03.2010
- Managed all admitting department operations
- Direct supervisor and managed operations of the facility on rotating weekend shifts
- Educated and guided families through the Medicaid Global Options Assisted Living Waiver
- Assisted residents and families in coping with assisted living placement, physical illness, and the grieving process
- Responsible for educating residents on Advance Directives and Resident Rights
- Maintained all admissions charts and record keeping
- Resolved family and resident complaints
Education
Master of Social Work -
Rutgers University
New Brunswick, NJ01.2013
Bachelor of Arts - Social Work
Rutgers University
Camden, NJ01.2007
Skills
- Case Management
- Utilization Management
- Quality Management
- Discharge Planning
- Training
- Community Education
- Leadership
- Strong Analytical Skills
- Team Oriented
- Customer Service
- Complaint Resolution
- Auditing
- Process improvement
- Team leadership and direction
- Training and development
Certification
South Carolina, LMSW, 103019
Professionalaccomplishments
- Rated Exceptional Performer on all annual reviews at Beacon Health Options since hire
- Recognized as a Beacon Health Options Top Performer in 2017. Bonus Received April 2018
- Recognized for work on the Out of Area Substance Abuse Initiative. Received bonus in March 2017
- 2006 Recipient of the Burlington County Faculty Association Scholarship
- 2007 Recipient of the Rutgers Brian C. Wright Award for commitment to social work values and ethics
Timeline
Clinical Quality Program Manager
Elevance Health
08.2023 - Current
Training Specialist
Elevance Health
12.2019 - 08.2023
Quality Management Specialist II
Beacon Health Options
10.2018 - 12.2019
Clinical Care Manager
Beacon Health Options
05.2014 - 09.2017
Inpatient Psychiatric Social Work Intern
Lourdes Health System
09.2012 - 05.2013
Hospital Social Worker
Deborah Heart And Lung Center
10.2011 - 05.2014
Community Educator
Light House Hospice
03.2010 - 09.2010
Director of Marketing and Admissions
Spring Oak Assisted Living
08.2008 - 03.2010
Bachelor of Arts - Social Work
Rutgers University
Master of Social Work -
Rutgers University
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