Shelli A Doom

• Analyzed data from various sources to identify trends and patterns.
• Created detailed reports that documented findings and presented recommendations to senior leadership.
• Reviewed business requirements documents and developed project plans accordingly.
• Provided guidance on insurance policies and procedures to members.
• Resolved member complaints efficiently and effectively.
• Maintained accurate records of all interactions with members.
• Interfaced with other departments to ensure timely resolution of issues.

• Developed and maintained relationships with key network providers/facilities within assigned region: support continued regional network development activities necessary to meet network adequacy requirements.
• Acted as front line support as needed with the member, partner facility and integrated care team to ensure the needs of the member and the plan were met.
• Managed database of patient information and frequently used computerized systems to track details.
• Met with each member enrolled in ISNP plan and/or their family monthly.
• Ensured that all interactions with the member were compliant with CMS regulations.
• Collaborated with multi-disciplinary staff to improve overall patient care and response times.
• Provided knowledgeable and compassionate service in response to patient questions and concerns.

Behavioral Health Coordinator-Remote (Optum) 6/1/2020-9/2021

• Handled inbound/outbound calls from/to members and providers for Medicare Advantage and Family Support Program.
• Completed HRA (High Risk Assessments) for each identified member.
• Entered patient insurance, demographic and health information into software and confirmed records.
• Disseminated information to correct department, individual or outside location.

Medicaid Outreach Care Coordinator-Northern Colorado (UHG) 11/15/2015-6/1/2020

• Arranged for medical, mental health or substance abuse treatment services according to individual needs or court orders
• Gathered community resources and coordinated referrals to obtain services.
• Collaborated with interdisciplinary team of professionals as well as patients and families to determine appropriate treatment options.
• Facilitated on-going assessment of patient and family needs and oversaw implementation of interdisciplinary team plan of care.

• Responsible for onboarding and supervising all for Entry Points Staff and Eligibility Service Coordinators on the Greeley Human Service Campus.
• Supervising and monitoring department wide customer service activities.
• Ensuring all staff are in compliance with County, State, and Federal policies and procedures.
• Responsibilities include planning, assigning and directing work, appraising performance and coverage.

• Directly supervised all the components of the Home and Community Based Services Medicaid IDD Waiver Programs.
• Developed robust marketing plans to increase awareness of programs.
• Oversaw completion of productivity goals and educated employees on established company processes.
• Liaised between organizations, partners, stakeholder, and members to promote and improve services and communication.
• Managed program operations and provided strategic leadership for all workers.
• Designed and implemented standard operating procedures in various departments for optimal efficiency.
• Managed program operations and provided strategic leadership for workers.