Sofia L. Eddleman
Concord,USA
Summary
Dynamic professional with extensive experience in behavioral health operations at Aetna, excelling in client relations and administrative support. Proven track record in developing effective care plans and enhancing operational efficiency. Adept at cross-functional collaboration and problem-solving, driving impactful outcomes in healthcare delivery and community engagement.
Overview
29
29
years of professional experience
Work History
Owner
Mobile Food Truck Business
01.2019 - Current
- Manage all aspects of a mobile food service business, including operations, menu development, budgeting, licensing, and customer service.
- Built a strong local customer base through quality service and community presence.
Care Planner
Aetna
02.2014 - Current
- Provide administrative, coordination, and case-management support to behavioral health clinical teams, ensuring efficient workflows and timely care delivery.
- Lead member outreach initiatives to promote engagement in specialized programs and services.
- Partner with licensed clinicians to develop, implement, and monitor individualized care plans based on clinical needs and organizational guidelines.
- Conduct provider searches and coordinate referrals to ensure members access appropriate care quickly and efficiently.
- Oversee transition-of-care processes, including discharge verification and post-discharge follow-ups, to support continuity of care and improve outcomes.
- Maintain accurate, HIPAA-compliant documentation across multiple systems and platforms.
- Serve as liaison between members, providers, and internal departments to resolve issues quickly and accurately.
- Utilize Rumba, ASD, CAT, ECHS, and Microsoft Office to track cases, document interactions, and manage daily administrative operations.
- Identify operational inefficiencies and recommend workflow improvements to enhance process effectiveness.
- Assist in onboarding and training new team members, promoting teamwork and knowledge-sharing.
Founder & CEO
Daughters of Sarah Inc.
01.1997 - Current
- Lead nonprofit organization supporting women and families through education, empowerment, and community outreach.
- Oversee fundraising, program development, and volunteer engagement.
- Lead nonprofit organization supporting women and families through education, empowerment, and community outreach.
Behavioral Health Representative
Aetna / CVS Insurance
12.2006 - 02.2014
- Resolved inquiries from members, providers, and sponsors across multiple health service lines.
- Processed service authorizations and maintained detailed, compliant case documentation.
- Cross-trained in Medical, Pharmaceutical, and Authorization departments to support operational needs.
- Ensured accuracy and compliance when researching member eligibility, benefits, and service coverage.
Education
Certificate in Business Administration -
Palmer Business Institute
Lancaster, PAHigh School Diploma -
Reading Senior High School
Reading, PASkills
- Client and provider relations
- Behavioral health operations
- Administrative and clinical support
- Microsoft Office proficiency
- Healthcare systems expertise
- Cross-functional collaboration
- Problem solving
- Decision making
Leadership And Entrepreneurship
- Founder & CEO, Daughters of Sarah Inc., 01/01/97, Present, Lead nonprofit organization supporting women and families through education, empowerment, and community outreach., Oversee fundraising, program development, and volunteer engagement.
- Owner, Mobile Food Truck Business, 01/01/19, Present, Manage all aspects of a mobile food service business, including operations, menu development, budgeting, licensing, and customer service., Built a strong local customer base through quality service and community presence.
Timeline
Owner
Mobile Food Truck Business
01.2019 - Current
Care Planner
Aetna
02.2014 - Current
Behavioral Health Representative
Aetna / CVS Insurance
12.2006 - 02.2014
Founder & CEO
Daughters of Sarah Inc.
01.1997 - Current
Certificate in Business Administration -
Palmer Business Institute
High School Diploma -
Reading Senior High School