Susan M Wiley

• In 2002 I was promoted to Health and Social Service Manager from Case Manager.
• I was highly encouraged by other staff members and the manager who was moving to another part of UHC
• Currently I am a supervisor for fourteen direct reports that consist of Registered Nurses and Community Health Workers
• My primary role is to educate, provide resources, and ensure that we are doing what needs to be done to help satisfy our three-way contract with the Department of Medicaid
• Just as important as providing staff oversight and education I provide them with emotional support to try to make their jobs seamless so they can work smarter and not harder. By doing this it will allow them to achieve job satisfaction and work life balance.
• There are many other duties that a Health and Social Service Manager has as well, such as auditing charts, , presenting in National Audits, creating job aids, holding my own caseload when staff is overwhelmed to give them some relief or just taking on some of their more difficult members.
• Education is important and I am known as the educator for the Cleveland area and do supplemental education throughout the year for the Cleveland team in what I call "pop ups". I scatter these throughout the week so they can attend when time allows, they are all voluntary.
• Currently the leader in working with Public Partnerships and The Department of Medicaid for Self-Directed members for the MMP Central Region.

My role as a Case Manager was to assist our member with functioning as well as they possibly could while living in the community, as well as providing them with education and resources to help them stay healthy and out of hospitals. In conjunction with assisting our members assisting their family was also top on my list. Caregiver role strain plays an important role in members success.

• In addition to that role, I also supported and work closely with Waiver Service Coordinators from Western Reserve Area Agency on Aging, our own Community Health Workers, LTC-Case Managers, and SRS Care Managers by reviewing documentation and addressing our member’s needs as they arise
• Assisting member with repatriating back to the community was also a big part of this job
• As a Case Manager I also trained new hires, assist the other CMs with questions daily, when our manager was on vacation or out of the office.
• I volunteer for Work Groups and provide support at COVID-19 Clinics when time allowed

• Charge Nurse hired to be in administration once Memory Care Unit was built.
• Passed medications, wound care. My employment allowed them to take on patients who needed central line and implanted port care. Provided constant collaborated with doctors and families for optum patient results.
• I worked here on my Capstone project for the RN-BSN program at Notre Dame College
• The project was to create a manual for Requirements of Participation for Medicare and Medicaid
• I created a competency manual for Behavioral Heath with a focus on Dementia for a new building and department that was being created.
• Early on I realized that this was not the place for me because I really enjoyed case management and working much closer with people in the community. Four walls was not for m.

• Responsible for transitioning patients to a private home setting from either a hospital or skilled nursing facility and to decrease hospital readmission rates
• Assessed patient's home environment for safety, need for therapy, social work, home health aide, or any other services and then coordinate that care.
• Provide home infusion therapy via ports or insertion of IVs, for long-term antibiotic treatment or for heart failure therapy so member could reside in their home during treatment rather than a skilled nursing facility.
• Provided would care for homebound patients who could not get to the wound care clinic and worked very closely with the doctors ordering the care.
• Provide as much oversight as needed and as much support as needed to patient and family to help them feel safe and secure while receiving care in a home setting.
• Provided a great deal of education on many chronic disease processes, diet, and medications to both the patient and family members in a way that they could understand so they could be successful.
• Supervised Licensed Practical Nurses, and Home Health Aides to ensure plan of care was being followed.
• Participate on Unit Based Council and assist with training and hiring new employees
• Work independently out of home office and attended weekly meetings for Case Conference and Unit Based Council as scheduled
• Experience with Medicare and Medicaid
• Nominated for Nightingale Award 2018

• Managed care of patients from intensive care units at hospitals who needed more time to heal
• Responsible for patients on ventilators/respiratory therapy, severe wound care, infectious diseases, deep vein thrombosis, ran may drips at one time including vasopressors, heparin, and may different forms of antibiotics.
• I did not stay here long because I received a call that I had the opportunity to start case management and that is the field that I desired to be in as a nurse.

• Managed the care of post-operative, telemetry, and overflow patients from Medical Surgical Unit
• Administered prophylactic antibiotics and pain control medications to surgical patients
• Managed the care of cardiac patients and the chemically dependent as needed