Victoria Muckelroy
Desoto,TX
Summary
Highly motivated professional who demonstrates ability to develop and implement successful plans of action to address company needs. Possesses strong problem-solving skills to reduce barriers. Enthusiastic learner who is passionate and committed to company success, establishes genuine and professional rapport with co-workers and peers. . Enjoy working as a team member as well as independently. Ability to grasp new ideas and integrate them into desired results. Empathic listener and persuasive speaker. .
Overview
10
10
years of professional experience
Work History
Behavioral Discharge Planner
Centene Corporation
11.2022 - Current
- Review clinical documentation from behavioral facilities within 48 hours to help initiate a safe discharge plan that resulted in members following up with Behavioral Health Outpatient providers for continued care
- Present high-risk members with clinical staff and leadership in medical rounds that results in helping members eliminate multiple admissions
- Complete health risk assessments and meet HEDIS measures that results in HIPPA compliance and successful member outreach
- Monitor and evaluate members discharge plan that results in member success for outpatient treatment
- Complete cross functional improvement work gaps designed to help members function in the community.
Care Coordinator
Centene Corporation
02.2017 - 11.2022
- Educated members and their families on health care issues including symptoms, relapse prevention, stress reduction, that resulted in healthier lifestyle choices and connected members with community resources and agencies
- Coordinated health care treatment options with health care providers for members that allowed members to understand their health care options
- Assisted members with problem solving by breaking down barriers for treatment to help members that need accessing care from providers.
Discharge Planner
Centene Corporation
12.2016 - 02.2017
- Review clinical documentation from behavioral facilities within 48 hours to help initiate a safe discharge plan that resulted in members following up with Behavioral Health Outpatient providers for continued care
- Present high-risk members with clinical staff and leadership in medical rounds that results in helping members eliminate multiple admissions
- Complete health risk assessments and meet HEDIS measures that results in HIPPA compliance and successful member outreach
- Monitor and evaluate members discharge plan that results in member success for outpatient treatment
- Complete cross functional improvement work gaps designed to help members function in the community.
Program Coordinator I
Centene Corporation
03.2015 - 12.2016
- Initiate authorization requests for output or input services in keeping with the prior authorization list
- Screen for eligibility and benefits and Identify members without a PCP and refer to Member Services for assistance
- Perform transition of care duties to include but not limited to, contact the member’s attending physician, member or medical power of attorney, other medical providers (home health agencies, equipment vendors) for information pertaining to special needs
- Data enter assessments and authorizations into the system
Intake Coordinator
Health Smart (Carlton Staffing)
06.2014 - 03.2015
- Answer incoming call request from physicians’ offices and hospitals for pre-certification authorization for patients’ medical procedures
- Obtain required demographic/patient information to complete or initiate the precertification process
- Obtain and input ICD9 codes and CPT codes for each diagnosis and planned procedure
- Perform data entry of new requests for authorization of services
Education
MBA Masters in Business -
University of Phoenix
Kansas City, MO07.2023
BS Healthcare Management and Administration -
University of Phoenix
Kansas City, MO05.2013
AA Healthcare Management and Administration -
University of Phoenix
Kansas City, MO05.2011
Skills
- Administrative skills
- Completed Professional Leadership Training
- Strategic workflow planning
- Quality Improvement
- Problem-Solving
- Progress Monitoring
- Intervention Planning
- Work Planning and Prioritization
- Staff Assistance
- Training and Teaching
Timeline
Behavioral Discharge Planner
Centene Corporation
11.2022 - Current
Care Coordinator
Centene Corporation
02.2017 - 11.2022
Discharge Planner
Centene Corporation
12.2016 - 02.2017
Program Coordinator I
Centene Corporation
03.2015 - 12.2016
Intake Coordinator
Health Smart (Carlton Staffing)
06.2014 - 03.2015
MBA Masters in Business -
University of Phoenix
BS Healthcare Management and Administration -
University of Phoenix
AA Healthcare Management and Administration -
University of Phoenix
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