Wendy Indelicato
Tucson,AZ
Summary
Compassionate Case Manager experienced in Long Term Care environments. Hardworking and dedicated to achieving desired case outcomes. Offers excellent problem-solving, conflict resolution and communication abilities.
Overview
28
28
years of professional experience
Work History
Long Term Care Case Manager
Aetna , Mercy Care
10.2011 - Current
- Position in Long Term Care Services and Support for AHCCCS as a Case manager collaborating with members, family member, providers and physicians.
- Traveled to predominantly Skilled Nursing Facilities, Assisted Living Facilities, and occasionally member's homes to complete assessments and coordinate care.
- Evaluated patient needs and coordinated appropriate services, ensuring timely and efficient care delivery.
- Streamlined communication between various healthcare providers, ensuring consistent information sharing and collaboration for optimal patient care. Making referrals to providers as needed.
- Tracked hospital admissions and collaborated with providers to reduce hospital readmissions and create appropriate discharge plans.
- Collaborated with healthcare professionals and members to create comprehensive, person-centered case management for patients.
- Developed positive relationships with patients and their families, fostering trust and open communication.
- Served as a liaison between patients, families, healthcare providers, insurance companies, and community agencies to ensure seamless service provision.
- Educated patients on available resources and assisted them in accessing necessary services through referrals or direct coordination efforts.
- Improved patient satisfaction by addressing concerns promptly and advocating for patients' needs within the healthcare system. Reporting issues to APS and CMS as appropriate.
- Assisted patients in identifying personal goals related to their health status or desired living situation improvements when formulating long-term care plans.
- Maintained detailed records of case management activities in compliance with regulatory requirements, including AHCCCS required Person Centered Service Plan assessments and NCQA required documentation. Gathered Diabetic and vaccination records to meet AHCCCS requirements.
- Developed comprehensive discharge plans to transition clients to appropriate service providers in community.
- Attended interdisciplinary Care Plan meetings along with Nursing Facility Behavioral Health Meetings to review cases, discuss patient updates, and coordinate ongoing service provision.
- Assisted clients in navigating insurance benefits and public benefits to gain access to valuable resources.
- Coordinated services with other agencies, made Referrals for services, such as Behavioral Health and Home Health Services as needed. Monitored patient progress and adjusted care plans as needed to optimize outcomes.
- Coordinated individualized discharge plans to manage safe transition back into community and home environments.
- Member of the Mercy Care Member Council and the Desktop Committee, reviewing policies and procedures.
Case Manager
Pima Health Systems/ Bridgeway
08.2007 - 09.2011
- Casemanaged long term care members at various Skilled Nursing Facilities in Tucson, AZ.
- Conducted thorough member assessments, evaluated for level of care, completed Behavioral Reinsurance packets. situations, identifying issues, goals, and necessary interventions.
- Maintained accurate documentation on all cases, ensuring compliance with regulations and confidentiality requirements.
- Made Referrals for Behavioral Health Services, medical services, durable medical equipment, coordinated with providers to authorize services.
- Educated families, members and skilled nursing facilities, in regards to navigating members' benefits.
- Advocated for members, worked with providers, members, and families to ensure standards of care were maintained. Assisted in resolving concerns. Made referrals to Quality Management as appropriate. Provided information on advanced directives.
- Collaborated with facilities, families, members, and providers on admissions, transfers, and discharges. Participated in Care Plans, Behavioral Health Meetings, hearings for Guardianship and Court ordered treatment involving members.
Social Services Worker
Desert Life Nursing Facility
02.2007 - 08.2007
- Assisted Rehab patients with mapping their goals/discharge plans.
- Maintained accurate and up-to-date case files, ensuring compliance with agency guidelines and state regulations, including social history assessments, care plans, PASRR evaluations.
- Improved client outcomes by developing and implementing individualized case plans.
- Participated in Medicare Meetings, Care Plan Meetings, collaborating with insurance companies.
- Notified families and members of end of skilled benefits and assisted with applying for ALTCS, Hospice as appropriate, and outside agencies.
- Worked closely with Insurance plans, care team, members and families to ensure a safe discharge plan.
Arcadia Unit Manager
HCR Manor Care
05.1999 - 02.2007
- Managed a 23 bed Alzheimer's Unit. Provided supervision and education.
- Supported families and patients on the unit, led a family support group and organized fundraisers for the Alzheimer's Association.
- Ensured compliance with regulations and standards through regular audits, staff education, and policy updates.
- Resolved conflicts among team members quickly to maintain a positive working environment conducive for continued excellence in patient care.
- Oversaw the unit staff and activities on the unit. Resolved conflicts among team members to maintain a positive work environment.
- Marketed the Unit and did on-site assessments of potential patients.
Social Services Director
Heartland Healthcare
08.1996 - 04.1999
- Referred families to shelters, legal resources, and educational programs.
- Referred clients to appropriate team members, community agencies and organizations to meet treatment needs.
- Completed required documentation, social service assessments, created care plans, assisted wtih Discharge plans.
- Chair person of the Ethics, Grievance, and Behavior Committees.
- Interim Admissions Director assessing patients and creating case histories.
Education
Bachelor of Arts - Fine Arts
Western Illinois University
Macomb, IL05.1991
Skills
Case Evaluation
Assessment skills
Care Planning
Positive Attitude
Problem-Solving
Organization and Multitasking
Case Documentation
Patient Assessments
Care Coordination
Discharge Planning
Case Management
Community Outreach
Timeline
Long Term Care Case Manager
Aetna , Mercy Care
10.2011 - Current
Case Manager
Pima Health Systems/ Bridgeway
08.2007 - 09.2011
Social Services Worker
Desert Life Nursing Facility
02.2007 - 08.2007
Arcadia Unit Manager
HCR Manor Care
05.1999 - 02.2007
Social Services Director
Heartland Healthcare
08.1996 - 04.1999
Bachelor of Arts - Fine Arts
Western Illinois University
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