Whitney Brian
Summary
Driven and compassionate healthcare professional with nineteen-years hands-on experience in fast-paced healthcare environments. Accountable and responsible with a strong focus on patient wellness. Healthcare Administrator with proven to deliver exemplary level of healthcare service delivery to patients. Coordinate admission and discharge of patients. Plan and implement strategies for developing improved health care management. Proven problem solver and excellent communicator. Strong organizational skills, superb understanding of data collection and performance metrics. Recognized for staff development leading to high performing teams.
Overview
21
21
years of professional experience
Work History
Intake Manager
VillageCareMAX
01.2023 - 11.2023
- Monitored the Intake Call Center Phone queue.
- Ran weekly call center reports for Senior Director of Intake/Enrollment.
- Oversaw daily day to day Intake/Enrollment operations.
- Assisted with creating and implication of SalesForce application.
- Managed over 25 Intake and enrollment representatives.
- Trained staff on Medicare and Medicaid policy.
- Assigned daily referral assignments to the Intake coordinators for new enrollees.
- Assigned RN for daily Assessment scheduling.
- Completed bi-weekly phone queue audits.
- Directed contact with homecare agencies to obtain new Intake referrals.
- Daily utilization of ePaces and MarX websites.
- Conducted assessments of clients to determine eligibility for services.
- Maintained accurate records of client information and data.
- Assisted in developing policies and procedures for the intake process.
- Provided guidance on complex cases and assisted with problem solving.
- Recruited, hired and trained all staff, providing direct supervision, ongoing staff development and continuing education to employees.
- Created training manual of Intake and Enrollment polices and procedures.
Manager Support
Senior Whole Health LLC- MLTC
11.2018 - 12.2022
- Assisted Nurse Care Managers with comprehensive assessments of members.
- Documented and help resolve members grievances and appeals.
- Coordinated discharge planning from hospital and skilled nursing facility.
- Collaborated with health care providers and develops personalized plans of care.
- Coordinated member's homecare services, PT, OT, and ST.
- Checked member's eligibility on ePACES.
- Assisted Case Managers with obtaining CDPAS MD and Acknowledgement documents.
- Reviewed and approved Privacy documents submitted.
- Managed incoming calls to case management phone queue.
- Managed and reviewed authorizations, notes, etc. send via HHA ExChange portal.
- Liaised with production manager, suppliers and vendors to support production needs.
- Worked with support manager to maintain QA, engineering, marketing and operations goals.
Case Aide/Case Manager
GuildNet-MLTC
01.2016 - 06.2018
- Developed patient care plans, including assessments and evaluations.
- Provided telephonic case management of long-term health care services.
- Maintained a case load of 90+ members.
- Worked as part of team to execute proper care of body mechanics and safety.
- Coordinated member's homecare services, PT, OT, and ST.
- Approved member's durable medical equipment following Medicaid guidelines.
- Coordinated discharge planning from hospital and skilled nursing facility.
- Collaborated with health care providers and developing personalized plans of care.
- Assisted in conducting needs assessments to identify key areas of service needs.
- Developed and maintained relationships with community organizations and agencies.
Care Specialist
Emblem Health-MLTC
02.2013 - 12.2015
- Collected customer feedback and made process changes to exceed customer satisfaction goals.
- Provided accurate and appropriate information in response to customer inquiries.
- Worked with upper management to ensure appropriate changes were made to improve customer satisfaction.
- Made reasonable procedure exceptions to accommodate unusual.
- Processed and reviewed authorizations for patients: DME, personal care service, transportation request etc.
- Reviewed members assessment cases from the UAS system to input in data system.
- Monitored customer care goals and developed improvements.
- Reported unusual or urgent circumstances in patients' condition or environment immediately to nurse supervisor.
Service Coordinator
HealthPlus Amerigroup
03.2010 - 10.2012
- Collected customer feedback and made process changes to exceed customer satisfaction goals.
- Ran reports and supplied data to fulfill customer report requirements.
- Developed effective relationships with all call center departments through clear communication.
- Trained staff on how to improve customer interactions.
- Handled a market of customers within 13 States.
- Medical management liaison between providers and medical director.
- Authorized emergent inpatient admissions, prenatal care, and minor outpatient surgeries.
Provider/Member Customer Service Coordinator
US Family Health Plan
08.2002 - 12.2009
- Addressed customer service inquiries in a timely and accurate fashion.
- Collected customer feedback and made process changes to exceed customer satisfaction goals.
- Provided accurate and appropriate information in response to customer inquiries.
- Demonstrated mastery of customer service call script within specified timeframes.
- Developed effective relationships with all call center departments through clear communication.
- Ran reports and supplied data to fulfill customer report requirements.
- Worked with upper management to ensure appropriate changes were made to improve customer satisfaction.
- Built customer loyalty by placing follow-up calls for customers who reported product issues.
- Formulated and enforced Service Center policies, procedures and quality assurance measures.
- Provided cross training to 8 staff members.
- Led a team of customer service representatives to increase service center profitability.
- Properly directed inbound calls in phone queues to improve call flow.
Education
Master of Science - Healthcare Administration
Purdue University
West Lafayette, IN04.2019
Bachelor of Science - Human Services
Touro College
New York, NY06.2015
Skills
- Educated in Medicare and Medicaid guidelines
- Educated in Manage Long Term Care policies and procedures
- Experienced in Utilization Management
- Verbal and Written Communication
- Team collaboration
- Task prioritization
- Team Collaboration
- Logistical Planning
- Risk Management
Timeline
Intake Manager
VillageCareMAX
01.2023 - 11.2023
Manager Support
Senior Whole Health LLC- MLTC
11.2018 - 12.2022
Case Aide/Case Manager
GuildNet-MLTC
01.2016 - 06.2018
Care Specialist
Emblem Health-MLTC
02.2013 - 12.2015
Service Coordinator
HealthPlus Amerigroup
03.2010 - 10.2012
Provider/Member Customer Service Coordinator
US Family Health Plan
08.2002 - 12.2009
Master of Science - Healthcare Administration
Purdue University
Bachelor of Science - Human Services
Touro College
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