Aug 2019 – Jan 2020 · 5 mos · Ohio Homecare Waiver

• Casual Assessment Specialist working independently from home via telephone and traveling a six-county, primary service area to complete documentation and provide recommendations for Ohio Home Care waiver (OHCW) eligibility, per program and CareStar guidelines.

Mar 2014 – Jun 2019 · 5 yrs 3 mos

• High-risk population management through risk stratification and assessment tools to identify gaps, barriers in meeting individual care needs.
• Reduced unplanned hospitalizations, reduced inappropriate emergency room care by engaging individuals and caregivers in the decision-making process.
• Coordinated transitions of care with discharge planners across varied settings for cost-effective, accurate and timely care delivery in the least-restrictive, safe environment.
• Collaborated with state-wide and local providers and resources to create improved outcomes for cases of high-risk maternity, oncology, transplants, and substance use disorders.

Dec 2000 – Mar 2014 · 13 yrs 3 mos

• Helped to expand utilization management and large case management programs.
• Offered plan navigation for clients across the age- and care-continuum, including high-risk pregnancy, preterm births, oncology, pre- and post-transplant.
• Coordinated clinical review policy development for Pharmacy and Therapeutics Committee.
• Established a framework for Specialty Pharmacy case management to support the pharmacy benefit management program.

Jun 1990 – Dec 2000 · 10 yrs 6 mos

• Skilled, intermittent home care in rural counties.
• Established and managed physician-directed care plans for all ages, and across all payers.
• Educated patients and caregivers on home intravenous infusions and enteral feedings.
• Coordinated home care referrals to outside agencies, working as a home care liaison in tandem with discharge planners.