Manager, Clinical Educator

• Sep 2023 - Present

Lead Clinical Educator

• Nov 2021 - Sep 2023

Sr. Clinical Educator

• Jun 2017 - Nov 2021

Health Services Clinical Supervisor

• Oct 2016 - Jun 2017

Health Services Clinical UM supervisor Health Services Clinical UM supervisor

Training Consultant, Clinical Trainer and Auditor

• Jan 2003 - Sep 2016

Highly motivated corporate trainer knowledgeable about theories and methods in designing, developing and delivering successful training programs and adult learning concepts. Dependable and resourceful professional adept at organizing and facilitating management and team building training programs. As an expert on Medicare, was a reference for training Medicare related topics and was a resource to answer questions, reviewed policies, assisted departments with problem solving cases related to… Show more Highly motivated corporate trainer knowledgeable about theories and methods in designing, developing and delivering successful training programs and adult learning concepts. Dependable and resourceful professional adept at organizing and facilitating management and team building training programs. As an expert on Medicare, was a reference for training Medicare related topics and was a resource to answer questions, reviewed policies, assisted departments with problem solving cases related to area of knowledge. Planned, developed and delivered new hire on boarding curriculum for nurses in the Utilization Review Department. Continuously evaluated training needs of business and made adjustments to programs and training materials. Created and performed train the trainer sessions for other training colleagues so they could assist with disseminating initiative to 2700+ nurses and physicians. Training sessions delivered in various settings including in person and over virtual meeting rooms using Power Point and other training tools. Developed training material. Created over 30 job aids and training guides for several job roles and Power points used during training sessions. Assisted with the development of department policies and procedures. Reviewed and provided input during creation of documents. Show less Highly motivated corporate trainer knowledgeable about theories and methods in designing, developing and delivering successful training programs and adult learning concepts. Dependable and resourceful professional adept at organizing and facilitating management and team building training programs. As an expert on Medicare, was a reference for training Medicare related topics and was a resource to answer questions, reviewed policies, assisted departments with problem solving cases related to… Show more Highly motivated corporate trainer knowledgeable about theories and methods in designing, developing and delivering successful training programs and adult learning concepts. Dependable and resourceful professional adept at organizing and facilitating management and team building training programs. As an expert on Medicare, was a reference for training Medicare related topics and was a resource to answer questions, reviewed policies, assisted departments with problem solving cases related to area of knowledge. Planned, developed and delivered new hire on boarding curriculum for nurses in the Utilization Review Department. Continuously evaluated training needs of business and made adjustments to programs and training materials. Created and performed train the trainer sessions for other training colleagues so they could assist with disseminating initiative to 2700+ nurses and physicians. Training sessions delivered in various settings including in person and over virtual meeting rooms using Power Point and other training tools. Developed training material. Created over 30 job aids and training guides for several job roles and Power points used during training sessions. Assisted with the development of department policies and procedures. Reviewed and provided input during creation of documents. Show less

Principle Clinical Analyst

• Jan 2003 - Feb 2008

Assisted health plan members navigate their health insurance and maximize their benefits. Coordinated with account managers, Medical Groups, medical directors, appeals and grievances department, and risk management to resolve member disputes and complaints according to the Department of Managed Health Care and Center for Medicare and Medicaid Services definitions and regulations. Developed care plans, completed patient assessments and computer documentation of conversations and actions.… Show more Assisted health plan members navigate their health insurance and maximize their benefits. Coordinated with account managers, Medical Groups, medical directors, appeals and grievances department, and risk management to resolve member disputes and complaints according to the Department of Managed Health Care and Center for Medicare and Medicaid Services definitions and regulations. Developed care plans, completed patient assessments and computer documentation of conversations and actions. Communicated with physician offices, medical groups, medical directors, nurses and the member to coordinate care needs. Assessed possible legal risks and worked with internal risk management department on individual cases. Functioned as a liaison between the health plan and the member to coordinate member care and ensure services were carried through and provided to the member. Worked as a nurse reviewer for Quality Management reviewing health plan member clinical care cases. Show less Assisted health plan members navigate their health insurance and maximize their benefits. Coordinated with account managers, Medical Groups, medical directors, appeals and grievances department, and risk management to resolve member disputes and complaints according to the Department of Managed Health Care and Center for Medicare and Medicaid Services definitions and regulations. Developed care plans, completed patient assessments and computer documentation of conversations and actions.… Show more Assisted health plan members navigate their health insurance and maximize their benefits. Coordinated with account managers, Medical Groups, medical directors, appeals and grievances department, and risk management to resolve member disputes and complaints according to the Department of Managed Health Care and Center for Medicare and Medicaid Services definitions and regulations. Developed care plans, completed patient assessments and computer documentation of conversations and actions. Communicated with physician offices, medical groups, medical directors, nurses and the member to coordinate care needs. Assessed possible legal risks and worked with internal risk management department on individual cases. Functioned as a liaison between the health plan and the member to coordinate member care and ensure services were carried through and provided to the member. Worked as a nurse reviewer for Quality Management reviewing health plan member clinical care cases. Show less

Case Manager

• Jun 2001 - Jan 2003

Followed health plan members via telephone. Performed assessments, verified services were received after discharge from inpatient facilities. Helped with referrals for hospice and other outpatient services available through their purchased plans. Followed health plan members via telephone. Performed assessments, verified services were received after discharge from inpatient facilities. Helped with referrals for hospice and other outpatient services available through their purchased plans.

Staff Nurse

• Aug 1999 - Jun 2001

As a staff nurse, provided bedside nursing activities and care including physical assessments, dispense medications and hanging chemotherapy, bedside nursing procedures and patient/ family education, which were all documented in medical charting to pediatric patients in the Hematology and Oncology unit. As a staff nurse, provided bedside nursing activities and care including physical assessments, dispense medications and hanging chemotherapy, bedside nursing procedures and patient/ family education, which were all documented in medical charting to pediatric patients in the Hematology and Oncology unit.

Staff Nurse

• Jun 1998 - Aug 1999

As a staff nurse, performed bedside nursing duties including physical assessment, dispense medications, pre- surgical prep and post surgical care, wound assessment and dressings and patient/ family education to adult Surgical Oncology patients. As a staff nurse, performed bedside nursing duties including physical assessment, dispense medications, pre- surgical prep and post surgical care, wound assessment and dressings and patient/ family education to adult Surgical Oncology patients.