Experience

Peach State Health Plan

• United States
• Hospitals and Health Care
• 1 - 100 Employee

• Manager of Case Management

  • Dec 2018 - Present

  Manager of Case Management for Medicaid line of Business. Manager of Case Management for Medicaid line of Business.



Kaiser Permanente

• United States
• Hospitals and Health Care
• 700 & Above Employee

• RN Manager of Telephonic UM Inpatient Services

  • Aug 2008 - Dec 2018

  Responsibilities include:Oversight of daily operations, resultant outcomes, staffing and budget for acute Inpatient ,Hospice, LTAC, Rehab, and SNF concurrent review and utilization management based on MCG criteria. Also discharge planning, case/ disease management, transitional care and quality improvement processes.

• Inpatient/ outpatient Precert Utilization Management and review

  • Apr 2005 - Aug 2008

  Utilization management and review for inpatient setting to include Acute/SNF/Rehab and LTAC, Pre-certification and review for outpatient services, and coordination of care to include discharge planning.

• Clinical Supervisor

  • Sep 2003 - Apr 2005

  Managed Family Practice Office staff and operation, caring for members of all ages and different medical conditions, quality improvements, HEDIS measures and minor emergency treatments.

• Clinical Supervisor

  • Oct 2000 - Sep 2003

  Managed Internal Medicine Office staff and operation, caring for adult members with multiple medical conditions, quality improvements, HEDIS measures and minor emergency treatments.



Henry Medical Center

• Stockbridge, GA

• Emergency Room Clinical Coordinator

  • May 1997 - Oct 2000

  Emergency Room Clinical coordinator responsible for managing second shift team and nursing operation to include caring for cardiac, trauma and emergency patients. Emergency Room Clinical coordinator responsible for managing second shift team and nursing operation to include caring for cardiac, trauma and emergency patients.