A Regional Case Manager acts as a social service assistant, who supports people going through a difficult time for an assigned region or area. Typical examples of duties are mentioned on the Regional Case Manager Resume as – identifying people in distress or difficult situations, referring clients to various healthcare and social services, collaborating with various human service providers, creating recovery plans, helping individuals gain access to community resources, and analysing the effectiveness of programs. Other duties may include visiting clients who are unable to travel and determining their needs, managing outreach programs, and compiling reports.
Job skills include excellent communication and interpersonal skills, problem-solving orientation, compassion, and networking skills. Most of those successful in this line have a good understanding of the social work industry and knowledge of current social issues. Individuals seeking to make a career in this line should earn at least a degree or master’s degree in social work or psychology.
Summary : Regional Case Manager with 10 years of experience in Establishing the members PLOF upon admission, Ensuring that members are receiving treatment from therapy department thats clinically appropriate, Directing line of communication to external insurance Case Managers, Completing weekly update forms with current therapy progress notes, nursing documentation related to admitting diagnoses, weekly wound care assessment, eMARs and members discharge plan.
Optimized the health of the member and decrease medical costs.
Responsible for assessing, planning, implementing and coordinating all case management.
Activitied with members, evaluating their medical and disability needs, and facilitating the members overall wellness.
Telephonically conducted an interview with the member to evaluate the member's needs and facilitated a smooth transition to other Aetna programs.
Assessed member's pain and address symptom control.
Coordinated members care with a multidisciplinary team.
Examined the multitude of documentation to provide a determination if the individual is entitled to the payment, which statutes, regulations or Comptroller General Decisions apply and their impact on the decisions, and the significance of the injuries, illness or disease condition sustained and how it would affect a Soldiers ability to perform their duties.
Experience
10+ Years
Level
Senior
Education
GED
Regional Case Manager Resume
Headline : Obtain a rewarding Regional Case Manager position where I can utilize and grow my well-rounded management, legal, and leadership skills to contribute to the overall goals and objectives of a successful company.
Skills : Spanish certification for bilingual counseling services, Brazilian Portuguese Proficiency, German Proficiency, comprehensive understanding of issues which are prevalent within urban communities.
Description :
Analysed and approved Incapacitation Pay benefits and entitlement offered by Armed Forces.
Managed, directed, and coordinated activities and oversight, administration, and implementation of policies pertaining to state medical affairs, and exercise of programs.
Ensured goals and objectives are accomplished in accordance with established priorities, time limitations and finding constraints.
Maintained regulatory and statutory as well as privacy concerned with the release of individuals medical information including The Health Insurance Portability and Accountability Act HIPPA regulations.
Worked closely with States Adjutant General AG and State Military Personnel Officers MILPO and provide assistance on difficult cases to ensure that Army National Guard ARNG unit Analyze Standard Operating Procedures SOPs, electronic tracking systems, and dissemination of information related to the health services programs on Line of Duty and Incapacitation Pay Benefits.
Discussed and resolved problems and provided advice on, methodology, standard, procedures, practices, and lessons learned.
Approved and analysed over 800 cases when evidence substantiates that a new Line of Duty determination is warranted, or forwards the appeal to Department of the Army for adjudication when the evidence provided does not warrant a reversal of the original findings.
Experience
5-7 Years
Level
Executive
Education
Associate Of Science
Regional Case Manager Resume
Summary : Obtain a Regional Case Manager position that will enable me to use my strong organisational skills, customer service background, and ability to work well with others, Attends appropriate social service provider network meetings (i.e., pantry network).
Distributes Emergency Assistance Program Intake Policy to agencies, churches, and schools, and interprets policies and services as needed, Attending emergency service workshops sponsored by various agencies.
Skills : Inpatient and ambulatory care case management experience; Strong verbal and organizational; Familiar with Interqual criteria, Medicare quidelines and discharge planning.
Description :
Actively managed the underwriting process of life and disability applications.
Tracked and followed up with field advisers and in-house advisers on New Business applications from pre-sale to activation.
Monthly trained for new hires for in-house advisers on insurance underwriting process.
Provided excellent and timely customer service, including answering our advisors questions and resolving issues within the underwriting of a case.
Field visited with RSD & RVP.
Gathered financial data to prepare clients' financial plans.
Served as liaison between patient, physician, care team members, payer, and the discharge planner by coordinating, monitoring, and communicating.
Experience
10+ Years
Level
Senior
Education
Associate Of Science
Regional Case Manager Resume
Objective : Over one year of experience as an ARNG State Health Services Specialist concerning LOD investigations and Incapacitation (INCAP) Pay benefits. 10 years of military service to include tours in Iraq and Afghanistan. Acquired problem solving skills and leadership experience with the ability to produce results in high stressful situations.
Skills : Great customer service , Great time management, Administration and accounting and leadership.
Description :
Provided customer service support to national and regional stakeholders concerning health claim investigations and incapacitation pay benefits.
Managed claim investigations and pay requests for Soldiers using an information management system.
Oversaw, administered and executed policies concerning State medical affairs and the implementation of major ARNG medical programs affecting all ARNG Soldiers in 54 states and territories.
Reviewed, evaluated and interpreted legal and regulatory guidance, policies and procedures applicable to health services programs using knowledge of the Health Insurance Portability and Accountability Act (HIPAA) and other applicable laws and regulations.
Provided technical guidance to system users and stakeholders through the development of policies, procedures and tracking systems and through the dissemination of strategic communications related to program services.
Organized, coordinated and provided health services briefings and training for unit and executive level workshops.
Advised ARNG staff and executive staff regarding program objectives, methods, policies, procedures, techniques, and expected outcomes regarding LOD investigations and the INCAP pay program.
Experience
2-5 Years
Level
Executive
Education
B.S.
Regional Case Manager Resume
Summary : Visionary and high-performing Regional Case Manager professional with over 20 years of diversified experience in the healthcare sector. Established administrator of multiple medical practices with proven ability to maintain cost-effective operations. Dedicated patient advocate with 16 years of case management experience. Over 12 years of exemplary management experience in the healthcare industry.
Skills : Microsoft Office, Electronic Medical Records.
Description :
Managed a grant funded medical program which provided case management services to newly discharged patients from inpatient and/or post-acute medical system who incurred an Acquired Brain Injury, Spinal Cord Injury and Neuromuscular Disorders.
Managed the daily operation of regional case management team.
Worked with interdisciplinary team to identify and develop safe discharge plans.
Provided human resource functions to recruit, hire, retain, and execute disciplinary actions.
Served as content expert regarding community resources.
Provided disability related seminars to schools systems throughout the country orienting students, faculty, and administration to catastrophic diagnosis and its impact on school reentry.
Determined and secured community resources to assist patients with community reintegration.
Experience
7-10 Years
Level
Management
Education
M.S. In Rehabilitation
Regional Case Manager Resume
Headline : To secure a Regional Case Manager position with an organization that will value and utilize my education, experience and interpersonal skills for mutual benefit and success, as well as work in a challenging solution-oriented environment.
Skills : Insurance Sales, Customer Service, Professional Office Environment.
Description :
Worked received cases for clients seeking reimbursement for out of pocket maintenance expenses.
Reviewed warranty claims to determine client eligibility for approved reimbursement.
Worked closely with Regional Managers throughout the United States to obtain vehicle inspection reports to assist in the reimbursement eligibility process.
Handled complaints regarding customer dissatisfaction with new vehicles.
Handled on-line troubleshooting issues for navigational systems.
Provided youth advocacy, coordinated services for youth clients placed out of the home and well as in-home, and created various reports and psychosocial summaries for use by the court system.
Coordinated closely with community service providers, schools, parents, and relatives to reintegrate youths into productive community environments.
Experience
5-7 Years
Level
Executive
Education
A.S. In Health Information
Regional Case Manager Resume
Objective : To obtain a Regional Case Manager position where I can maximize and utilize my knowledge and experience in the financial services industry and exceed company standards, goals, and satisfaction as well as the customer expectations.
Skills : Case Management, Utilization Review, Nursing.
Description :
Procured and directed the allocation of grant funding for financial assistance to assist with medical, social, and auxiliary needs of patients serviced within the Marcus Community Bridge Program.
Acted as liaison between DoD, DA, HRC, Physical Disability Agency (PDA), private sector stakeholders and other professional organizations and government agencies to ensure current and consistent knowledge of program service and policies regarding the INCAP pay program.
Conducted briefings and training on the execution of policy and procedures pertaining to medical claim investigations and Sexual Assault Response Coordinator (SARC) investigations and the INCAP pay program to State Health Services Specialists, Sexual Assault Resource Coordinators and ARNG Regional Case Managers.
Participated in cluster meetings led by the Regional Coordinators.
Participated in divisional or territorial educational forums and webinars designed to facilitate understanding of a wide range of topics so to enhance services with Emergency Assistance and Pathway of Hope.
Recruited, invited and provided case management with families who desire to participate in Pathway of Hope.
Performed time sensitive assessment screenings, goal assistance and collaboration with community resources to best help the family meet personalized goals.
Experience
2-5 Years
Level
Executive
Education
GED
Regional Case Manager Resume
Objective : Regional Case Manager with 3 years of experience in Maintaining concise comprehensive written case records on all clients requesting assistance, including FEMA, utility assistance programs and seasonal Christmas assistance. Consistently updates interviewers notes on client database, Interviewing notes include assessment, service plan, assistance given, and referrals made.
Skills : Managing, Coordinating Skills, Communication Skills.
Description :
Conducted on-going assessment of behavior, mental status, signs and symptoms of mental health disorder, physical and dental health, substance use, and educational, social, legal, financial, housing, developmental and family functioning.
Refered, advocated and linked client and family for additional services as identified.
Acted as liaison and collaborates with community agencies/institutions and support systems to maintain coordination of the treatment process.
Provided supportive and educational counseling services (individual, family and group) to develop daily living and coping skills.
Assisted clients with developing natural support systems.
Provided on-call crisis intervention services during nighttime and weekend hours as assigned.
Provided transportation, respite and tutoring services as assigned.
Experience
2-5 Years
Level
Executive
Education
G.E.D
Regional Case Manager Resume
Objective : Regional Case Manager with 2 years of experience in Meeting weekly face-to-face or by phone to check on clients progress,
Entering required data for Pathway of Hope caseload into SIMS, Maintaining an updated community resource file of area services and maintains positive relationships with frequently used service providers.
Skills : Service Assistant, Training, Office Equipment.
Description :
Participated in treatment team meetings.
Maintained client’s chart updated and all documentation entered within established timeframe.
Completed all required agency and department trainings.
Loaded and to changed settings, devices, fixtures, on various equipment used in and around an office environment.
Operated telephone and other electronic communication devices.
Operated various other office equipment including personal computers, copiers, fax machines, and scanning equipment.
Interviewed persons, requesting assistance, to assess their need.
Experience
2-5 Years
Level
Executive
Education
MS
Regional Case Manager Resume
Objective : To obtain a Regional Case Manager position responsible for Distributing seasonal Christmas assistance, according to the Corps Seasonal Assistance Program Policy & Procedures (i.e., Christmas baskets, toy distribution, Adopt-A-Family, etc.), Making referrals, based upon need and as a part of the total service plan, Making specific arrangements for client to apply for additional resources, when appropriate.
Skills : Programming, Policy Management, MS office.
Description :
Obtained background information from client and makes assessment.
Developed service plan with the individual or family to identify service needs and goals.
Collaborated with area agencies involved with client in implementing service plan.
Granted material assistance based upon need and as a part of a total service plan.
Verified eligibility. Documented income, expenses, and family size.
Distributed in-kind or financial aid according to Emergency Assistance Program Policies & Procedures Manual, (i.e., clothing, food, household furnishings, vouchers for rent/utilities, etc.).
Distributed utility assistance, according to established Share the Warmth, Sharing and other existing program policies.
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