Health Advocate Resume Sample
Victoria D'Amore
283 Laurianne Ports,
Chicago,
IL
+1 (555) 342 5408
Work Experience
Shield Concierge Health Advocate Lead
04/2018
-
PRESENT
Boston, MA
- Consistently exhibits behavior and communication skills that demonstrate HealthCare Partners’ (HCP) commitment to superior customer service, including quality, care and concern with each and every internal and external customer
- Facilitates the identification, recommendation, appropriate enrollment and registration of patients to Disease Management, High Risk programs, Pharmacy, patient transportation and other community-based assistance or other support programs based on PCP or Care Manager’s care decisions
- Uses, protects, and discloses HCP patients’ protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards
- Monitors all provider message logs to ensure that messages are addressed or resolved within 24 hours of provider availability
- Mentor Medical Assistants (MA) to help solve any patient challenges
- Be a liaison between the physician and the call center to ensure that patients are able to be seen within the defined guidelines
- Assists the Care Manager (CM) in supporting patients during transitions of care
- Works closely with the Care Manager and clinical program resource to increase knowledge of Intermountain's Care Process Models for chronic conditions and for coaching patients
Behavioral Health Advocate
07/2015
-
12/2017
Dallas, TX
- Provide organization, direction and staffing for all assigned service calls and case load assistance/resolution to ensure that all calls are answered in accordance with Health Advocate’s policies and procedures and service metrics
- Escalate cases through the appropriate channels in accordance with Health Advocate’s policies and procedures
- Essential physical functions of the job include fingering, grasping, pulling hand over hand, and repetitive motions to utilize general computer software/hardware continuously throughout the work day
- Ensures DC planning at levels of care appropriate for the members’ needs and acuity
- Assesses member’s health behaviors, cultural influences and clients’ belief/value system
- Evaluates all information related to current/proposed treatment plan and in accordance with clinical practice guidelines to identify potential barriers
- Determines realistic goals and objectives and provides appropriate alternatives
Nursing Assistant Health Advocate Scribe Patient Aligned Care Team
09/2010
-
03/2015
Phoenix, AZ
- Participates as a team member and communicates effectively with the health care team. Participates in staff meetings and other interdisciplinary meetings
- Documents/reports patient’s concerns and symptoms, reactions, and changes (appropriate to age) to licensed clinic personnel
- Performs clinical documentation of all appropriate notes, in the patient’s medical record, and/or care management system both timely and accurately under the direction of the Care Management team, ensures that patient receives results of laboratory and diagnostic tests, special test instructions, and other information in a timely manner
- Participates in and supports developed care plans for members and evaluates the members need for alternative services and third party needs
- Interacts continuously with members, family, physician(s), and other resources to determine appropriate action needed to address/support medical needs. Reviews benefits options, researches community resources, coordinates services, trains/creates activities of daily living routines and enables members to be active participants in their own healthcare
- Monitors patient-reported biometrics, medication adherence, reported challenges/barriers and promptly connects the patient with the appropriate resources, and/or notifies the patient�s care team for additional follow-up
- Assists providers� offices with member specific missed appointments through outreach and scheduling
Education
University of Phoenix - Memphis Campus
2004 - 2009
Bachelor's Degree in Psychology
Professional Skills
- Strong interpersonal and critical thinking skills; ability to negotiate and make quick effective and efficient decisions to resolve cases and issues
- Strong communications skills, verbally and in writing
- Demonstrated database skills
- Strong Etiquette skills
- Clinical expertise in directing / managing difficult callers through intervention skills while maintaining business appropriate integrity
- Discern and determine follow up questions to pursue using critical thinking skills
- Demonstrates cultural competence to work effectively, respectfully, and sensitively within the clients’ cultural context
How to write Health Advocate Resume
Health Advocate role is responsible for database, software, training, integration, security, reporting, research, insurance, travel, health.
To write great resume for health advocate job, your resume must include:
- Your contact information
- Work experience
- Education
- Skill listing
Contact Information For Health Advocate Resume
The section contact information is important in your health advocate resume. The recruiter has to be able to contact you ASAP if they like to offer you the job. This is why you need to provide your:
- First and last name
- Telephone number
Work Experience in Your Health Advocate Resume
The section work experience is an essential part of your health advocate resume. It’s the one thing the recruiter really cares about and pays the most attention to.
This section, however, is not just a list of your previous health advocate responsibilities. It's meant to present you as a wholesome candidate by showcasing your relevant accomplishments and should be tailored specifically to the particular health advocate position you're applying to.
The work experience section should be the detailed summary of your latest 3 or 4 positions.
Representative Health Advocate resume experience can include:
- Experience/familiarity with Motivational Interviewing
- Experience in a related mental health environment working in the local Rhode Island community
- Experience working with Pediatrics
- Clearly understand problem statement and discern issues and priorities
- Post-Masters experience in a related mental health environment
- Direct clinical experience
Education on a Health Advocate Resume
Make sure to make education a priority on your health advocate resume. If you’ve been working for a few years and have a few solid positions to show, put your education after your health advocate experience. For example, if you have a Ph.D in Neuroscience and a Master's in the same sphere, just list your Ph.D. Besides the doctorate, Master’s degrees go next, followed by Bachelor’s and finally, Associate’s degree.
Additional details to include:
- School you graduated from
- Major/ minor
- Year of graduation
- Location of school
These are the four additional pieces of information you should mention when listing your education on your resume.
Professional Skills in Health Advocate Resume
When listing skills on your health advocate resume, remember always to be honest about your level of ability. Include the Skills section after experience.
Present the most important skills in your resume, there's a list of typical health advocate skills:
- Demonstrated good attention to detail
- Effectively use organization’s health information technology resources in patient management
- Effectively communicate with patient and referral sources to ensure complete resolution of inquiry to their satisfaction
- Experience working in an environment that required coordinating benefits and utilizing multiple groups and resources for patients
- Three years of experience working with individuals with behavioral health concerns in a behavioral health care setting
- Over 1 year and up to and including 3 years of experience in a healthcare setting
List of Typical Experience For a Health Advocate Resume
1
Experience For Behavioral Health Advocate Resume
- Collaborate with providers and consumers to define precipitants, symptoms, recovery and resiliency needs, desired outcomes and interventions, and discuss appropriate levels of care placement based on clinical presentation and risk factors
- Support outcome-focused, evidenced-based best practices and guidelines with providers
- Provide consultation to providers and/or consumers on a variety of issues including benefit information, safety issues, confirmation of prior authorizations/ approvals, procedures for higher level of care evaluations, and requests for an explanation of the level of care, coverage determination, or best practice guidelines
- Establish and maintain professional working relations with referral sources, community resources, and care providers and be able to identify and communicate network gaps to appropriate resources
- Administer benefits in compliance with plan inclusions, limitations, and State / Federal mandates
- Participate in clinical supervision, staff meetings, case conferences, and in-service opportunities
2
Experience For Shield Concierge Health Advocate Lead Resume
- Meet all documentation audit standards
- Establish and foster positive relationships with medical team, participate in medical-behavioral integration activities and discussions
- Participate jointly in rounds, discussions, supervision and staffings
- Able to facilitate effective and efficient resolutions to patient equipment usage issues and compliance challenges that the patient understands, accepts and can adhere to
- Work within the limitations of the role in communication to patients. Specifically limited to non-clinical, based on process documentation. When patient interactions reach this limitation, escalates the interaction to clinical resources
3
Experience For Patient Health Advocate Resume
- Follows Apria’s Quality program to ensure that we give the best service to all transactions
- Manage caseload of members with behavioral health related issues
- Conduct assessments and develop plans of care to improve member health outcomes
- Provide clinical consultation to nonclinical staff on behavioral health related issues
- Work as part of an interdisciplinary team
- Meet all identified performance metrics
- Research and resolve customer complaints and complex or multi - issue appeals submitted by consumers and physicians / providers to UnitedHealth Group executives, state attorney generals and other regulatory agencies
4
Experience For Licensed Vocational Nurse Health Advocate Pact Resume
- Assure member complaints / grievances and appeals and provider appeals are resolved within regulatory timeframes
- Prepare material discussed at member / provider appeal committee meetings
- Word / Excel background
- Able to hold a conversation with a state agency or regulator
- In depth research ability over many systems and platforms (Iset, Linx, Unet, Facets)
- Meet with consumers in - person at facilities, provider offices, and in homes as appropriate for market
5
Experience For Health Advocate Perioperative Services Pacu Resume
- Establish and foster positive relationships with medical team, participate in medical - behavioral integration activities and discussions
- Identify high - risk, co - morbid needs of consumers
- Coalesce BHCA role and relationships within context of established Care Advocacy Operating Model and customer/contractual requirements; collaborate early and frequently with other teams in the management of cases stratified as having intensive, complex, and high - risk needs
- Assumes responsibility for professional development and ongoing education; discuss personal goals for continued development with supervisor and/or DON
- Assist in the development of a relevant and consumer - specific aftercare plan
- Maintain approved workload
List of Typical Skills For a Health Advocate Resume
1
Skills For Behavioral Health Advocate Resume
- Effectively collaborate with other departments to meet consumer needs
- Demonstrated knowledge of available behavioral health community resources
- Valid California driver’s license for travel between St. Joseph Health locations
- Managed care or utilization review experience
- Experience post licensure
- Managed care experience (MCO)
- Experience with Behavioral Health claims and/or appeals
- Customer service experience in a healthcare environment
- Related experience is required
2
Skills For Shield Concierge Health Advocate Lead Resume
- Able to facilitate effective and efficient resolutions to patient compliance challenges that the patient understands, accepts and can adhere to
- Use applications to manage administration features, patient administration/data and prioritize work assignments
- Facilitating access to healthcare providers, benefit and entitled coverage information, health services, and health resources
- Appropriately identify need for higher level of review such as staffing, peer review or MD consultation; formulate concise case presentations for staffing
- Has completed coursework or has working knowledge of Medical Terminology
- Think and act independently using clinical judgment
3
Skills For Patient Health Advocate Resume
- Create plan balancing risk and responsibility
- Remains current on training in order to remain proficient at this role and its expectations
- Remains current on training, in order to remain proficient at this role and its expectations
- Collaborate with internal departments to resolve member complaints / grievances according to regulatory timelines
- Provide supportive follow - up, monitoring and education as indicated
- Coordinate a seamless transition for consumers from an inpatient setting to community based services
- Other activities as assigned, including but not limited to
- Participate in committees, educational opportunities and training
4
Skills For Licensed Vocational Nurse Health Advocate Pact Resume
- Intermediate Microsoft Excel is required
- Respond to customers statements/needs professionally and appropriately
- Computer savvy with: MS Excel, MS Office and MS Project required
- Technical Skills: Ability to utilize all systems required to perform expectations of the job, including but not limited to logging in/out maneuvering between menus/screens, performing functions of the system (i.e. reading usage data in multiple monitoring sites, updating records, etc.), understanding support/troubleshooting process
- Managing workflow of all incoming calls and cases. This includes developing and implementing policies and procedures, training staff to perform specific functions and managing employee performance
5
Skills For Health Advocate Perioperative Services Pacu Resume
- Full, active, current and unrestricted licensure as a licensed practical or vocational nurse in a US State, Territory, or Commonwealth
- Current, unrestricted license to practice in the state of residence
- Demonstrated familiarity and experience with the current Diagnostic and Statistical Manual and best practice standards for treatment Proficiency with Microsoft Office Suite
- Learn and navigate multiple proprietary software applications
- Knowledge of or ability to research and connect with community resources, including ability to utilize features of search engines as well as Intranet to discern available resources for any caller
- Current, unrestricted driver’s license and access to reliable transportation
- Live in Mountain Standard time zone
6
Skills For Health Advocate Proactive Health Resume
- Work between the hours of 8am - 5pm MST
- Active and unrestricted Licensed Clinical Social Worker (LCSW) in the state of Missouri
- Reliable transportation for field visits
- Travel locally to conduct field visits up to 40% of the time
- A work a split shift until 8pm CST, as needed (i.e. 8am – Noon; 4p – 8p)
7
Skills For Nursing Assistant Health Advocate Scribe Patient Aligned Care Team Resume
- Access to high speed internet and dedicated workspace for home office set up
- Travel in the field in the greater Seattle, WA or Pierce area
- Basic knowledge of MS Word, Outlook, and Excel required
- A current/active and unrestricted state RN licensure is required
- Based on area of assignment
- Build relationships with members in order to collaborate and develop plans of action by going above and beyond members' initial requests, taking responsibility for members' case records, and encouraging members to call back with future concerns/questions
- Actively solicits clients’ involvement
- Demonstrates the ability to develop quick rapport to effectively coach and motivate patients to utilize their therapy equipment in accordance with their physician’s direction
8
Skills For Personal Health Advocate Resume
- Effectively demonstrates the ability to utilize workflow and scripting materials to inquire and help identify patient barriers to complying with equipment utilization
- Manages all aspects of patient compliance monitoring for a specified regional and/or state demographic using patient monitoring applications and resources
- Manage and administrate premium referral accounts to include troubleshooting, processing orders and providing patient compliance results
- Promptly and professionally respond to incoming telephone calls and emails from patients, employees and referral sources
- Assists management in developing solutions to better enhance work flows and process efficiency
- Assists management in identifying opportunities for business growth and improved profitability
- Demonstrates the ability to understand the limitations of their advice, guidance and coaching when it reaches the point of requiring a licensed professional; typically, that of being considered medically-related advice or assessments
- Use applications to manage administration features, patient administration/data (loading and correcting usage data, creating or editing patient accounts, downloading reports) and prioritize work assignments
- Conduct field office intervention calls to assist staff with specific patient support to overcome barriers and improve their therapy usage
9
Skills For Medical Assistant, Ma-health Advocate Resume
- Create work orders and schedule patients for field office visits with appropriately trained staff
- Monitors patient concerns, patient satisfaction and grievance issues for investigation and resolution
- Make telephonic outreach to patients, conduct assessments, support them and determine appropriate levels of care
- Administer benefits, review treatment plans, and coordinate transitions between various areas of care
- Focus of Case Management is to engage the consumer in their own recovery process and to empower them to access services within the community to increase their community tenure
- Identify and examine gaps and other determinants of readmission to higher levels of care facility
10
Skills For Medical Assistant Health Advocate Resume
- Successfully reach out to consumers within 30 days of discharge from facility-based care to ensure engagement in the follow-up program
- Develop and implement recovery plans with consumers focusing on strengths and personal goals; identify gaps in care and provide referrals to resources to address those gaps
- Identify available resources and promote use of educational materials and web-based information including liveandworkwell.com
- Educate and encourage consumers to utilize self-directed treatment and Personal Advanced Behavioral Health Directive
- Assist consumers by answering questions, providing program information and education about care coordination program services, network and community resources and coverage determination guidelines
- As appropriate consult with family members, employers, health plan, existing providers, and primary care physicians regarding patients' treatment needs and goals and to provide proper coordination of care
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