Jo Stout
Fouke
Summary
Clinical administrative professional with strong expertise in healthcare management and patient coordination. Proven ability to streamline operations, enhance patient satisfaction, and support clinical teams effectively. Adept at navigating complex healthcare systems, ensuring compliance, and adapting to changing priorities. Reliable team player known for fostering collaboration and achieving high-impact results.
Overview
10
10
years of professional experience
1
1
Certification
Work History
Senior Clinical Administrative Coordinator
UHC- UMR E&I
05.2024 - Current
- Manage administrative tasks related to health care services and clinical care. Managing referrals, prior authorization (approvals, denials and reviewing appeals process with members), resolving inquiries from members and preparing for care team engagement
- Maintain and update databases and systems with accurate patient information and accurate documentation of interactions. Following established procedures and guidelines to ensure compliance with regulations and standards. Advanced in JACADA, Aerial, IPro, My Health Direct, CXOne, Concur, HCDB, One Note, Excel, Microsoft office.
- Specializing in Enhanced Behavioral Health support/engagement. Engaging high-risk patients telephonically to schedule appointments with clinical care team and providing support to patient in accessing necessary healthcare services.
- Managed high volume of outgoing calls, providing prompt assistance to members
Clinical Quality Specialist Patient Navigator
Optum
03.2022 - 05.2024
- Facilitate communication with members to ensure coordination and quality of care. Ensuring member care for best medical outcomes by providing members with local, state, and national resource and assisting in navigating resource when necessary.
- Researching resources on all levels and providing contact information within team structure to share system wide usage.
- Direct calls to members to obtain satisfaction and potential areas of concern regarding healthcare, pharmacy, referrals, appointments, social determinants of health, activities of daily living, vaccinations, fall risk, and quality of care.
- Work within a team to accomplish goals within specified time frames and metrics as outlined. Precepting/training new team members in best business practices.
HSS Coordinator
Cigna/Molina Healthcare
04.2020 - 03.2022
- Effectively manage caseload of 240-280 members
- Conducted face to face assessments, evaluate members for LTSS: communications, referrals to various teams as appropriate to effectively meet members needs
- Care manager/service coordinator for Texas Medicaid- reviewed and analyzed medical records to assess the patient's medical history, treatment plans, and current health status.
- Strong verbal and written communication skills to explain to clients, family members and friends and professionals the case and care plan and maintain good case records.
- Critical thinking and problem solving to determine the best care plan for each client after assessing clients, analyzing notes from health care and social workers.
- Improved team productivity with regular communication and progress updates, fostering a collaborative work environment.
- Enhanced customer satisfaction by responding promptly to inquiries and addressing concerns professionally.
Patient Care Coordinator
Kindred Hospice
03.2019 - 04.2020
- Office management, scheduling, assist team with re-training, precepting new hires and office administration tasks.
- Support chart chase processes by requesting records from provider offices/hospitals/ home health agencies as needed, analyze chart data, chart auditing.
- ICD 9/10 coding, Process At Risk and Expedite referrals and work with contracted network providers outside our company
LPN (Licensed Practical Nurse)
LHC Group
07.2015 - 01.2020
- Coordination with social workers, RNs, MDs, assisted living facilities, LTC, members and families regarding the different managed care available as well as services and treatment needs.
- Identifying early risk factors and conducting ongoing assessments and documenting in an electronic file.
- Chart abstraction
- Clinical work such as performing wound care, iv antibiotic, assessments, catheter care, wound vac, PICC line, trach care, ostomy care, medication reconciliation, Order supplies. Accept Orders, write orders, schedule out visits.
Education
Vocational - Nursing
Texarkana College
Texarkana, TX02-2010
Skills
- Client support
- Electronic medical record systems
- Risk assessment
- Patient education
- Medical registration expertise
- Proficient in medical terminology
- Strong analytical skills
- Strong attention to detail
- Proficient in written and verbal communication
- Task prioritization in remote settings
- Skilled in compassionate communication
- Results-driven with excellent organizational capabilities
- Calendar management
- Skilled in data management and analysis tools
- Team collaboration in dynamic settings
- Staff development
- Quality assurance auditing
- HIPAA compliance
- Patient confidentiality
- Clinical documentation
Accomplishments
Medicare and Retirement Certification
Certification
- PN Licensed in the following states
- Arkansas L05507
- New York 351724
- Connecticut 46681
- Michigan 4703130519
- Illinois 4499336
- MassachusettsLN1002342
- Minnesota
- Oregon 10031986
- Nevada 882238
- California748148
- Alaska 229356
- District of Columbia LPN200002931
- Hawaii 21306
- M&R 3 Certified
- UHG Leadership Foundations
Languages
English
Native or Bilingual
Timeline
Senior Clinical Administrative Coordinator
UHC- UMR E&I
05.2024 - Current
Clinical Quality Specialist Patient Navigator
Optum
03.2022 - 05.2024
HSS Coordinator
Cigna/Molina Healthcare
04.2020 - 03.2022
Patient Care Coordinator
Kindred Hospice
03.2019 - 04.2020
LPN (Licensed Practical Nurse)
LHC Group
07.2015 - 01.2020
Vocational - Nursing
Texarkana College
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