Humana - Clinical Director Resume Example

Customize this Resume

Lkley Esfftuor

XXXX XX XXXX XXXXX, Coral Springs, FL 33071 | (H) XXXXXXXXXXXX | XXXXXXXXXXXXXXXXXXXXXXXXX

Summary

Accomplished and energetic Clinical Director with a solid history of achievement in Long Term Care and Case Management. Motivated leader with strong organizational and prioritization abilities. Areas of expertise include Implementing, and Coordination, Judgment and Decision Making, as well as Management of Financial Resources and responsibility

Skills

Administration and Management
Critical Thinking

Complex Problem Solving
Speaking

Coordination
Judgment and Decision Making

Management of Financial Resources
Operations Analysis

Computers and Electronics

Experience

Clinical Director, Long Term Care 12/2014 to Current
Humana – Miramar, FL

Conduct and administer fiscal operations, including accounting, planning budgets, authorizing expenditures, establishing rates for services, and coordinating financial reporting.

Direct, supervise and evaluate work activities of LTC management staff
Lead medical, nursing, technical, clerical, and other personnel.

Maintain communication between governing boards, medical staff, and department heads by attending board meetings and coordinating interdepartmental functioning.

Plan, implement and administer programs and services in a health care or medical facility, including personnel administration, training, and coordination of medical, nursing and physical plant staff.

Develop and implement organizational policies and procedures for the LTC program
Lead successful integration of Humana Comfort Choice and American Elder Care
Involved in the development of LTC Platform
Develop and Mentor LTC staff
Attest to AHCA monthly, quarterly and annual reporting requirements
Review and implement quarterly contract amendments
Maintain compliance of all contract requirements

Regional Manager for Long Term Care 04/2014 to 12/2014
Humana – Miramar, FL

Provide leadership and guidance to other nurses and social workers
Ensure that staff is properly trained
Address any personnel issues to promote a productive and supportive work environment
Monitor member services for quality and compliance
Collaborate with top management, interdisciplinary teams and other stakeholders in order to develop, implement and evaluate programs and services
Participate in State required Audit
Review required ACHA monthly and quarterly reports

Front Line Leader 01/2013 to 04/2014
Humana – Miramar, Florida

l Processed monthly reports for department performance.
l Increased team productivity.
l Demonstrated ability to lead and motivate outstanding healthcare teams.
l Contributed substantially to successful department NCQA audit.
l Ensured HIPAA compliance.
l Strong leader for direct reports assigned.
l Oversaw and managed number clinical and support staff in member care activities while maintaining a high level of staff morale and professionalism.
l Implemented new processes including SCM center based assignments.
l Provide support for Senior Bridge Transitions with daily calls to ensure positive outcomes.

Case Manager 11/2011 to 01/2013
Humana – Miramar, FL

l Developed treatments and casework programs for an average of 60 patients each month.
l Processed monthly reports for department performance.
l Managed care for post-discharge members.
l Ensured HIPAA compliance.
l Coordinated care with interdisciplinary team.
l Trained new staff.

Registered Nurse 10/2008 to 04/2011
Broward Health – Coral Springs, Florida

l Primary care, assessment and evaluation of neonatal and adult patients.
l Counseled and educated patients about health issues and wellness.
l Self-directed with astute judgment skills.
High level of personal accountability.
l Performed lab tests and communicated results.
l Contributed substantially to successful department JCAHO accreditation.
l Ensured HIPAA compliance.
l Developed patient care plans, including assessments, evaluations and nursing diagnoses.

Server 05/1998 to 07/2007
Runyons, Inc – Coral Springs, Fl

l Assisted in maintaining preparation and service areas in a sanitary condition l Greeted each customer with friendly eye contact l Performed all transactions in a cordial, efficient and professional manner l Spoke with patrons to ensure satisfaction with food and service l Trained new employees l Ensured perfect service provided for the Prefect consumer experience.

Internal Auditor/Sales Associate 04/1996 to 06/1998
HVAC, Inc – Pompano Beach, Fl

l Supervised a sales force of sales associates.
l Supported the sales team in writing proposals and closing contracts.
l Developed a comprehensive training program for new sales associates.
l Built relationships with customers and the community to establish long-term business growth.
l Analyzed and reviewed cost reports.
l Articulated audit findings, risks and detailed recommendations to upper management.

Manager 01/1993 to 12/1995
Jimmy's Italian Restaurant – Coral Springs, FL

l Carefully interviewed, selected,trained and supervised staff.
l Clearly and promptly communicated pertinent information to staff, such as large reservations or last minute menu changes.
l Interacted positively with customers while promoting services.
l Carefully developed a lucrative annual food and beverage marketing plan and strict budget to maximize profits.
l Actively participated in ongoing customer service programs to build sales and rapport in the community.
l Led and directed team members on effective methods, operations and procedures.
l Promoted a positive atmosphere and went above and beyond to guarantee each customer received exceptional food and service.
l Maintained a safe working and guest environment to reduce the risk of injury and accidents.

Server/Bookkeeper/General Manager 11/1989 to 12/1995
Jimmy's Italian Restaurant – Coral Springs, FL

l Maintained integrity of general ledger, including the chart of accounts.
l Analyzed monthly balance sheet accounts for corporate reporting.
l Generated financial statements and facilitated account closing procedures each month.
l Consistently stayed under monthly controllable expense budget.
l Provided excellent customer service.

Education

Associate of Science: Nursing Broward College - Nursing Coconut Creek, Fl 2008l Recipient of Broward Health Scholarship

Love this resume? Customize this Resume

Clinical Director Case Manager Registered Nurse Server Internal Auditor Sales Associate Manager Bookkeeper General Manager