Chitrangi Pascall
Generations Healthcare
TEMECULA
3
Languages
1
Certification
31
years of professional experience
Results-driven Utilization Manager experienced in resource optimization and patient-centered care. Enhanced healthcare delivery and improved patient outcomes through effective communication, critical thinking, and team collaboration. Streamlined processes and mentored staff to elevate team performance while fostering collaborative environments that support continuous improvement in care quality.
Work History
Utilization Manager
7 Years 4 Months- Led utilization management initiatives, enhancing care delivery and resource allocation across departments.
- Developed and implemented strategies to optimize patient flow and reduce service delays.
- Analyzed clinical data to identify trends, driving improvements in care efficiency and quality outcomes.
- Collaborated with multidisciplinary teams to ensure compliance with regulatory standards and best practices.
- Mentored junior staff on utilization review processes, fostering professional development and team effectiveness.
- Streamlined documentation processes, improving accuracy of patient records and expediting review timelines.
- Conducted regular audits of utilization patterns, identifying opportunities for cost reduction without compromising quality.
- Coordinated with other department leaders to align utilization management initiatives with broader organizational goals and objectives.
- Established strong working relationships with insurance companies, effectively advocating for patients'' needs during reimbursement negotiations.
- Championed patient-centric care by integrating a holistic approach to medical case reviews, addressing not only physical but also social and emotional aspects of health for optimal outcomes.
- Collaborated with interdisciplinary teams to develop effective care plans tailored to individual patients'' needs.
- Optimized resource allocation by conducting regular assessments of staffing levels and workload distribution within the department.
- Reduced unnecessary hospitalizations by implementing rigorous case management strategies and monitoring patient progress closely.
- Maintained up-to-date knowledge of industry trends, regulations, and guidelines, contributing to the continuous improvement of utilization management practices within the organization.
- Evaluated the performance of remote and in-house utilization review teams, providing feedback and guidance to drive continuous improvement efforts.
- Identified gaps in service delivery and recommended improvements to optimize resource utilization and quality of care.
- Enhanced patient care by conducting thorough utilization reviews and coordinating with healthcare providers.
- Improved patient satisfaction scores through diligent follow-up on requests and addressing concerns in a timely manner.
- Provided training and mentorship to new team members, fostering a collaborative work environment focused on achieving departmental goals.
MDS Plan Coordinator/Utilization Manager/Medical Records Analyst
23 Years 3 Months- Analyzed MDS data to identify trends and improve resident care outcomes.
- Streamlined documentation processes, enhancing accuracy of resident assessments and care plans.
- Developed and implemented training programs for staff on MDS compliance and updating procedures.
- Coordinated interdisciplinary team meetings to ensure comprehensive care planning for residents.
- Led quality assurance audits to maintain adherence to state and federal regulations.
- Mentored junior staff in effective MDS completion techniques and best practices.
- Collaborated with healthcare providers to optimize individualized care strategies for residents.
- Enhanced communication channels between departments to facilitate timely information sharing regarding resident needs.
- Maintained compliance with federal regulations by staying current on industry standards and best practices for MDS coordination.
- Streamlined data collection processes for improved accuracy in MDS assessments and care planning.
- Reduced discrepancies in reported data by conducting regular audits of MDS records and recommending corrective actions where needed.
- Served as a valuable resource for staff members seeking guidance on complex case management situations, fostering a collaborative and supportive work environment.
- Enhanced patient care by developing and implementing comprehensive MDS plans tailored to individual needs.
- Ensured accurate reimbursement claims by diligently tracking changes in patient conditions and updating MDS accordingly.
- Maximized patient satisfaction by incorporating their preferences into individualized care plans whenever possible.
- Facilitated smooth transitions between care settings by effectively communicating relevant information regarding patients'' individual needs.
- Mentored new staff members on MDS procedures, contributing to a well-informed and highly skilled workforce.
- Demonstrated exceptional time management skills by consistently meeting deadlines for completion of MDS assessments and care plan submissions.
- Improved communication between team members by organizing regular meetings to discuss MDS updates and plan adjustments.
- Collaborated with interdisciplinary teams to ensure optimal patient outcomes and consistent quality of care.
- Improved patient satisfaction scores through diligent follow-up on requests and addressing concerns in a timely manner.
- Enhanced patient care by conducting thorough utilization reviews and coordinating with healthcare providers.
- Identified gaps in service delivery and recommended improvements to optimize resource utilization and quality of care.
- Maintained up-to-date knowledge of industry trends, regulations, and guidelines, contributing to the continuous improvement of utilization management practices within the organization.
- Reduced unnecessary hospitalizations by implementing rigorous case management strategies and monitoring patient progress closely.
Director of Staff Development/Charge Nurse
7 Years 3 Months- Fostered a culture of continuous learning through regular workshops and professional development sessions.
- Collaborated with departmental leaders to identify training needs and align programs with organizational goals.
- Developed and implemented comprehensive training programs to enhance staff competencies and performance.
- Streamlined onboarding processes, improving new hire integration and retention rates across departments.
- Mentored staff development coordinators, enhancing their skills in training delivery and program evaluation.
- Analyzed training outcomes to refine curricula, ensuring alignment with best practices and regulatory standards.
- Coordinated patient care plans with multidisciplinary teams and implemented effective communication strategies.
- Mentored new nurses, fostering skill development and promoting a culture of continuous learning.
- Conducted regular assessments of patient conditions, adjusting care plans based on clinical evaluations.
- Developed training programs for nursing staff on compliance regulations and safety protocols.
- Managed staffing schedules to optimize resource allocation while maintaining high standards of care delivery.
- Trained new nurses in proper techniques, care standards, operational procedures, and safety protocols.
- Coordinated nursing care on unit through staff assignments, assisting and rounding with physicians, monitoring patient orders, and communicating with ancillary departments.
- Conducted daily shift briefs to inform staff of changes in patient care assignments.
- Optimized patient satisfaction through timely response to concerns and effective communication among staff members.
- Collaborated with other healthcare professionals to provide quality patient care.
- Served as a liaison between nursing staff, physicians, and management, fostering open communication channels among all parties involved in patient care.
- Supervised and managed daily scheduling, tasking, and administration.
Education
Post-Baccalaureate Diploma - Nursing
No Degree - Prerequisite For RN Program
Skills
Healthcare
Medical terminology
Healthcare regulations
Insurance verification
Resource optimization
Case management proficiency
Data analysis
Documentation accuracy
Critical thinking
Motivational leadership
Interdisciplinary collaboration
Collaboration
Patient advocacy
Organizational skills
Multitasking
Reliability
Workflow optimization
Operational consistency
Stakeholder engagement
Teamwork and collaboration
Customer service
Adaptability and flexibility
Attention to detail
Positive attitude
Computer skills
Problem resolution
Certification
- Licensed Licensed Vocational Nurse - License NO. VN168400 1995 to Current
- AHA/BSL CPR Certification, American Heart Association - Current
- MDS 3.0 Training
Languages
Russian
Limited Working
Sri Lankan
Native or Bilingual
English
Native or Bilingual
Timeline
Utilization Manager
Sharp Healthcare
04.2019 - CurrentRead More
MDS Plan Coordinator/Utilization Manager/Medical Records Analyst
Generations Healthcare
05.2003 - CurrentRead More
Director of Staff Development/Charge Nurse
Paradise Valley Healthcare Center
02.1996 - 05.2003Read More
Mount San Jacinto College
No Degree from Prerequisite For RN Program
Read More
Maric College of Medical Careers
Post-Baccalaureate Diploma from Nursing
Read More