Jackie Goldberg

• One-on-one coaching, serving clients navigating lifestyle change
• Facilitative partnership with clients, helping them reach their health-related goals by providing structure, guidance on SMART goal setting, and accountability

• Built and maintained strong partnerships with FQHCs and healthcare organizations through consistent communication and alignment across teams.
• Managed multiple partner projects and service-line launches (CCM, RPM, AWV, BHI, TCM) with on-time delivery and high satisfaction.
• Analyzed and presented partner performance data via dashboards and reports to drive strategic decisions.
• Created and refined PowerPoint presentations that clearly communicated project updates and insights.
• Collaborated cross-functionally to design and implement new workflows (SDoH, EHR documentation, behavioral health) that improved efficiency.
• Coordinated calendars, meetings, and action items for remote teams to ensure timely follow-through.
• Streamlined communication and reporting processes, enhancing partner engagement and retention.

Key Responsibilities & Achievements

Provided motivational health coaching and care management to patients nationwide, driving engagement, adherence, and improved clinical outcomes through proactive communication and goal setting.

• Delivered motivational interviewing and health coaching to support patients with chronic conditions in setting and achieving SMART health goals.
• Monitored patient progress, closed care and HEDIS gaps, and coordinated resources to improve health outcomes and care continuity.
• Collected and shared patient success stories to highlight best practices and reinforce positive behavioral change.
• Supported clinical teams in improving key metrics such as patient satisfaction, adherence, and follow-up rates.
• Demonstrated strong organizational, problem-solving, and relationship building skills in a fast-paced, data-driven environment.

• Research, investigate and resolve Quality of Service (QOS) member complaints and grievances.
• Communicate with members and Health Net departments in the acceptance, research and interpretation of complaints to determine the appropriate site of resolution, in accordance with both company policy and governmental regulators.
• Compose and send case outcome letters to members

Managed the insurance pre-authorization process in a high-volume medical office to ensure both timely patient care and payment of medical treatments.

• Increased business revenue and streamlined the patient-treatment process by identifying and performing payer / insurance authorizations for procedures and medications.
• Skillfully presented patient’s clinical history to payers adhering to Medical Utilization Management and/or Pharmacy Benefits Management standards.
• Evaluated prescriptions to determine necessity for prior authorization; knowledgeable about drug formularies, drug information and generic alternatives.
• Filed appeals and grievances with carriers on patients’ behalf, resulting in favorable outcomes.
• Provided patients with easy to understand information on costs, benefits, and treatment options.
• Comprehensively documented call notes in Electronic Medical Records (EMR) throughout the prior authorization and verification process.
• Maintained appropriate logs and reports according to professional, state and federal requirements.