Patsy Watts
Newport Beach
Summary
Dynamic Certified Case Manager with a proven track record at Prospect Medical Group, excelling in case evaluation and care planning. Leveraged analytical problem-solving to enhance quality and compliance, while advocating for clients' access to resources. Recognized for delivering impactful outcomes through collaborative decision-making and meticulous documentation.
Overview
8
8
years of professional experience
Work History
Certified Case Manager
Prospect Medical Group
01.2014 - 09.2016
- Assessed client needs to develop comprehensive care plans tailored to individual circumstances.
- Coordinated services among healthcare providers to ensure continuity of care and support for clients.
- Monitored client progress, documenting outcomes and adjusting care plans as necessary for optimal results.
- Advocated for clients' access to resources, educating them about available healthcare options and benefits.
- Participated in daily rounds with the Medical Director to evaluate the patient's need to remain in the hospital.
- 24-hour on-call to manage out-of-network patients.
- Correlated outpatient needs regarding continued care.
Clinical Quality and Data Analyst
Coalition of the Orange County Community Clinics
01.2011 - 01.2014
- Analyzed data trends to support program development and improve clinic services.
- Developed comprehensive reports for stakeholder presentations, enhancing decision-making processes.
- Implemented data management systems to streamline information retrieval and reporting accuracy.
- Collaborated with cross-functional teams to ensure alignment on data-driven initiatives.
- Oversaw quality assurance processes, identifying areas for continuous improvement in data handling.
- Led project teams in the execution of data analysis projects that informed strategic planning efforts.
- Consistently met deadlines and delivered high-quality work, demonstrating a strong commitment to excellence in data management.
- Managed sensitive information responsibly, adhering to strict security protocols and maintaining confidentiality at all times.
- Chart review for HEDIS
Quality Review Specialist
Universal Care Medical Group
03.2009 - 01.2013
- Analyzed review data to identify trends and recommend improvements.
- Collaborated with cross-functional teams to enhance review processes and workflows.
- Developed training materials for onboarding new review specialists, promoting consistency in evaluations.
- Conducted quality assurance checks on reviews to ensure adherence to standards and guidelines.
- Pre-contractual review of all ancillary provider facilities as well as retrospective review on existing contracts.
- Annual to biannul review of doctore offices, facilities for consideration.
- Perform DHS audits as necessary.
- Data collection to assesss medical group and individual physicinan offices and clinical operations conforming to the standards of HEDIS, NCQA, and DHS.
Education
No Degree - General Studies
Riverside Community College
Norco, CABachelor of Science - Hospital Administration
Indiana University, Purdue University Indianapolis
Indianapolis, IN04-2023
No Degree - Licensed Vocational Nursing
North Orange County Regional Occupational Program
Anaheim, CA06-1986
Skills
- Case evaluation
- Data analysis skills
- Care planning
- Quality enhancement
- Legal compliance
- Positive attitude
- Analytical problem-solving
- Time management
- Analytical reasoning
- Detailed case documentation
- Collaborative decision-making
Timeline
Certified Case Manager
Prospect Medical Group
01.2014 - 09.2016
Clinical Quality and Data Analyst
Coalition of the Orange County Community Clinics
01.2011 - 01.2014
Quality Review Specialist
Universal Care Medical Group
03.2009 - 01.2013
No Degree - General Studies
Riverside Community College
Bachelor of Science - Hospital Administration
Indiana University, Purdue University Indianapolis
No Degree - Licensed Vocational Nursing
North Orange County Regional Occupational Program