Alison Langley
Paxton,IL
Summary
Talented Case Manager adept at handling high caseloads without sacrificing quality of care. Operates in high-pressure environments while recommending best resources and courses of action to benefit patient needs and return each to optimal quality of life.
Overview
9
9
years of professional experience
1
1
Certification
Work History
Admissions Director
Accolade Healthcare
05.2023 - Current
- Oversees all new admissions into the facility.
- Coordinates with central intake team and communicates with families regarding facility policies, expectations, benefits, and addresses any other questions.
- Completes all admission agreements following new admissions.
- Works directly with hospital providers overseeing patients in the facility.
- Compiles weekly spreadsheet for Post Acute Care Meeting and leads meeting.
- Assists all departments with any needs that arise
Director of Case Management
Altitude Health Services
02.2019 - 05.2023
- Oversee all skilled admissions.
- Review clinical and verify benefits prior to accepting patient to admitting to the facility.
- Once patient admits to the facility, oversee care and communicate with health plan and hold weekly IDT meetings.
- Market and network within the area with providers, insurances, and other facilities.
- Work with patient and social services on discharge planning to facilitate safe transition from SNF to home.
- Oversee daily census, admission/discharges, and re-hospitalizations.
Regional Case Manager (SNF), Centralized Intake Referral Manager
HCR Manorcare
03.2017 - 02.2019
- Review all insurance referrals for medical necessity to meet skilled criteria for authorization from the patient's health plan.
- Obtain benefit details from health plans for SNF coverage.
- Request/obtain authorization for SNF admission from health plans.
- Follow the patient's progress throughout SNF stay completing clinical review with health plan utilization management team in order to advocate for the patient and assist with DC planning as needed.
- Collaborate with interdisciplinary teams within each facility in order to provide the best care and interventions for each patient in order to return the patient back to his or her prior level of function.
- Managed caseload of 80+ patients over 8 facilities. Increased revenue by 40% quarterly identifying higher reimbursement opportunities within managed care contracts.
Director of Rehab, COTA
ONR Rehabilitation
06.2016 - 03.2017
- Managed and oriented staff between both buildings.
- Provided and implemented treatments for residents to improve quality of life.
- Completed documentation and prepared all required documentation for billing.
Education
Associates - Applied Sciences
Parkland College
Champaign, IL05.2014
Skills
- Health plan authorization requirements
- Managed care contracting
- Sales experience
- Medicare and Medicaid
- Recognizing concerns of senior citizens
- Team building, Leadership, and Communication
- Time Management and Problem solving
- Microsoft Word, PowerPoint, Excel
Licenses Certificates
- Licensed Occupational Therapy Assistant, IL
- Certified by the National Board of Certification of Occupational Therapy
Certification
- COTA - Certified Occupational Therapy Assistant
Timeline
Admissions Director
Accolade Healthcare
05.2023 - Current
Director of Case Management
Altitude Health Services
02.2019 - 05.2023
Regional Case Manager (SNF), Centralized Intake Referral Manager
HCR Manorcare
03.2017 - 02.2019
Director of Rehab, COTA
ONR Rehabilitation
06.2016 - 03.2017
Associates - Applied Sciences
Parkland College
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