Gina DeGuzman

Experience

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  McClain Inc

  Nov 2001 - Nov 2002

  Trainer for Developmentally Disabled Adults

  Supervised client’s daily life skills training. I regularly trained residents in proper communication, personal finances and appropriate public conduct. I also assisted clients with securing and maintaining employment and provided transportation to all medical and social outings. Additionally, I participated in the creation of educational programs to optimize client achievement.

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  Florida Department of Children and Families

  Nov 2002 - Jun 2011

  ESS I

  I assisted clients in obtaining food stamps, Medicaid, and cash assistance benefits by conducting intake interviews in order to determine eligibility based on federal and state policy guidelines. Using knowledge of community partner resources, I matched clients with outside the agencies offering services such as financial assistance, legal aid, housing, job placement, and education. I collaborated with other professionals to evaluate patient’s medical or physical conditions and assessed client’s case management needs. Show less

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  Family Preservation Services

  Feb 2011 - Apr 2013

  Senior Mental Health Practioner

  Provided in home counseling services to adults and children with mental health issues in order to develop coping skills and manage their conditions more effectively. I completed strengths assessments and developed plans for treatment. I monitored, evaluated, and recorded client progress according to measurable goals described in treatment and care plans that adhered to Medicaid and ACHA guidelines.

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  Humana

  Apr 2013 - Nov 2017

  Health Care Manager

  I conducted proactive telephonic outreach to eligible Humana Medicare members in need of case management, social services, and other community or supportive resources. As a Health Care Manager, I contributed to and supported the multidisciplinary team efforts of the Humana At Home Special Needs Plan model. I completed assessments to identify areas of member need. I constructed care plans and followed up on member’s progress. I supported member’s needs by following an integrated holistic approach along with an Interdisciplinary Care Team of professionals. My focus as a Health Care Manager was to assist the member with locating the resources needed for day-to-day management of his/her conditions and treatment, provide health information, and help the member navigate through health and community systems. I worked to empower the member to actively participate in their health decisions through prioritizing, problem solving, and making informed choices. Show less

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  Centene Corporation

  Jan 2018 - now

  Behavioral health UM Care Manager

  I currently perform prior authorization and concurrent reviews for behavioral health services, review psychotropic medication utilization, prepare cases for the medical directors and assist with discharge planning.