Chelse Didriksen

Experience

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  Olsson Associates

  Mar 2007 - Dec 2009

  Human Resources Assistant

  • Assisted in all aspects of the hiring process by attending career fairs, performing phone interviews and reference checks, and maintaining resume database.• Coordinated new employee orientation.• Researched and created reports for presentation materials.• Representative for company wellness program.• Tracked and reported HR expenses.

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  Brian Memorial Hospital

  Aug 2009 - Dec 2009

  Mental Health Technician

  • Completed discharge plans with clients.• Collaborated with psychiatrists and social workers to ensure each patient had a plan that was fit for their needs and to help with executing plans during their stay at the facility.• Facilitated daily group activities for all patients.

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  Optum

  Feb 2010 - Mar 2015

  ● Supported the Western Region teams to build the provider network by reaching out to behavioral health providers and educating them on the commercial, Medicare, and Medicaid networks. ● Supervised, mentored, and trained new employees and provide job specific trainings to the Western Region team.● Investigated claims issues and determine appropriate plan for resolution.● Facilitated meeting with providers and facilities in the Washington and Oregon to discuss contracts and service delivery. ● Attended health plan meetings to discuss new issues in health care, billing, and general operational procedures.● Provided training to providers for changes in CPT codes and upcoming DSM-V and ICD-10 changes.● Negotiated rates and contract language for behavioral health providers in the Western Region.● Collaborated with Senior Leadership on business operations and barriers to any specific job duties. Show less ● Coordinated team tasks by assigning daily cases to Care Advocates and answering policy and procedure questions.● Assisted in training process by training the team on new or changing procedures.● Reviewed medical records for claims and HEDIS auditing purposes.● Collaborated with providers for benefits verification and authorization for outpatient appointments.● Worked directly with health plans for quality of care purposes.● Created and analyzed utilization management reports and presented to teams. Show less

  • Clinical Network Manager

    Sept 2014 - Mar 2015

  • Clinical Network Associate

    Feb 2010 - Sept 2014

  • Public Sector Team Assistant

    Feb 2010 - Feb 2013
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  The Salvation Army

  Sept 2012 - Jun 2013

  Social Work Intern

  • Worked as main advocate for winter mat program.• Assisted with developing new recovery language for the program.• Worked with clients to find housing and jobs.• Empowered women by leading weekly groups.• Provided immediate decisions while on-call for late night staff.

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  Cascade AIDS Project

  Sept 2013 - May 2014

  Social Work Intern

  Created updated training manuals for data entry and funding compliance.Analyzed data to provide numbers to managers and directors for presentation and funding purposes Provided training for volunteers and new interns.Collaborated with leadership on development and program implementation of new Client Services Center Program.Completed initial assessments for new clients.Worked directly with clients to discuss housing options and treatment goals. Provided support to Real Talk, an African-American support group. Show less

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  ZOOM+

  Mar 2015 - Nov 2015

  Health Plan Operations Specialist

  Held multiple positions in health plan operations including claims and membership manager, accreditation specialist, claims quality assurance manager, and trainer. ● Participated in health plan leadership meetings to advise executive team on policies and procedures. ● Developed and implemented a professional training program for Health Plan Operations (Membership, Billing, Claims, and Compliance). ● Developed Quality Assurance Plan and executed claims audits weekly per QA Plan.● Lead the Zoom+ Organization through URAC health plan accreditation.● Researched, developed and implemented new policies and procedures for Health Plan Operations.● Collaborated with Compliance Team to develop and implement policies to ensure the health plan was in compliance with state and federal regulations.● Trained customer service team on membership management and provider relations.● Developed baseline metrics for claims and membership teams for quarterly milestone tracking.● Completed monthly claims audits for quality assurance and performance guarantee metric monitoring and reporting. Show less

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  Salvation Army Female Emergency Shelter

  Nov 2015 - Sept 2017

  Executive Director

  ● Influence policy conversations and implement decisions. ● Manage staff by using a strengths based approach to motivate others and manage all conflict. ● Analyze shelter statistics and reporting to assess needs and set clear goals. ● Manage and work within annual budgets and contracts.● Create relationships with partner agencies and housing partners to increase housing options for women experiencing homelessness. ● Collaborate with Grant Writer to write and submit grants for programs within SAFES and Safe Harbor to increase and diversify funding. ● Ensure that all projects and programs are executed and implemented on time.● Speaks effectively when presenting to Board Members, stakeholders, clients, employees, and at conference workshops. ● Supervise MSW interns in collaboration with Universities (Portland State, USC, Simmons, and George Fox) and provide MSW supervision. Show less

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  Moda Health

  Sept 2017 - Aug 2021

  • Project Manager

    Oct 2019 - Aug 2021

  • Sr. Contract Negotiator

    Sept 2017 - Oct 2019
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  Care Partners Hospice

  Oct 2019 - Oct 2023

  Board Member
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  Girls Inc.

  Jan 2020 - Aug 2021

  Social Work Field Instructor
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  Northwest Permanente

  Aug 2021 - May 2024

  Senior Contract Manager
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  Regence BlueShield of Idaho

  May 2024 - now

  Director, Provider Contracting