At Aetna/CVS Health, I lead holistic case management for complex Medicare Advantage and Dual-Eligible members with medical, behavioral, and social health needs.
I manage 50–60 members, build proactive care plans for conditions including CKD, ESRD, diabetes, hypertension, and behavioral health, and coordinate with providers through interdisciplinary case conferences. I use motivational interviewing, utilization review, discharge planning, and community resources to close gaps in care and reduce avoidable readmissions.
I've maintained audit compliance above 95% and member satisfaction above 98%, drawing on prior RN case management experience at Arkansas Blue Cross Blue Shield and four years supporting medical communications in the U.S. Army.
