Naomi JNJ
Open to opportunities

Naomi J

@naomij

Results-driven case manager with expertise in Medicaid and HEDIS.

United States
Message

What I'm looking for

I am looking for a role that values community health, offers growth opportunities, and allows me to make a meaningful impact.

I am a results-driven Case Manager with over 18 years of experience in Medicaid and Medicare programs, specializing in HEDIS quality improvement and long-term support services. My proven track record includes enhancing care coordination, increasing HEDIS scores, and implementing effective case resolution strategies. I excel in motivational interviewing, regulatory compliance, and client advocacy, ensuring that diverse populations receive the support they need.

Throughout my career, I have successfully delivered case management for aging populations, conducted biopsychosocial assessments, and created compliant care plans. My experience spans various roles, including Case Management Analyst at Aetna CVS and Older Youth Case Manager at Geminus Corporation, where I provided mentorship and resources to foster youth. I am passionate about community health outreach and have led initiatives to improve HEDIS metrics through direct member engagement and collaboration with quality management teams.

Experience

Work history, roles, and key accomplishments

AC
Current

Case Management Analyst – Medicaid LTSS

Aetna CVS

Aug 2022 - Present (2 years 11 months)

Delivered case management for aging populations (29+) with emphasis on long-term care, waiver services, and holistic care coordination. Evaluated eligibility, conducted biopsychosocial assessments, and created care plans compliant with regulatory guidelines.

GC

Older Youth Case Manager / Family Advocate

Geminus Corporation

Feb 2020 - Present (5 years 5 months)

Supported foster youth in transition to independence post-DCS involvement through tailored case plans and resource connections. Provided mentorship, community engagement, and life skills education to promote employment and post-secondary success.

SL

Case Manager

Seeds of Life

Aug 2019 - Present (5 years 11 months)

Delivered intensive case management for families and youth in foster care. Coordinated behavioral health services, conducted assessments, and tracked developmental progress.

MH

HEDIS Specialist

Molina Healthcare

Aug 2016 - Present (8 years 11 months)

Supported HEDIS and quality improvement programs by analyzing gaps in care and engaging members in preventive services. Coordinated telephonic outreach and scheduled appointments to close care gaps.

FN

Health Outreach Coordinator

Family Health Network

Oct 2014 - Present (10 years 9 months)

Organized disease prevention fairs and led outreach calls to drive HEDIS compliance. Facilitated referrals, authorizations, and managed care coordination across provider networks.

BP

Community Health Advisor / CHW

Buckeye Community Health Plan

Jun 2013 - Present (12 years 1 month)

Conducted home visits to educate members on health benefits, improve HEDIS scores, and reduce ER re-admissions. Organized educational and promotional events to strengthen member engagement.

Education

Degrees, certifications, and relevant coursework

AU

Ashford University

Bachelor of Arts, Psychology

Obtained a Bachelor of Arts in Psychology, focusing on foundational psychological principles and theories. Developed a comprehensive understanding of human behavior and mental processes.

UP

University of Phoenix

Associate of Arts, Psychology

Completed an Associate of Arts in Psychology, building a strong base in psychological concepts. Gained initial insights into the field of psychology and its applications.

Tech stack

Software and tools used professionally

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Naomi J - Case Management Analyst – Medicaid LTSS - Aetna CVS | Himalayas