Coleta Schmidlin
Healthcare Executive | Quality Management | Accreditation and Regulatory Compliance | Utilization Review | Case Management
- Role
- Manager Behavioral Health Utilization Management and Case Management at Anthem Blue Cross and Blue Shield
- Location
- Cincinnati, OH, US
- LinkedIn followers
- 500 followers
About Coleta Schmidlin
I am a healthcare leader with proven results that have improved patient and financial…
Experience
Manager Behavioral Health Utilization Management and Case Management
Anthem Blue Cross and Blue Shield
Apr 2022 — Present · Columbus, OH, US
Manages two teams of licensed clinicians and non-clinical support staff responsible to ensure medical necessity and appropriateness of care for inpatient/outpatient BH services along with staff engaged in telephonic outreach to members and development and evaluation of care plans designed to optimize member health care across the care continuum and ensuring member access to services appropriate to their health needs.Leads development and maintenance of positive relationship with providers and works to ensure quality outcomes and cost effective care, develops clinical guidelines and policies and procedures, provides leadership in the development of new pilots and initiatives to improve care or lower cost of care. Supports process improvement and quality assurance activities, ensures adherence to appropriate policies, best practices, relevant clinical standards and member contracts.
Education
University of Toledo
Bachelor of Education (BE)
University of Toledo
Master of Science and Education (MSE)
Skills
- Home Care
- Healthcare
- Healthcare Management
- Psychiatry
- Nursing
- Elder Care
- Healthcare Consulting
- Medicine
- Epic Systems
- Emr
- Acute Care
- Revenue Cycle
- Quality Improvement
- Inpatient
- Budgets
- Physicians
- Medicaid
- Physician Relations
- Policy
- Informatics
- Patient Safety
- Healthcare Industry
- Healthcare Information Technology
- Accreditation
- Managed Care
- Clinical Research
- Ehr
- Psychotherapy
- Jcaho
- Medicare
- Public Speaking
- Leadership
- Hospitals
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