SUZANNE M. LEE

• Direct complex case management and collaboration with providers and health services to meet the medical and behavioral health needs of members. Provide high quality, cost-effective healthcare outcomes including personalized care plans, resource mobilization and education for members and their families.
• Contributes clinical knowledge to assist in the resolution of quality of care concerns, clinical reviews and Operational Reviews. Completes an independent review of data management and other deliverables, technical assistance, and focused studies/reviews, including the behavioral health delivery system, to ensure compliance with contractual and policy requirements for all lines of business. Follow-up on written reports, action plans, provider education, and related actions as appropriate.
• Develop improved processes and procedures to improve the efficiency of the unit. Lead special projects and reviews to ensure completion within the designated timelines. Provide ongoing updates to Management.
• Collaborate with Quality Management, and provide monitoring and oversight of AHCCCS providers.
• Knowledge of AHCCCS and Medicaid regulations, policies and procedures and applicable federal and state statutes, regulations and rules
• Knowledge of medical terminology and PA processes and procedures to benefit utilization of health services

PRN RN to Banner pediatric hospitals, one Saturday or Sunday shift per month to maintain clinical skills.

• Provide excellent care to pediatric patients and families in Pediatrics and NICU departments
• Conduct regular generalized and localized assessments of newborns, infants, toddlers and school age children; implement accurate and timely EMR documentation; implement medication administration as prescribed by the physician and monitor patients for side effects
• Collaborate with members of the healthcare team to provide high quality patient care.
• Educate patients, caregivers and families on diagnoses, disease management and equipment management

• Researched and developed the maternal and child health program strategy to reduce the incidence of pre-term birth in Arizona
• Implemented train-the-trainer pregnancy classes for additional roll-out to high-risk populations in Arizona state
• Laid off: organizational financial restructuring nationwide

• Provided age-appropriate developmental play and therapeutic activities for patients and siblings at level 1 trauma center for Central Texas.
• Spearheaded, designed and executed evidence-based, quality improvement project: Researched effects of music/noise machines in PICU and NICU settings. Piloted machine in PICU and assessed nurse feedback on its use and level of satisfaction.
• Wrote/obtained grant: machines were installed in every PICU and IMC room.
• Wrote article; published in Association of Child Life Professionals Bulletin (Spring 2017)