iSixSigma

Sandra Bolden

Profile

iSixSigma Membership

Name

Sandra Bolden

Title

HRCM

Biography

Sandra K. Bolden is a Level 3 Care Manager for Optum Health. She is responsible for:
Developing and maintain excellent performance and quality service for Optum Health customers by maintaining a focus on the customer service through policy and program decisions and considering the impact of these activities on the members, facilitating interdepartmental communication as needed for integration purposes and problem resolution with members, providers, and other agencies or entities as needed, conducting initial and follow-up assessments within designated timeframes on patients identified as having highest risk complex case management needs (assessment areas include clinical, behavioral, social, environmental and financial), assessing the patient’s current medical and social circumstances to identify any gaps or barriers that would impact compliance with the prescribed treatment plan, engaging patient, family, caregivers, and healthcare providers to assure that a well-coordinated treatment plan is established, utilizing holistic approaches to patient care and integrate patient’s life and motivational goals into the treatment plan, prioritizing care needs, setting goals and developing treatment plans that also addresses gaps and/or barriers to care and using evidence-based practice as the foundation, tracking the patient’s health status and progress in achieving clinical and personal goals. providing education, information, direction, and support related to care goals of patients, communicating with patients, families, caregivers, physicians, and other service providers to coordinate the care needs for the patient, working to facilitate patient compliance a to ensure continuity of care, monitoring and evaluate the patient’s response to treatment(s), collaborating with the attending physicians and Medical Director to revise treatment plans as needed documenting assessments, interventions, and follow-up on disease management activities, regularly assesses the effectiveness and quality of services provided to patients by analyzing outcomes (clinical, functional, and financial) and maintaining a focus on timely, quality customer service.

Sandra Bolden has experience in numerous clinical areas including: acute inpatient, SNF, Homecare as well as MSO.
She is a graduate of the Adelphi University School of Nursing in Garden City, New York in 1985 and is certified in Professional Utilization Review in via McKesson Health Solutions LLC since 2007.
She is also versed in various system programs including CareOne, Diamond, Milliman, Impact Pro, Interqual, Canopy, ECIN, Clinical Pathways, Access, Eagle and Reflections.
Sandra Bolden also has extensive background and experience in and knowledge of Medicare and Medicaid guidelines as well as extensive assessment and coordination skills.

Certification Level

application in process

LinkedIn Profile

http://lnkd.in/spfR6M