Shelly Koman
Clover
Summary
Dynamic healthcare professional with extensive experience at Atrium Health at Home, excelling in patient advocacy and care coordination. Proven ability to enhance client outcomes through effective communication and collaboration. Skilled in critical evaluation and assertive mediation, ensuring compliance with Medicare guidelines while fostering strong relationships with patients and families.
Overview
2026
2026
years of professional experience
1
1
Certification
Work History
Transition Liaison
Atrium Health at Home
2017 - Current
- Served as the initial point of contact with patient for post acute care. Meeting patient and family to thoroughly explain home health services.
- Collaborate with Case Managers on patient appropriateness for home health services. Ensuring home service orders are accurate and all necessary services are ordered for optimal client outcomes.
- Maintained up-to-date knowledge of medicare guidelines for home services, including DME.
- Coordinate with home infusion and home health branches to ensure timely visits when same day care is need in the home.
- Manage HH referral through discharge, uploading all signed documents within 48 hours of discharge.
- Maintained a high degree of professionalism at all times, representing the organization with integrity in both internal and external interactions.
Care Manager
Carolinas Medical Center
2015 - 2017
- Managed complex caseloads, ensuring timely assessment, intervention, and documentation for optimal care outcomes.
- Facilitated family meetings to address concerns, establish goals of care, and provide psychosocial support.
- Assessed each patient to determine discharge needs.
- Educated clients and families on community resources, treatment options and health care services to better manage conditions.
- Developed strong rapport with patients and families through empathetic listening and compassionate communication techniques.
- Obtained durable medical equipment and oxygen as needed.
- Collaborated with medical team to refer patients facilities and home health agencies as appropriate.
Insurance Agency Owner
Allstate
2013 - 2014
- Ensured compliance with all federal/state regulations as well as company policies while managing daily operations of the insurance agency.
- Increased client retention by consistently providing exceptional customer service and maintaining strong relationships.
- Responded promptly to customer inquiries, addressing concerns and providing knowledgeable guidance on various insurance matters.
- Boosted agency visibility through targeted marketing campaigns, enhancing brand awareness and attracting new customers.
- Conducted periodic reviews of clients'' insurance portfolios to identify gaps in coverage and offer appropriate solutions.
- Oversaw agency financial management activities including budgeting, forecasting, expense tracking, revenue generation strategies development.
Utilization Review Nurse
Highmark Blue Cross Blue Shield
2006 - 2013
- Reduced healthcare costs through efficient utilization of resources and identification of unnecessary treatments or procedures.
- Ensured compliance with regulations and accreditation standards by maintaining accurate documentation of all utilization review activities.
- Maintained professional competence by staying current on industry trends, best practices, and regulatory requirements specific to utilization review nursing.
- Evaluated medical guidelines and benefit coverage to determine appropriateness of services.
- Performed prior authorization review of services requiring notification.
- Minimized financial risk associated with denials or payment discrepancies through diligent validation of medical necessity prior to service provision.
Registered Nurse, Labor and Delivery
Ohio Valley General Hospital
2003 - 2005
- Provided emotional support and guidance to new mothers and families during labor, delivery and postpartum.
- Responded to emergency situations such as pre-eclampsia, early labor, and fetal distress.
- Assisted physician during delivery, examination and surgical procedures by anticipating needs, encouraging patient, and attending to baby after birth.
- Supported physicians in both planned and emergency Cesarean section procedures.
- Assessed infant health directly after birth using APGAR and monitored health for specified amount of time for any changes in status.
- Aided with induction of labor for women suffering from complications such as preeclampsia.
- Coached new mothers with breastfeeding techniques, postpartum self-care and infant care to promote easier transition into motherhood.
Education
Bachelor of Science - Nursing
LaRoche University
Pittsburgh, PANursing
Community College of Allegheny County
Pittsburgh, PASkills
- Assertiveness
- Mediation skills
- Influencing skills
- Representative experience
- Critical evaluation capacity
- Verbal and written communication
- Team collaboration
Certification
- CCMC - Certified Case Manager since 2010
Timeline
Transition Liaison
Atrium Health at Home
2017 - Current
Care Manager
Carolinas Medical Center
2015 - 2017
Insurance Agency Owner
Allstate
2013 - 2014
Utilization Review Nurse
Highmark Blue Cross Blue Shield
2006 - 2013
Registered Nurse, Labor and Delivery
Ohio Valley General Hospital
2003 - 2005
Bachelor of Science - Nursing
LaRoche University
Nursing
Community College of Allegheny County
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