Summary
Overview
Work History
Skills
Systemsskills
Timeline
Generic

Tiffany Darlington

Auckland,New Zealand

Summary

Experienced with managing diverse and challenging case loads. Utilizes strategic planning and client assessment to create effective solutions. Track record of strong conflict resolution and advocacy skills. Professional with expertise in case management, prepared to deliver impactful results. Skilled in conflict resolution, risk assessment, and client advocacy. Strong focus on team collaboration and achieving tangible outcomes, adapting seamlessly to changing needs. Reliable and driven, with keen ability to manage complex cases and support clients effectively. Talented Case Manager adept at handling high caseloads without sacrificing quality of care. Operates in high-pressure environments while recommending best resources and courses of action to benefit patient needs and return each to optimal quality of life.

Overview

17
17
years of professional experience

Work History

Senior Case Manager

Asteron Life
03.2024 - Current
  • Collaborated with external agencies to secure resources for clients, ensuring optimal support and care.
  • Managed high-risk cases effectively, implementing crisis intervention techniques when necessary to ensure client safety.
  • Informally mentored new case managers and service coordinators, answering questions, offering opportunities to shadow and observe and explaining basic information about company procedures.
  • Created well-written, effective care plans appropriately matching needs of clients following standards and guidelines of funders, contractors and governmental regulations.
  • Communicated with supervisor regarding issues related to case management, resourcing, service collaboration and development of new resources.
  • Reduced client wait times with effective prioritization and time management strategies.
  • Increased client satisfaction by providing exceptional service, empathy, and timely assistance in resolving issues.
  • Conducted thorough assessments of client needs, resulting in targeted interventions and improved outcomes.
  • Coordinated multi-disciplinary teams including healthcare professionals, social workers, legal advisors to provide comprehensive support to clients.
  • Developed and implemented comprehensive case management plans to address client needs and goals.

Case Manager - Workplace Injury claims

Howden Care
08.2023 - 03.2024
  • Assessment of work injury claims, dealing with clients empathetically and in accordance with industry-leading customer service standards
  • Manage a portfolio of work injury claims including some which are complex or contentious, applying sound technical, legal and medical knowledge and experience
  • Regular communication with clients, providers, and other stakeholders including face to face meetings
  • Promotion and coordination of rehabilitation with clients to assist with a sustainable return to work outcome
  • Understanding of Case Management best practice and knowledge of the Accident Compensation Act and AEP Audit standards
  • Ability to work systematically and juggle priorities to ensure key requirements and milestones are met
  • Excellent problem-solving ability, able to think outside the square and push the boundaries to create the best outcomes for all parties
  • Open to change and continuously learning

Claims Consultant - Disability Claims

Partners Life
02.2021 - 07.2023
  • Assess and pro-actively manage a portfolio of injury and illness disability claims
  • Make and effectively communicate decisions in line with policy wordings and company guidelines
  • Review and interpret complex medical and financial information
  • Identify rehabilitation opportunities and liaise with providers and external parties
  • Ensure accurate and timely calculations and payment of benefits
  • Provide excellent stakeholder management of clients and advisers
  • Manage client relationships in an empathetic and professional manner
  • Ability to interpret policy wordings effectively
  • Good time management
  • Excellent written and verbal communication

Claims Administrator / Claims Coordinator / Case Manager / Learning and Development Team Trainer

Wellnz
08.2008 - 02.2021
  • Claims Administrator (August 2008 to August 2010): Opening incoming mail, Requesting clinical notes, Sending consent forms, Transferring claims to Accident Compensation Corporation (ACC), Requesting claims from Accident Compensation Corporation (ACC), Sending forms, Requesting work injury reports, Requesting ACC45 injury claim forms, Making diary tasks and following them up appropriately, Issuing accept letters, Couriering, Issuing claim extensions, Issuing non-contact letters, Completing treatment approvals, Making copy files, Clearing public folders, Uploading documents, Answering phones, Updating cost centres
  • Claims Coordinator (September 2010 to November 2013): Establish effective working relationships with Case Managers and clients to ensure the Client Service Level Agreement, ACC Partnership Programme Audit Standards and Wellnz quality standards and procedures are maintained
  • Ensure a high standard of customer service to clients and injured employees is achieved and maintained
  • Co-ordinate and facilitate appropriate and comprehensive claims management services to ensure a timely, efficient and cost effective service is provided, on behalf of clients
  • Develop effective and efficient working relationships with both external and internal clients and providers
  • Maintaining and develop knowledge of appropriate legislation, procedures, information systems and claims management skills to provide a high standard of client service
  • Providing support to Case Managers in the implementation and delivery of services that meets the Client Service Level Agreements, ACC Partnership Programme Audit Standards and Wellnz's commitment to quality
  • Management of a portfolio of clients delivering case management support services
  • Case Manager (December 2013 to February 2021): Establish effective working relationships with clients
  • Ensure a high standard of customer service to injured employees is achieved and maintained in accordance with the Code of Claimant Rights
  • Ensure the client Service Level Agreement, client negotiated KPI's, ACC audit standards and Wellnz quality standards and procedures are maintained
  • To co-ordinate and facilitate appropriate and comprehensive rehabilitation services to ensure a timely, efficient and cost-effective service is provided, on behalf of clients
  • Regular client contact to discuss claims and develop effective and efficient working relationships
  • Keep management adequately informed as to progress and ongoing relationships with clients
  • Recognise and act upon new business opportunities
  • Ensure all non-conforming products and services are reported
  • Develop and maintain a competency practice
  • Develop abstract concepts by thinking holistically about techniques, systems and processes, and translating these concepts into specific advice and original, workable solutions
  • Offer innovative and original ideas that do not stem from existing processes, and identifying less evident models or original combinations
  • Proactively carry out goal-setting and the precise delineation of plans and arrangement of activities
  • Make decisions based on complete/incomplete information and initiates necessary steps to implement the decision
  • Support others by accepting a formal role as a mentor and by acting as an example
  • Provide focused advice and establishes mutually beneficial relationships on the basis of credibility and expertise
  • Guide customers by providing tailored advice regarding their options
  • Always puts customers first by offering personalised services and proactively maintaining constructive contacts
  • Learning and development team trainer (February 2017-September 2018): Ensuring consistent, high-quality training is developed and implemented to the Team
  • Ensuring that all staff have completed or are working towards their relevant Competency Programme or, Annual Certification
  • Identify training and development needs of the team through job analysis, appraisal schemes and regular consultation with Branch Managers and Team Leaders
  • Provide day to day training support to the Team
  • Ensure Wellnz is committed to established quality management standards
  • Undertake project work as and when required to support new initiatives
  • Coordinate training activities, schedules, and instructors for training and development for both internal and external clients
  • Coordinating, delivering and overseeing the induction of new team members
  • Identifying and developing opportunities with existing and potential clients where the team can provide new services

Skills

  • Microsoft Word
  • Microsoft Excel
  • Microsoft PowerPoint
  • Microsoft Outlook
  • Typing

Systemsskills

Microsoft Word, Excel, PowerPoint, Outlook, 54, 97%

Timeline

Senior Case Manager

Asteron Life
03.2024 - Current

Case Manager - Workplace Injury claims

Howden Care
08.2023 - 03.2024

Claims Consultant - Disability Claims

Partners Life
02.2021 - 07.2023

Claims Administrator / Claims Coordinator / Case Manager / Learning and Development Team Trainer

Wellnz
08.2008 - 02.2021

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Tiffany Darlington