Margaret Sizemore Recognized for Efforts on New UM Work Flow

Cardinal Innovations Healthcare — August 23, 2019 — 4 min read

For Margaret Sizemore, an Intellectual and Developmental Disabilities (IDD) Care Manager in Utilization Management (UM), working at Cardinal Innovations Healthcare means being part of a team that together can accomplish great things for all of its members. 

“We are working with people who are in their most vulnerable state – people who are in need of help. We serve our members by being kind, attentive, and respectful,” Sizemore said. “By using our combined skills, we can come up with solutions and treatment options that best meet the needs of our members. It takes all of us working as a team. What keeps me going is knowing that we are in this together.” 

In partnership with the Lean Six Sigma Team, IDD UM was the first UM department to transition recently from an individual workflow to a “Pod” workflow, meaning each person plays a different part in the review process of a single service request. Sizemore helped define roles in the new work flow, which is improving efficiency and will ultimately benefit members.

“Margaret has been instrumental developing the day-to-day duties for IDD UM’s POD,” said Tony Martin, UM’s IDD Care Management Manager. “She has continuously shown leadership in the POD. She makes great suggestions and is a very thorough Care Manager.” 

The IDD UM Care Management team reviews requests for services made by members on the Innovations waiver, working closely with the Care Coordination, Medical, Finance, Registry and Appeals departments, to make thoughtful, person-centered and clinically appropriate determinations toward all service requests, Sizemore said. 

“Our focus has been to work together as a team to streamline the service review process and to build consistency within our department,” Sizemore said. “As a team, we have overcome many hurdles and continue to work through obstacles. I do believe we now have a deeper knowledge and appreciation for each of our individual strengths, and we, as a ‘Mega Pod,’ are stronger together than we could ever be apart.” 

Sizemore’s role in the Mega Pod is as a floater. “By design, I go where I am needed,” she said. “My specific job is to be knowledgeable of the current processes for each area of the pod and jump in and get done what needs to get done.” 

Dellyne Samuel, UM IDD Care Management Supervisor, said Sizemore is a critical thinker who is results driven. “She foremost invests in meeting the needs of the members and always ensuring that policies and procedures are adhered to, to make that happen,” Samuel said. 

UM IDD care Management Supervisor Christy Anderson noted that Sizemore has been recognized as Care Manager of the Quarter three times since 2017. 

This month (August 2019), Care Coordination selected Sizemore as Care Manager of the Quarter, for educating others on new and existing processes, for being kind and patient while handling assignments with urgency and for being “a person you want to talk to when you need answers.” She was also described as “a person you want on your team, who represents the culture that Cardinal Innovations has been striving to reach.”

Sizemore also received the Care Manager of the Quarter recognition from Care Coordination in August 2018 and in April 2017. 

“I have worked to improve communication between our departments and break down the firewall,” she said. 

“The relationship between UM and Care Coordination has been strained in the past. (UM is responsible for reviewing the work of Care Coordination and when corrections or changes need to be made, it can create tension.) I believe that being kind and supportive of each other is the key to our success.

“Kindness is a bridge for all people,” Sizemore said. “I can’t do my job without the Care Coordination Department and I appreciate them and their hard work on the front line supporting our members and families.”

Sizemore grew up in High Point, N.C., where her family runs a small garden center. She said something most people don’t know about her is that she won the 1996 State High School Policy Debate Championship. 

Sizemore has worked in the human services field for 21 years. Her experience includes working with residents in the Alzheimer’s unit of a retirement home. She also managed, planned and carried out day programs and camps for a children’s museum, worked in Level 3 state run group homes for adolescent sex offenders, and worked one-on-one with children and adults with intellectual and developmental disabilities. 

“I have, even since I was a child, found great joy and satisfaction in helping others. I think that is what drew me to study the social sciences and specifically sociology,” she said.

Before joining Cardinal Innovations’ UM department in 2015 when Cardinal Innovations and CenterPoint Human Services consolidated, Sizemore worked at Easter Seals UCP for 13 years. She started in this field as a one-on-one worker. She later became a supervisor and worked with a lot of different groups within the organization from auditing offices around the state and finally working on a KiZan team to develop companywide procedures.  

When she’s not working, Sizemore enjoys cooking and gardening to help her relax and reduce stress. “I make it a point that my personal life is easy and uncomplicated,” she said, adding that finding a healthy balance between work and personal life is important to her. 

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