Care Manager Resume Example Company Name

CARE MANAGER

Summary

Motivated, reliable individual with demonstrated accomplishments in enhancing patient care as experienced Care Manager. Successful in minimizing hospital stays through proactive attention to internal standards and patient requirements. Dedicated to optimizing resource utilization and team efficiency with solution-oriented approach.

Experience

Company Name | City, StateCare Manager07/2015 - Current

Responsible for evaluating the medical necessity and appropriateness of services using working knowledge of Interqual and clinical judgement.
Perform regular reviews of admissions, length of stays, services performed, and consults obtained.
Reviewing cases and discussing with multi-disciplinary personnel to determine appropriate status, treatment and planning needs for discharge.
Obtaining initial SNF and Swing bed authorizations and submitting fot continued stay reviews for Swing bed patients.
Utilizing Navinet and UPMC portals to obtain authorizations and contacting any necessary health plans for notifications, determinations, continued stay reviews, etc.
Provide written notice to patients according to Medicare guidelines.
Written communication to Home Health with referrals as well as nursing homes, Home IV companies, DME companies and other services identified after collaboration with patient and family.
Completion of PASRR's and MA51's.
Ongoing communication with the patient/family to determine most appropriate discharge planning needs.
Problem solving between Care Management, Social Work departments and other inter-disciplinary team members on difficult discharges
Verbal and/or written communication to various department leaders and/or administration to collaborate on identified patients with barriers to discharge.
Coordinated support services and optimized communication between healthcare workers and patients.
Coordinated resources from diverse providers for intervention plan
Determined and coordinated appropriate level of care to meet individual patient needs.
Collaborated with various healthcare providers to facilitate delivery of services.
Informed patients and families of treatment options and at-home care strategies to reduce unnecessary readmissions.
Lowered costs while improving care quality by coordinating services and collaborating with dedicated healthcare team to decrease length of stay and readmission rate.
Documented plans, findings and results and submitted to employers and insurance carriers.

Company Name | City, StateWound, Ostomy and Continence Nurse08/2012 - 07/2015

Caring for and providing advanced wound care and pressure ulcer prevention for patients along with education on these topics to patients and/or families.
Providing education and support to new and current ostomy patients.
Coordination of care with multidisciplinary teams and medical staff along with discharging facilities to provide optimal patient results.
Built the documentation layout in Paragon for wound findings and provided education to the nursing staff.
Developed and implemented policies and procedures in PolicyStat.
Provided educational classes to all nursing staff hospital wide during the re-orientation process.
Provided education to local nursing schools by lecturing in the classroom ath the college and students shadowing to learn wound classifications, pressure ulcer staging and basic wound care.
Assist the wound clinic and home health with care in complex cases.
Development of a skin champion team for the nursing staff to utilize as a resource.
Cared for patients with various wounds caused by injuries, medical treatments and diseases.
Classified wounds using staging system based on visual evaluation of affected tissue.
Educated patients, family members and caregivers on findings, recommendations and care of the wound.
Communicated with patient, family and physician when starting or adjusting treatment.
Worked with healthcare teams to assess patients, manage wounds and monitor healing.
Managed draining wounds by wound vac, drainage appliance or other methods as necessary.
Minimized patient skin breakdown by devising and carrying out skin care plan.
Coordinated care with charge nurse and other staff through daily communication.
Conducted wound assessments for patients and documented information.
Provide post-surgery treatment for patients with ostomies including detailed step by step appliance removal and reapplication along with care of the stoma and diet to facilitate patients returning to a productive lifestyle.

Company Name | City, StateWound, Ostomy, and Continence Nurse11/2011 - 08/2012

Worked as a Wound, Ostomy and Continence RN at Memorial Medical Center, which is a 545 bed facility.
Orientation for this position included a six week training course at the outpatient wound clinic, learning the various stages and treatments of wounds and various skin issues.
Assisting the medical staff and collaborating with multi-disciplinary teams to determine appropriate treatments.
Training continued at Memorial Medical Center under the direction of a certified Ostomy Nurse.
Working with functioning fistulas and ostomies with assessment of output and containment.
Treating a variety of wound types and skin conditions.
Determined a plan of care by assessment of the patient's skin and reviewing the patient's past medical history, current medications, diet and activity.
Recommendation of appropriate treatments, deterioration or changes of the wound or failure of treatment reported to the physician.

Company Name | City, StateMed-Surg Registered Nurse08/2009 - 08/2012

Cared expertly for individuals with wide array of medical issues such as pulmonary, cardiology and infectious disease patients.
Medication administration, surgical and non-surgical dressing changes.
Facilitated admissions, discharges and transfers; participated in discharge planning by coordinating care with multidisciplinary team.
Recorded any action or behavior of clinical significance in and ongoing communication with physicians, when necessary.
Developed and implemented individualized care plans to meet each patients' unique needs.
Improved care outcomes with proactive education, communication and guidance for patients and family members.
Delivered physician-ordered treatments and monitored responses to quickly spot complications and side effects.
Helped patients and families feel comfortable during challenging and stressful situations, promoting recovery and reducing compliance issues.
Immunized patients against diseases such as influenza and pneumonia to protect vulnerable populations from serious illnesses.

Education and Training

Capella University | City, StateBachelor of Science in Nursing

Currently enrolled

Conemaugh School Of Nursing | CityDiploma in Registered Nurse06/2009

Two-year accredited program approved by Pennsylvania State Board of Nursing •1,000+ hours of clinical practicum

Allegany College of Maryland, Conemaugh School of Nursing2006

Certifications

Currently enrolled, Case Management Certification, ACMA
2019 BLS Certified, Penn State Fayette
2015 Wound Care Certification, Wound Care Education Institute, NAWCO

Personal Information

Nursing is a rewarding career and I find Care Management to be the most fascinating. I wish to always expand my current working knowledge of healthcare to assist patients, families, and the facility to which I am employed with the best potential outcomes.

Resume Overview

School Attended

Capella University
Conemaugh School Of Nursing
Allegany College of Maryland, Conemaugh School of Nursing

Job Titles Held:

Care Manager
Wound, Ostomy and Continence Nurse
Wound, Ostomy, and Continence Nurse
Med-Surg Registered Nurse

Degrees

Bachelor of Science in Nursing
Diploma in Registered Nurse

Care Manager Resume Example

Resume Score: 80%

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