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Carelink Hospital Transitions Care Coordinator For Iredell Memorial Hospital Resume Example

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Jessica Claire
  • Montgomery Street, San Francisco, CA 94105
  • H: (555) 432-1000
  • C:
  • resumesample@example.com
  • Date of Birth:
  • India:
  • :
  • single:
Affiliations
  • Certified Rehabilitation nurse 1990-2015
  • ARN member for 8 yrs.
  • Certified Case Manager since 2005.
  • Committee member of 2 Health Forums one in Statesville/ Mooresville N.C., Health sector committee member for Drug abuse Free Iredell/ Lazarus Project
  • Score panel participation for the CRRN exam 1994. 
  •     Presented at the National ARN conference 1991 and 1992.
  • Health Subcommittee Member for Project Lazarus- Initiative in Iredell County       to prevent prescription drug overdose.
  • Selected to participate for UNC Transitional institute 2015
  • Participated as panel speaker in the Transitional Summit 2014
  • Professional Summary

    Competent and supportive case manager with more than  15 years of experience  in patient advocacy. Adept multi tasking Nurse  with extensive skills in care coordination of the patients with chronic diseases post discharge. Possesses exceptional interpersonal personal communication skills . Led the implementation of a Care Transitions Program for the high risk Medicare beneficiaries in a 247 bed acute hospital which resulted in the significant reduction of hospital readmissions and the improvement  in the quality of patient care through the continuum.

    Work History
    CareLink Hospital Transitions Care Coordinator for Iredell Memorial Hospital, 2013 to Current
    Grane , ,
    • Successfully implemented a Care Transitions Program, CareLink at Iredell Memorial Hospital for the high risk Medicare/ Moderate/ High Risk uninsured patients beginning of 2013.
    • Through efficient d/c planning, proficient patient educational skills and motivational interviewing skills , has resulted in a significant reduction in avoidable hospital and ER readmissions.
    • Utilization of effective collaborative and leadership skills among the hospital staff team and community base providers has led to the refinement of the CareLink Program
    • Participates in measuring clinical outcomes, data procurement and analysis to identify opportunities for improvement
    • Demonstrates the ability to cement relationships with the hospital team utilizing  this opportunity to successfully make recommendations for improvements in hospital\'s discharge planning process, patient discharge education process and medication reconciliation process with the use of the outcomes data.
    • Skillfully assisted with the development of departmental goals, program objectives, standards of performance, policies and procedures.
    • Trained and coached on average of 1new employee per year.
    Home Care Coordinator, 01/2005 to 01/2013
    Mhc Equity Lifestyle Properties Morgan Hill, CA,
    • Job role included coordination of home health services, DME, infusion services for the patients in the hospital, SNF, and ALF settings.
    • Collaboration with nurse case managers, MSW, discharge planners and physicians to facilitate continuity of care in the transition of patients returning to the home setting/ or ALF.
    • Provided community education regarding health/ wellness at senior centers and health fairs.
    • Educated physicians and hospitals and facilities regarding the benefits of home health services.
    • Skillfully developed departmental goals, objectives, standards of performance, policies and procedures.
    • Led the planning and achievement of goals and objectives consistent with the agency mission and philosophy.
    Orthopedic Case Manager/ Total Joint Educator, 01/2004 to 01/2005
    Therapy Management Corporation Lufkin, TX, Case manager for a 31 bed orthopedic unit initiating patient care coordination including discharge planning. Performed concurrent payer reviews. Functioned also as Total Joint Care Coordinator which entailed performing preoperative education and coordinating discharge planning for the patients undergoing a total joint replacement(s) Instrumental in the development of a total joint education preoperative class for the total joint patient as well as assisting with the development a total joint education manual for these patients.
    • Skillfully collaborated with the orthopedic physicians in the development of standardized discharge orders for the total joint orthopedic patient to assist in discharging patients timely and efficiently.
    Assistant Manager, 2002 to 2004
    King's Daughters Medical Center Portsmouth, OH,
    • Assisted in the management and development of a 36 bed sub acute rehab unit
    • Collaborated with interdisciplinary team to assist and develop patient care plans and effective d/c planning.
    • Organized the department in accordance with administrative guidelines in order to provide specified nursing services to meet the legal, organizational and medical staff guidelines.
    Rehab Coordinator, 01/2001 to 01/2002
    Charlotte Institute Of Rehabilitation City, STATE,
    • Assessment and screening of patients on acute neurological, orthopedic units as well as going on site to other hospitals and SNF facilities to evaluate if patients who met acute rehab criteria.
    • Assisted in working with primary insurance and 3rd party payors to get authorization for acute rehab
    • Assisted with the coordination and transfer of rehab candidates to acute rehab unit at Carolinas Institute Rehabilitation Facility.
    Case Manager, 01/1995 to 01/2001
    St. Joseph\'s Hospital City, STATE,
    • Assessment, screening, discharge planning and coordination of care of the neurological patient across the spectrum of care including neuro ICU, step down, acute floor and rehabilitation.
    • The role included concurrent payer reviews/updates.
    • The use of creative and resourceful discharge planning led to the successful and safe medical transfer of various medically complex Hispanic patients from Mexico and Central America.
    Home Care Coordinator, staffing Coordinator, RN Case manager, 01/1995 to 01/1998
    St. Joseph\\'s Hospital City, STATE,
    • Responsible for the coordination of home health services for the patients of a 620 bed medical center.
    • Served as a staffing coordinator.
    • Role included coordination of patient care assignments for the field nurses, C.N.A s\\' and social service staff.
    • Direct liaison to all levels of clientele utilizing problem solving skills and customer service techniques.
    • RN Home Health Case Manger- Coordinated and delivered patient care for the homebound patient.
    • Effective communication skills with the physician and interdisciplinary team promoted comprehensive and efficient home care.
    Rehab Nurse, 01/1989 to 01/1998
    St. Joseph\'s Hospital , ,
    • Provided nursing care to the neuro rehab patient in a 45 bed CARF accredited hospital based acute rehab unit
    • Specialized in the care of the spinal cord injured
    • Assisted with the implementation/development of patient education tools/materials for the spinal cord and stroke patient
    • Assisted with the development of a spinal cord education class for patients and families and served as a patient educator
    • Served as an interpreter for Spanish speaking patients/families
    Rehab Nurse, 1989 to 1998
    St. Joseph's Hospital , ,
    • Provided nursing care to the neuro rehab patient in a 45 bed CARF accredited hospital based acute rehab unit
    • Specialized in the care of the spinal cord injured
    • Assisted with the implementation/development of patient education tools/materials for the spinal cord and stroke patient
    • Assisted with the development of a spinal cord education class for patients and families and served as a patient educator
    • Served as an interpreter for Spanish speaking patients/families 
    Skills
    • Pays close attention to detail
    • Bilingual (Spanish)
    • Culturally competent care
    • Experienced patient educator
    • Innovative
    • Good critical thinking skills
    • Over 15 years experience in hospital/ home health case management
    • 3 years experience in development of a care transitions program
    • Patient /family advocate
    • Motivational interviewing /patient centered care skills
    • Excellent interpersonal skills
    • Self Motivated /autonomous
    Education
    Nursing Diploma Graduate: , Expected in 1985
    to
    Bishop Clarkson College of Nursing - Omaha,
    GPA:

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    Resume Overview

    School Attended
    • Bishop Clarkson College of Nursing
    Job Titles Held:
    • CareLink Hospital Transitions Care Coordinator for Iredell Memorial Hospital
    • Home Care Coordinator
    • Orthopedic Case Manager/ Total Joint Educator
    • Assistant Manager
    • Rehab Coordinator
    • Case Manager
    • Home Care Coordinator, staffing Coordinator, RN Case manager
    • Rehab Nurse
    • Rehab Nurse
    Degrees
    • Nursing Diploma Graduate