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Dedicated and hard working rehab case manager, RN who can effectively plan, assist evaluate and coordinate care to carry out a client's need.
Able to communicate and work with the patients , their families and the patient's physician and support staff to achieve and optimal health care plan to aid in their well being in order for a safe discharge.
Able to document on health care systems electronic medical record. Have used Cerner and Athena.
As variable pert time case manager, able to adapt to multiple case loads at any given time.
Effectively plan, assist, evaluate and coordinate care to carry out a client's needs. Communicate and work with patients and their physicians to achieve an optimal healthcare plan to aid in their well being. Familiar with electronic medical records and software in health management systems ( Cerner and Athena). Review and assess patient's rights, serve as a patient's connection between families and other organizations or parties, discuss goals and coordinate with supervisors on specific cases. Coordinate and execute discharge from current facility for a safe discharge to home, SNF, etc. | Coordinate post acute discharge therapies and services, i.e, home health therapy, IV infusion therapy, wound care therapy, home care assistance, follow up medical appointments. Participate in weekly team meetings with patient and family with physiatrist and nursing, PT,OT, ST staff to coordinate and establish safe discharge plan. Compassionate and respectful listener to patient during initial assessment and throughout course of hospital stay and beyond. Advocate for patient between staff, physician and family. As variable part time, able to step in to any case load and be able to assist. |
- Identified care needs of individual patients and coordinated responses based on physician advice, insurance limitations and procedural costs.
- Addressed disruptions in patient care, including delays in discharge, postponed procedures and discharge equipment unavailability.
- Helped patients receive appropriate, high-quality care with reasonable results.
- Partnered with physicians, social workers, activity therapists, nutritionists and case managers to develop and implement individualized care plans and documented all patient interactions and interventions in electronic charting systems.
- Managed support services and fostered communication among social workers, physical , occupational and speech therapists, hospital staff and patients.
- Took active role in patient and family planning process, detailing instructions and responding appropriately and effectively to questions and concerns.
- Evaluated treatment plans against individual goals and healthcare standards.
- Consulted with clinicians to devise and manage effective ongoing care plans for at-risk patients.
- Worked with different disciplines to provide cohesive care to patients.
- Collaborated with interdisciplinary healthcare personnel to meet patients' personal, physical, psychological and cognitive needs.
- Equipped patients with tools and knowledge needed for speedy and sustained recovery.
- Adhered to established rules, ethical standards and codes of professional conduct conducive to positive learning atmosphere.
- Coordinated care of rehabilitation patients by liaising with hospital staff to organize treatments and program resources.
- Advised patients and caregivers of proper wound management, discharge plan objectives, safe medication use and disease management.
- Evaluated healthcare needs, goals for treatment and available resources of each patient and connected to optimal providers and care.
- Educated patients, families and caregivers on diagnosis and prognosis, treatment options, disease process and management and lifestyle options.
- Reported plans, findings and results to employers and insurance carriers.
- Informed patients and families of effective treatment options and at-home care strategies, enhancing long-term outcomes.
- Implemented care plans for patient treatment after assessing physician medical regimens.
- Assessed current treatment plan to identify barriers, clarify or determine realistic goals and objectives and seek potential alternatives.
- Screened medical records and information for necessity and appropriateness and referred for physician review cases not meeting medical criteria.
- Evaluated patients referred for case management to determine physical, mental, financial and psychosocial status by utilizing comprehensive, standardized criteria to identify existing and potential needs.
- Collected and inputted case data in managed care system and timely and accurately generated required correspondence and review notification for management.
- Educated patients and answered questions about health condition, prognosis and treatment.
- Educated family members and caregivers on patient care instructions.
- Explained course of care and medications, including side effects to patients and caregivers in easy-to-understand terms.
- Educated patients, families and caregivers on diagnosis and prognosis, treatment options, disease process and management and lifestyle options.
- Updated patient charts using Athena with data such as medications to keep records current and support accurate treatments.
Acted as a liaison between the patients and the Chairman of Neurosurgery and related physicians.
Worked as part of a multi -disciplinary team with several attending Neurosurgeons, medical students and residents in a dynamic teaching medical center. Participated in daily rounds on inpatients and attended weekly educational grand rounds.
Triaged patient phone calls in Neurosurgery office and executed appropriate nursing judgement.
Assisted in a high volume outpatient Neurosurgery clinic which included taking patient histories, obtaining all available lab and test results and x-rays and scheduling lab tests and x-rays as ordered by the physician.
Office responsibilities were but not limited to re-ordering patient's medications, communicating with insurance companies and making follow up telephone calls to the patient as directed by the physician.
Hagerstown Community College - Hagerstown, MD
Loyola University Of Chicago - Chicago, IL
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School Attended
- Hagerstown Community College
- Loyola University Of Chicago
Job Titles Held:
- Case Manager, RN- Variable Part Time
- Patient Center Medical Home Telephonic RN
- Neurosurgery Clinical Nurse to Chair of Neursosurg
Degrees
- Bachelor of Science
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