Knowledgeable Case Manager experienced in coordinating care for Adult and Geriaftric individuals. Proactive and resourceful with strong knowledge of community resources. Effective communicator with passion for helping others. 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. Proven history of success in optimizing patient care as well-qualified and highly experienced Case Manager/MDS Nurse. Minimize hospital stays through detailed focus on internal systems and individual patient needs. Focused on boosting utilization and department operational efficiency. Experienced Case Manager offering 6 years of planning, assessing and reporting experience with Adult-Geriatric clients. Proficient in documentation and compliance. Experienced MDS with over 25 years of experience in Healthcare . Excellent reputation for resolving problems and improving customer satisfaction.
Skills
Documentation proficiency
EMR / EHR
Treatment planning
Staff education and training
Indirect Patient Care
Medical Records Management
Progress evaluations
Interdisciplinary collaboration
Interviewing skills
Customer service
Proficient in PCC,AHT,MICROSOFT,VISION SOFTWARE PROGRAMS
Written and verbal communication
Client needs assessments
Onsite facility tours
Case Management
Staff Management
Needs assessment
Patient Management
Patient Assessments
Work History
Case Manager, 07/2020 to Current Connecticut Children's Medical Center – South Hadley, MA,
Addressed disruptions in patient care, including delays in discharge, postponed procedures and discharge equipment unavailability.
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.
Consulted with clinicians to devise and manage effective ongoing care plans for at-risk patients.
Reduced care costs without sacrificing quality through effective service coordination and multidisciplinary collaboration.
Adhered to established rules, ethical standards and codes of professional conduct conducive to positive learning atmosphere.
Worked with different disciplines to provide cohesive care to patients.
Updated patient charts using PCC with data such as medications to keep records current and support accurate treatments.
Evaluated treatment plans against individual goals and healthcare standards.
Increased referral rates by providing excellent service and building meaningful relationships with patients and caregivers.
Developing health plan relationships. Strong partnership with clients Such as REGAL, OPTUM, ALLIED PACIFIC, KAISER, LA CARE, and HEALTHNET
Over 6+ years of case manager experience. tracking Clinical outcomes and tracking level of care.
Case Manager, 03/2015 to 09/2020 Connecticut Children's Medical Center – East Hartford, CT,
Addressed disruptions in patient care, including delays in discharge, postponed procedures and discharge equipment unavailability.
Consulted with clinicians to devise and manage effective ongoing care plans for at-risk patients.
Reduced care costs without sacrificing quality through effective service coordination and multidisciplinary collaboration.
Adhered to established rules, ethical standards and codes of professional conduct conducive to positive learning atmosphere.
Worked with different disciplines to provide cohesive care to patients.
Improved staff performance by recreating disciplinary procedures commensurate with level of infraction, dramatically reducing turnover.
Updated patient charts using AHT with data such as medications to keep records current and support accurate treatments.
Evaluated treatment plans against individual goals and healthcare standards.
Updated patient charts using AHT with data such as medications to keep records current and support accurate treatments.
Increased referral rates by providing excellent service and building meaningful relationships with patients and caregivers.
5 star quality measures and Active role with Quality based purchasing programs
QASP Knowledge and Education
MDS Coordinator, 03/2015 to 09/2020 American Advanced Management, Inc – Willows, CA,
Communicated with healthcare team members to plan, implement and enhance treatment strategies.
Adhered to strict safety measures by carefully determining proper dosages before administering medications.
Reviewed post-operative orders and continuously monitored patients' post-operative vitals, set up PCA and fluids and oriented patients to unit to achieve optimal outcomes.
Performed triage on all incoming patients and determined severity of injuries and illnesses.
Provided skilled, timely and level-headed emergency response to critically-ill patients.
Reported patients' status and delegated nurse assignments to achieve optimal outcomes.
Addressed disruptions in patient care, including delays in discharge, postponed procedures and discharge equipment unavailability.
Followed all personal and health data procedures to effectively comply with HIPAA laws and prevent information breaches.
Collaborated with physicians to quickly assess patients and deliver appropriate treatment while managing rapidly changing conditions.
Delivered outstanding care to patients with various diagnoses and managed care from treatment initiation through to completion.
Delivered medications via oral, IV and intramuscular injections, monitoring responses to address new concerns.
Educated patients, families and caregivers on diagnosis and prognosis, treatment options, disease process and management and lifestyle options.
Delivered high level of quality care to diverse populations while overseeing patient admission and triaging based on acuity and appropriate department admission.
Educated patients and answered questions about health condition, prognosis and treatment.
Observed and documented patient factors such as diets, physical activity levels and behaviors to understand conditions and effectively modify treatment plans.
Participated in education activities, including evidence-based practice project implementation, nursing competency development and nursing simulation activities.
Vaccinated patients to protect individuals from measles, pneumonia, influenza and other illnesses of concern.
Managed patients recovering from medical or surgical procedures, including facilitating wound care, ostomy care, pressure ulcer prevention and pain management.
Implemented care plans for patient treatment after assessing physician medical regimens.
Sustained quality standards by performing routine medication audits and upholding internal and industry best practices.
Observed and reported patient condition, progress and medication side effects to accurately document updates.
Audited charts and reviewed clinical documents to verify accuracy.
Quickly responded to situations impacting safety and security to unit, actualizing crisis prevention interventions to control and de-escalate situations.
Reported findings to quality departments after conducting routine restraint audits and worked with team to devise corrective actions for deficiencies.
Facilitated therapeutic communication, conflict resolution and crisis intervention by redirecting negative behaviors and helping patients regain or improve coping abilities to prevent further disability.
Strengthened training and nursing knowledge by taking part in continuing education programs and MDS 3.0 workshops.
Used first-hand knowledge and clinical expertise to advocate for patients under care and enacted prescribed treatment strategies.
Updated patient charts using AHT with data such as medications to keep records current and support accurate treatments.
MDS Coordinator, 1996 to 03/2015 American Advanced Management, Inc – Coalinga, CA,
Communicated with healthcare team members to plan, implement and enhance treatment strategies.
Led successful 15-person team comprised of RNs, LPNs and ancillary staff.
Adhered to strict safety measures by carefully determining proper dosages before administering medications.
Reviewed post-operative orders and continuously monitored patients' post-operative vitals, set up PCA and fluids and oriented patients to unit to achieve optimal outcomes.
Performed triage on all incoming patients and determined severity of injuries and illnesses.
Provided skilled, timely and level-headed emergency response to critically-ill patients.
Collaborated with physicians to quickly assess patients and deliver appropriate treatment while managing rapidly changing conditions.
Delivered outstanding care to patients with various diagnoses and managed care from treatment initiation through to completion.
Delivered medications via oral, IV and intramuscular injections, monitoring responses to address new concerns.
Conducted ongoing monitoring and evaluations of behaviors and conditions, and updated clinical supervisors with current information.
Trained new nurses in proper techniques, care standards, operational procedures and safety protocols to optimize performance and safety.
Leveraged feedback and process improvement opportunities to create safer and healthier environment and increase patient satisfaction.
Maintained highest levels of patient satisfaction, generating referrals to maintain productivity levels for Geriatric rehabilitation unit.
Administered different therapies and medications in line with physician orders and treatment plan.
Provided direct patient care, stabilized patients and determined next course of action.
Audited charts and reviewed clinical documents to verify accuracy.
Quickly responded to situations impacting safety and security to unit, actualizing crisis prevention interventions to control and de-escalate situations.
Vaccinated patients to protect individuals from measles, pneumonia, influenza and other illnesses of concern.
Observed and documented patient factors such as diets, physical activity levels and behaviors to understand conditions and effectively modify treatment plans.
Participated in education activities, including evidence-based practice project implementation, nursing competency development and nursing simulation activities.
Offered exceptional care and support to individuals recovering from acute incidents and dealing with chronic conditions.
Kept optimal supply levels in treatment rooms, triage and other areas to meet typical patient loads.
Accurately documented all elements of nursing assessment, including treatment, medications and IVs administered, discharge instructions and follow-up care.
Education
High School Diploma: , Expected in 06/1995 Dorsey HIgh School - City Of Los Angeles, CA, GPA:
LICENSED VOCATIONAL NURSE: Health And Physical Education, Expected in 02/1996 Los Angeles Trade Technical College - Los Angeles, CA GPA:
Associate of Science: Health Education, Expected in 02/2006 East Los Angeles College - Monterey Park, CA GPA:
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