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case manager resume example with 15 years of experience

Jessica Claire
  • , , 609 Johnson Ave., 49204, Tulsa, OK 100 Montgomery St. 10th Floor
  • Home: (555) 432-1000
  • Cell:
  • resumesample@example.com
  • :
Summary

Motivational leader and organizational problem-solver with advanced supervisory, team building and customer service skills. Experience stepping into roles and quickly making positive changes to drive company success. 15 years of experience in Health Care Management. Operates exceptionally well in high-pressure environments. Well-versed in managing emergent cases with poise. Good communicator and relationship builder with exceptional skills in planning, resolving conflicts and solving diverse issues. Dedicated and hardworking with any task given.

Skills
  • Member's assessment
  • Educating Families
  • Audit of records for accuracy
  • Coordinating Services
  • Managing records
  • Team Collaboration
  • Customer Service
  • Client Relation
  • Ability to type fast
  • Hospitable and friendly
  • Experience in Medical admissions
  • Critical thinking proficiency
  • Organizational and planning
  • Effective customer communication
  • Flexible
  • Friendly, positive attitude
  • Fast learner
Experience
Case Manager, 10/2019 to Current
Northwell HealthMedford, NY,
  • Developed appropriate plan of care for members.
  • Coordinated services and optimized communication between healthcare workers and members.
  • Complete assessment, coordinate services that fit member's needs.
  • Maintain a list of resources helpful for the members.
  • Conduct monthly calls
  • Conduct Quarterly, Annual and Significant Visits.
  • Communicate with PCP, HHA and other provider to better assist member with needs.
  • Advocated for members and families to coordinate care for members.
  • Arrange services once member gets discharged from Hospital or Rehabilitation Center.
  • Manage caseloads and act as advocate for member's rights.
  • Evaluate and address individual member's needs and concerns.
  • Prepare patients for transition to independent living.
  • Submit Annual to complete Level of Care.
  • Maintain Level of Care accurate.
  • Maintained complete confidentiality in accordance with organization and legal requirements.
Social Worker Assistant/ Case Management, 02/2016 to 10/2019
Golden Glades Nursing & Rehabilitation CenterCity, STATE,
  • Complete assessments, coordinate and monitor patients.
  • Develop plan of care for the patients.
  • Act as a role model for patients by exhibiting positive behaviors.
  • Help patients with various community resources,including housing and transportation services.
  • Interviewed patients and relatives to compile detailed social information.
  • Maintained a lists of resources helpful to patients.
  • Develop discharge plans for patients prior to discharge.
  • Educate residents and families regarding community resources
  • Evaluate and address individual patients needs and concerns
  • Prepare patients for transition to independent living.
  • Manage caseloads and act as an advocate for clients rights.
  • Provide education and support to patient's family members.
Director of Admissions/Medicaid Specialist, 02/2016 to 10/2019
Golden Glades Nursing & Rehabilitation CenterCity, STATE,
  • Help patients with admissions process and adhere to state and federal laws
  • Complete secretarial task such as faxing, bookkeeping, and accurate document filing.
  • Handle insurance claim duties and verified that each patient meet standard of admissions.
  • Collaborate with provider to ensure that patients get the care that they needed.
  • Audit records to ensure accuracy.
  • Assist patient with incoming preliminary paperwork.
  • Communicate with Case manager at different hospitals regarding patients discharge orders and admissions to nursing home.
  • Explain benefit processes, and provide consent forms for patients or family to sign giving consent for Medicaid application to be processed.
  • Explain eligibility details and affordability options for patients with kindness and respect
  • Request Level of Care from CARES
  • Submit requested information to DCF
  • Follow up with application until Long term Medicaid is approved.
  • Submit yearly renewal for patient's long term medicaid.
  • Promoted high customer satisfaction by resolving problems with knowledgeable and friendly service.
Case Management/PASRR Coordinator, 11/2006 to 02/2016
Oceanside Extended Care CenterCity, STATE,
  • Complete assessment, coordinate and monitor patients.
  • Develop plan of care for the patients.
  • Help patients make informed decisions by acting as their advocate.
  • Coordinate and provide care that is safe, timely, effective and efficient.
  • Make sure that each patient has a PASRR prior to admission from the hospitals.
  • If patient has a provisional PASRR, submit require documentations in order for a Level II PASRR to be given
  • Insure that PASRR is inserted in the appropriate part of a patients chart
  • Fax complete information on a timely manner to KEPPRO.
  • Collaborated with multidisciplinary team to establish record of comprehensive patient care plans.
  • Interpreted regulations and policies to establish compliance with operational requirements.
Education and Training
Associate of Science: Nursing, Expected in 06/2006 to Keiser Career College -Miami Lakes - Miami Lakes,
GPA:

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Resume Overview

School Attended

  • Keiser Career College -Miami Lakes

Job Titles Held:

  • Case Manager
  • Social Worker Assistant/ Case Management
  • Director of Admissions/Medicaid Specialist
  • Case Management/PASRR Coordinator

Degrees

  • Associate of Science

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