certified case manager resume example with 10+ years of experience

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

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. Enthusiastic and eager to contribute to team success. Excellent time management, multitasking and communication abilities.

  • Documentation proficiency
  • EMR / EHR
  • Direct Patient Care
  • Utilization Review
  • Case Management (CCM)
  • Behavioral Health
Work History
02/2019 to 10/2022
Certified Case Manager Encompass Health Gainesville, GA,
  • Identified care needs of individual patients and coordinated responses based on physician advice, for workers compensation injured workers.
  • Updated patient charts with data such as medications to keep records current and support accurate treatments.
  • Performed evaluations on consistent basis to address changes in patient needs, conditions and medications, altering care plans when required.
  • Responded promptly and professionally to patient questions and concerns.
  • Coordinated care of injured workers by liaising with hospital staff to organize treatments and program resources.
  • Followed all instructions for medication administration and treatment plans as prescribed by physicians.
  • Worked with suppliers and vendors on provision of medical equipment, items and services.
  • Liaised with physicians regarding patient needs, performance and changes.
08/2017 to 02/2019
Admissions Nurse Nexion Health Marrero, LA,
  • Coordinated patients' tests and treatments with other hospital departments.
  • Provided physicians and other medical personnel with patient assessment details and answered patient care-related questions.
  • Directed patient admission and discharge tasks while managing patients and coordinating care.
  • Assessed new patients' care plans and administered prescribed medications and treatments.
  • Interacted professionally with families and provided empathetic support and professional guidance.
  • Assisted floor nurses with medication administration and prescribed treatments.
  • Recorded incoming patients' vital signs and current medication details in electronic charts.
  • Attended in-house trainings and continuing education classes.
08/2016 to 08/2017
Psychiatric Registered Nurse/Intake Specialist North Tampa Behavioral Health City, STATE,
  • Offered compassionate and attentive guidance to patients during moments of crisis and trauma.
  • Provided direct patient care, stabilized patients and determined next course of action.
  • Explained eligibility requirements, application details, payment methods and applicants' legal rights during intake assessment.
  • Entered referrals into appropriate system based on type of referral obtained.
  • Interacted with insurance providers to obtain necessary documents to complete registration.
  • Communicated with referral sources, physicians and associated staff to check documentation for proper signatures.
  • Worked with clinical and operations teams to facilitate client placement and obtain appropriate services for clients.
  • Collected, verified, recorded and processed client demographics, insurance payments and referral information.
  • Completed intake assessment forms and filed clients' charts.
  • Administered medications and treatment to patients and monitored responses while working with healthcare teams to adjust care plans.
08/2012 to 08/2016
Utilization Review/Registered Nurse Beacon Value Options City, STATE,
  • Evaluated medical guidelines and benefit coverage to determine appropriateness of services.
  • Obtained authorizations from multiple insurance carriers for various levels of care.
  • Performed prior authorization review of services requiring notification.
  • Submitted cases to physician advisors for criteria failures and helped facilitate resolutions and approvals.
  • Conveyed treatment options, diagnosis information and home care techniques to patients and caregivers to continue care consistency.
  • Used skills such as active listening and collaborative problem-solving daily to connect with patients and address concerns.
  • Evaluated risk to client or others by gathering information and conducting assessments.
  • Evaluated patients based on mental and physical parameters discovered through interviews and standardized assessments.
  • Conversed with individuals in crisis which called or texted hotline for assistance.
  • Interviewed clients, reviewed records and conducted assessments to evaluate mental or physical condition of clients or patients.
08/2003 to 07/2012
Behavioral Health Registered Nurse Company Name City, State,
  • Explained useful coping methods to relieve depression and anxiety.
  • Performed patient assessments to monitor expected response to medications and altering treatment plans.
  • Monitored primary care needs for patients to coordinate access to appropriate providers.
  • Administered medication and treatments to patients to observe and record responses.
  • Administered different therapies and medications in line with physician orders and treatment plan.
  • Accurately documented treatment, medications and IVs administered, discharge instructions and follow-up care.
  • Administered medications and treatment to patients and monitored responses while working with healthcare teams to adjust care plans.
  • Followed all personal and health data procedures to effectively comply with HIPAA laws and prevent information breaches.
  • Conducted ongoing monitoring and evaluations of behaviors and conditions, and updated clinical supervisors with current information.
  • Equipped patients with tools and knowledge needed for speedy and sustained recovery.
02/2000 to 07/2003
Obstetrics/Gynecological Registered Nurse Company Name City, State,
  • Coached new mothers with breastfeeding techniques, postpartum self-care and infant care to promote easier transition into motherhood.
  • Monitored labs, examined ultrasounds and informed mothers on what to expect in stages of pregnancy.
  • Worked closely with doctors and midwives in coaching pregnant women through childbirth and post-natal recovery.
  • Responded to emergency situations such as pre-eclampsia, early labor and fetal distress.
  • Scheduled follow-up visits and instructed care for new mothers for weeks immediately following childbirth.
  • Performed vital signs checks and administered vaccinations to infants following birth.
  • Educated family members and caregivers on patient care instructions.
  • Equipped patients with tools and knowledge needed for speedy and sustained recovery.
  • Offered exceptional care and support to individuals recovering from acute incidents and dealing with chronic conditions.
01/1999 to 02/2000
Medical Surgical Registered Nurse Company Name City, State,
  • Managed pre-op and post-operative patient care by stocking medical supplies and preparing operating rooms.
  • Educated patients and families on medical-surgical procedures, therapeutic regimens and pain management techniques.
  • Monitored patients before, during and after surgical operations to evaluate patient care.
  • Managed patients' pain by implementing pharmacological and non-pharmacological pain management interventions.
  • Managed caseload of eight patients simultaneously by providing bedside care, treatments, IV therapy and wound care.
Expected in 05/1999 to to
Associate of Science: Nursing
SUNY Dutchess Community College - Poughkeepsie, NY,
  • Certified Case Manager
  • Licensed in NY & Florida (eNLC)
Native or Bilingual

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Resume Overview

School Attended

  • SUNY Dutchess Community College

Job Titles Held:

  • Certified Case Manager
  • Admissions Nurse
  • Psychiatric Registered Nurse/Intake Specialist
  • Utilization Review/Registered Nurse
  • Behavioral Health Registered Nurse
  • Obstetrics/Gynecological Registered Nurse
  • Medical Surgical Registered Nurse


  • Associate of Science

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