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clinical supervisor case manager resume example with 10+ years of experience

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Jessica Claire
, , 100 Montgomery St. 10th Floor (555) 432-1000, resumesample@example.com
Summary

RN clinical manager accustomed to treating diverse patient needs while managing dynamic conditions. Offering excellent clinical knowledge and judgment combined with strong documentation, I have 10 years experience in many areas of Home Health from field nurse to Administration which includes QA. scheduling. managing staff, policy and procedure updates. implementation and review along with billing. ADRs and denial review

Skills
  • Patient assessment
  • Treatment plans
  • Quality assurance
  • Oasis review and export
  • Schedule staff
  • ADR review
  • ADR Denial review
  • Denial appeal
  • Regulatory requirements
  • Census goals
Experience
01/2021 to Current Clinical Supervisor/Case Manager Chris Kids | Decatur, IL,
  • Reviewed effectiveness of treatment for individual and family situations.
  • Determined and coordinated appropriate level of care to meet individual patient needs.
  • Review each ADR
  • Reviewed and recorded progress of patients.
  • Coordinated support services and optimized communication between healthcare workers and patients.
  • Collaborated with different disciplines to provide cohesive care to patients.
  • Review all Denials and do any appeals
  • Review POC for each patient
  • Inform patients and families of POC
  • Assisted patients in receiving high-quality, appropriate care with best possible results.
  • Used facility EMR system to update patient records, transmit prescriptions and transfer files.
  • Optimized program resource utilization to prevent unnecessary hospital admissions.
10/2017 to 01/2021 Director of Nursing Ucla Health | Irvine, CA,
  • Assessed competency of clinical staff to promote quality, continuity and safety.
  • Implemented changes needed to correct deficiencies found during State survey
  • QA charts and SN notes
  • Oversee Billing
  • Scheduled staff nurses, fostering environment supportive of both staff and patients.
  • Coordinated medical and health services in compliance with government regulations and policies set by board of trustees.
  • Monitored development, implementation and updates of individualized care plans.
  • Oversaw new nursing employee orientation process, including explanation of individual duties.
  • Reviewed incident reports for accuracy and proper notification to family, physicians and other agencies as required by regulations.
  • Review ADRs Denials and appleals
  • Headed clinical oversight to devise and establish policies, procedures and best practices in alignment with regulatory requirements.
  • Collaborated with QAPi manager to develop outcomes statistics.
  • Implemented changes needed to correct deficiencies found during government inspections.
08/2018 to 07/2020 Administrator Crossing Rivers Health | Prairie Du Chien, WI,

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  • Defined and documented office procedures, using updated SOPs to provide thorough and comprehensive training for all administrative support staff.
  • Increased office organization
  • Optimized personnel coverage, preparing work schedules based on staff availability and forecasted demands.
  • Evaluated employee job performance and motivated staff to improve productivity.
  • Organized activities to reward employees and provide motivation and improve efficiency.
  • Oversee Billing
  • QA charts and Oasis review
  • ADR reviews denials and appeals
  • Supported office needs including taking messages, scanning documents and routing business correspondence.
  • Worked with management team to improve workflows and eliminate unnecessary tasks.
  • Handled supply purchases and inventory management for office operations and equipment maintenance.
04/2011 to 11/2017 Registered Nurse DeQuincy Home Health | City, STATE,
  • Monitored and recorded patient condition, vital signs, recovery progress and medication side effects.
  • Coordinated care with physicians and other clinical staff to prepare for treatment, carry out interventions and enhance continuum of care to deliver comprehensive services.
  • Administered medications, tracked dosages and documented patient conditions.
  • Scheduling of nursing staff along with PT
  • Delivered care to 6-9 patients per day, including coordinating and evaluating interdisciplinary care.
  • QA of charts
  • Care of patients suffering from chronic and acute medical concerns, including asthma, seizure disorders and pneumonia.
  • Developed and adapted individualized treatment plans according to patient recovery goals.
  • Assessed Oasis and exported
  • Instructed patients, caregivers and families on diagnoses, treatment options
  • Updated physicians on patient test results and assisted in developing care plans.
  • Created and maintained all absentee calendars, agency nurse schedules and staff meeting minutes.
  • Trained new RN hires and ancillary staff members to meet patient service goals
  • Used facility EMR system to update patient records
Education and Training
Expected in 12/2000 to to Associate of Science | Nursing McNeese State University, Lake Charles, LA GPA:

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Resume Overview

School Attended

  • McNeese State University

Job Titles Held:

  • Clinical Supervisor/Case Manager
  • Director of Nursing
  • Administrator
  • Registered Nurse

Degrees

  • Associate of Science

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