Experienced Certified RN Case Manager Strong communication and customer services skills. Excellent analytical skills to problem solve and remedy issues immediately. Abel to work in an autonomous environment with success providing individualized patient care. Proven leadership focused on increasing and enhancing patient care and satisfaction.
Administer complex, high-touch concierge case management for a case load of 160 members in South Carolina and nationally identified into specialized programs such as chronic high-risk conditions.
Identified risks and provide outreach services to coordinate healthcare services and gap closure.
Provide individualized care plans to ensure cost effectiveness, overall care satisfaction, and improve quality of life; demonstrated by decrease ED and inpatient hospitalizations, medication management and physician followup.
Assess members and documented their medical history's, established goals, monitored their progress , passed on cost savings to their employers.
Coordinated Quality Improvement to identify performance areas for improvement to members health.
Telephonic, remote case management
Identified, screened , assessed member needs
Conducted remote telephonic clinical assessments , developed a personalized condition-specific action plan.
Provide resources of their medical condition to guide the person in self- management of their healthcare
Screen members to identify opportunities for health services, modifiable risk factors , educational needs , provide appropriate partner referrals as needed.
Evaluate member's progress ,meeting established goals , revise their individualized care plan accordingly
Coordinate patient care, education, documentation between insurance company, providers, care coordination team
Managed patient care with implementation, coordination, monitoring, assessment, planning, evaluation of outcomes with patients health care, utilizing case management process.
Oversaw multiple complex chronic disease conditions; Asthma, COPD, CAD, diabetes, cancer, depression, Alzheimer's, end of life care
PCMH/ Care First using URAC standards; Telephonic, remote case management
. Registered Nurse-South Carolina Registered Nurse 205731; Expires 04/30/2022-Compact License .
.Certified Case Manager April 2021 .
.Certificate Motivational Interviewing - 2020 .
.Certification BCBSSC Health Coach Certification -2020 .
.Certificate with the Alzheimer's Association for training-2009
.Administrator Certificate for Assisted Living; Senior Living University-2008
RN Case Manager, background in home health, Assisted Living, hospice, palliative care, disease management, chronic comorbidities.
Microsoft Word, PowerPoint, LiveOps, MDDS, and BlueVue
Resumes, and other information uploaded or provided by the user, are considered User Content governed by our Terms & Conditions. As such, it is not owned by us, and it is the user who retains ownership over such content.
Many factors go into creating a strong resume. Here are a few tweaks that could improve the score of this resume:
Job Titles Held: