Inpatient RN Complex Case Manager Resume Example Tufts Medical Center

INPATIENT RN COMPLEX CASE MANAGER

Summary

Expert RN seeking Case Management position with growth opportunities. Committed to exceptional quality care with passion for working directly with patients and families for best post-hospital outcomes. Excited by continued learning opportunities and growing in her profession.

Experience

02/2013 to Current

Inpatient RN Complex Case ManagerTufts Medical Center － Boston, MA

Manage caseload up to 27 patients on assigned units.
Experience in Case Management -float position to all med/surg, heme/onc, ED, and ICUs.
Case Manager for Floating Hospital for Children - med/surg, BMT, and PICU.
Case Manager for MICU/CCU and Cardiac Transplant/VAD units for adults.
Proficient in assessment and application of level of care for observation to inpatient status using InterQual guidelines and collaboration with physicians using medical necessity.
Initiate and direct collaboration with medical team - physicians, nurses, physical therapists, social workers, and other ancillary departments for discharge planning throughout hospital course.
Case management assessments on all patients, reviewed and updated throughout patient's hospital course.
Proficient in Medicare/Masshealth guidelines.
Present daily multidisciplinary rounds for appropriate level of care and discharge needs throughout hospital course.
Case management assessments on all patients, reviewed and updated throughout patient's hospital course.
Skillful in working closely with patients and families to educate on the discharge plan and the many questions/concerns that arise from said plan.
Develop and maintain relationships with liaisons from post acute hospitalization levels of care.

11/2012 to 02/2013

Inpatient RN Complex Case ManagerMount Auburn Hospital － Cambridge, MA

Manage caseload of 18 to 24 patients on assigned unit.
Experience in Case Management on med/surg floors, telemetry, MICU/SICU, and ED.
Proficient in assessment and application of level of care for observation or inpatient status using InterQual guidelines and collaboration with physicians using medical necessity.
Initiate and direct collaboration with medical team - physicians, nurses, physical therapists, social workers, and other ancillary departments for discharge planning throughout hospital course.
Case management assessments on all patients, reviewed and updated throughout patient's hospital course.
Accomplished in daily clinical reviews to commercial payers.
Daily case management progress notes on all patients.
Skillful in working closely with patients and families to educate on the discharge plan and the many questions/concerns that arise from said plan.
Develop and maintain relationships with liaisons from post acute hospitalization levels of care.

10/2011 to 09/2012

RN Complex Case ManagerBlue Cross Blue Shield of Massachusetts － Quincy, MA

Manage caseload of 45 to 50 members with up to 30 open cases for active interaction.
Calls placed to open members from daily to once a week related to needs.
Utilize motivational interviewing to engage members for support and education in disease processes, medications, and benefits.
Interact with members on preventative healthcare and proactive communications with healthcare team for improved health and lifestyle outcomes.
Empower members to find, apply for, and receive alternative resources.
Co-manage members with utilization reviewer for comprehensive coverage of members needs, directly and with facilities.
Knowledgeable on utilization review process and application of InterQual to cases.
Connect with members for medical needs, such as pre and post procedure/operative treatment plans, chemotherapy, radiation therapy, and recent hospitalizations.
Advocate for members with providers for optimum care and services member may receive from Blue Cross Blue Shield MA.
Discuss members in MD/RN rounds for medical and behavioral health issues for best practice management.
Selected to represent complex case management as education coordinator for team to create and deliver a new program of continuing education presentations.

08/2011 to 10/2011

RN Case ManagerBlue Cross Blue Shield of Massachusetts － Quincy, MA

Job description as above.

09/2010 to 06/2011

RN Case ManagerSeasons Hospice － Newton, MA

Manage caseload of 10 to 15 patients throughout the greater Boston area including west and north of city.
Visits made daily to weekly related to needs.
Provided exemplary care for hospice patients in the home, nursing facilities, and assisted living residences.
Strong facilitator and coordinator of team members delivering unified patient and family care.
Strong interpersonal relationships with facilities' staffs resulting in excellent management of patients and their outcomes.
Consistently excelled in providing evolving information and support to patients and caregivers resulting in sustainable autonomy and management of care.
Present succinct, relevant information at weekly multidisciplinary rounds.
Utilize ancillary services in timely manner.

04/2002 to 09/2009

RNBrigham and Women's Hospital － Boston, MA

Cardiovascular Recovery Room.
Extensive experience with pre and post procedure care for both in and out patients with wide variety of disease processes/illnesses having cardiac catheterization, vascular catheterization, electrophysiology, or interventional radiology.
Energized by and enthusiastic for patient education for positive lifestyle changes/outcomes.
Hemodynamic monitoring, peripheral IV, port-a-cath and tunneled line access and maintenance, discharge teaching, precise report to in patient unit nurse.
Knowledgeable and decisive charge nurse.
Cardiovascular Diagnostic and Intervention Center.
Deft intra-procedural care for cardiac and vascular/peripheral catheterizations.
Hemodynamic monitoring, peripheral IV, port-a-cath and tunneled line access and maintenance, Intravenous conscious sedation certified.
Coordinated care and functions with pre and post procedure care team for effective time management of case turnovers.
Thoracic ICU.
Highly skilled in the many facets of ICU/SICU care.
Ventilators, care and use of vascular and arterial access lines, hemodynamic monitoring, continuous veno-venous hemofiltration.
Continual interactions with members of interdisciplinary teams for exemplary patient care.
Composed in and up to date with knowledge during emergent situations.
Charge nurse experience.

01/2000 to 04/2002

RNCross Country/TravCorps － Malden, MA

Travel RN assignments in PACU.
Thrive and deliver in fast paced turn-overs of post-operative patients.
Adept at out patient discharges to unstable critically ill patients.

02/1997 to 01/2000

RNIndian River Medical Center － Vero Beach, FL

Staff nurse surgical floor.

Education and Training

Bachelor of Science: NursingEmmanuel College － Boston, MANursing Member Sigma Theta Tau International, Pi Epsilon Chapter

2018

Associate of Science: NursingMassachusetts Bay Community College － Wellesley Hills, MANursing Accreditations and Licenses RN license, MA expiration Jan 25 ACM certification, ACMA National Chapter expiration Sept 2018

Skills

ACMA, assisted living, behavioral health, benefits, Case Manager, Case Management, catheterizations, catheterization, chemotherapy, interpersonal, discharge planning, discharge plan, fast, hospice, notes, MA, access, nursing, patient care, PACU, presentations, processes, progress, radiology, teaching, telemetry, therapy, time management, treatment plans

Resume Overview

Companies Worked For:

Tufts Medical Center
Mount Auburn Hospital
Blue Cross Blue Shield of Massachusetts
Seasons Hospice
Brigham and Women's Hospital
Cross Country/TravCorps
Indian River Medical Center

School Attended

Emmanuel College
Massachusetts Bay Community College

Job Titles Held:

Inpatient RN Complex Case Manager
RN Complex Case Manager
RN Case Manager
RN

Degrees

Bachelor of Science : Nursing
Associate of Science : Nursing

Inpatient RN Complex Case Manager Resume Example

Resume Score: 90%

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