Manager Of Case Management Resume Example Erlanger Western Carolina Hospital

MANAGER OF CASE MANAGEMENT

Summary

Hardworking and reliable [Job Title] with strong ability in [Task] and [Task]. Offering [Soft skill], [Soft skill] and [Soft skill]. Highly organized, proactive and punctual with team-oriented mentality. Motivated to apply education and [Type] abilities to enhance [Type] operations. Eager to learn new skills and advance knowledge with hands-on experience. Proficient in [Software] and [Software] with advanced interpersonal abilities.

Skills

Community outreach
Well-trained in CPSI
Effective customer communication
Planning and coordination
Supervision
Administrative support
Insurance billing

Team management
Team building
Relationship development
Utilization review
Continuous assessments
Patient transfers and transitions
Intake and discharge

Experience

Manager of Case Management / Erlanger Western Carolina Hospital - Murphy, NC05/2020 - Current

Collaborated with team members to identify and accomplish agency objectives.
Coordinated referrals to community services by advocating for individual needs and addressing roadblocks.
Collaborated with other interdiscplinary team members to discuss patient's needs.
Earned reputation for good attendance and hard work.
Provided excellent service and attention to customers when face-to-face or through phone conversations.
Worked closely with team members to deliver project requirements, develop solutions and meet deadlines.
Assessed each patient's psychosocial needs.
Collaborated with providers to obtain required clinical information, supporting prior authorization determinations and individual inquiries.
Contacted insurance carriers to obtain authorizations for services delivered to patients.
Managed [Type] and [Type] processes pertaining to denials and potential denials as outlined by insurance carriers.
Reviewed patient admissions to determine medical necessity as directed by the Interqual criteria.
Coordinated care with physicians and other clinical staff to prepare for treatment, carry out interventions and enhance continuum of care to deliver comprehensive services.
Counseled patients and caregivers, providing emotional, psychological and spiritual support.
Maintained strict patient data procedures to comply with HIPAA laws and prevent information breaches.
Developed and adapted individualized treatment plans according to patient recovery goals.
Communicated with primary care physicians or emergency care providers to relay patient needs.
Counseled caregivers and families on end-of-life planning and educated on patient care options.

RN Supervisor / Immediate Care CenterCherokee, NC

Collaborated with team members to identify and accomplish agency objectives.
Developed and incorporated community-based programs to meet various needs and monitored each program's effectiveness.
Coordinated referrals to community services by advocating for individual needs and addressing roadblocks.
Documented services discussed and provided details in electronic medical records.
Maintained confidentiality in matters related to patient, family and client facility staff.
Collected data to represent symptoms, including onset, presenting problem and medical diagnoses.
Reviewed medical chart and requested appointments, prescriptions and consultations for urgent needs.
Communicated triage information to primary care team to discuss disposition.
Educated patients relative to health care urgency and community resources available to meet needs.
Answered incoming patient calls, gathering history and symptoms to determine scope of medical complaints.

RN Staff Nurse, House Supervisor / Murphy Medical CenterMurphy, NC

Monitored post-op vitals, set up PCA, fluids, reviewed post-op orders and assimilated patients to unit.
Assessed patient conditions, monitored behaviors and updated supervising physicians with observations and concerns.
Administered oral, intramuscular and IV medications to patients and monitored responses.
Coordinated with healthcare team to establish, enact and evaluate patient care plans.
Conducted patient assessments and diagnostic tests to provide physician with important patient health information.
Communicated with primary care physicians or emergency care providers to relay patient needs.
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 scheduled medications and therapies intravenously, rectally, orally, subcutaneously and via intramuscular injections while overseeing pain management plans.
Administered oral, IV and intra-muscular medications and monitored patient reactions.
Monitored and recorded patient condition, vital signs, recovery progress and medication side effects.
Trained and mentored new RNs on best practices, hospital policies and standards of care.
Answered patient questions and provided take-home materials for further information.
Delivered quality patient care from admission to discharge through direct supervision of all nursing and ancillary staff.
Helped patients and families feel comfortable during challenging and stressful situations, promoting recovery and reducing compliance issues.
Delivered information regarding care and medications to patients and caregivers in comprehendible terminology.
Counseled patients and caregivers, providing emotional, psychological and spiritual support.
Advocated for patient needs with interdisciplinary team and implemented outlined treatment plans.
Maintained strict patient data procedures to comply with HIPAA laws and prevent information breaches.

Education and Training

Western Carolina University - Cullowhee, NC12/2014Bachelor of Science: Nurisng

Tri County Community College - Murphy, NC05/2009Associate of Science: Nursing

Applachian Community College - Jasper, GA12/2000Licensed Nurse Diploma: Nursing

Certifications

Accreddited Case Manager (ACM)
Certified Medical Surgical RN (CMSRN)

Resume Overview

Companies Worked For:

Erlanger Western Carolina Hospital
Immediate Care Center
Murphy Medical Center

School Attended

Western Carolina University
Tri County Community College
Applachian Community College

Job Titles Held:

Manager of Case Management
RN Supervisor
RN Staff Nurse, House Supervisor

Degrees

Western Carolina University - Cullowhee, NC 12/2014 Bachelor of Science : Nurisng
Tri County Community College - Murphy, NC 05/2009 Associate of Science : Nursing
Applachian Community College - Jasper, GA 12/2000 Licensed Nurse Diploma : Nursing

Manager of Case Management Resume Example

Resume Score: 80%

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