nurse case manager resume example

Complex medical case manager, provided telephonic case management to members of ASC employer groups as well as smaller employer groups. Communicated closely with providers including acute hospitals, LTACs, rehabilitation hospitals, SNFs, home health agencies, and outpatient providers to ensure continuity of care and cost effective care for members. Utilized Interqual criteria to determine authorization for lower level of care for members in the appropriate and safe alternative level of care. Educated members on acute and chronic illness and how to recognize signs and symptoms of new or worsening illness. Advocated for members' rights to appropriate treatment within benefits of policy. Referred members to social work, dietitian, or mental health services as needed.

Auto Case Manager working with individuals who have been diagnosed with a traumatic brain injury resulting from motor vehicle accidents. Advocate for the clients' rights to have access to PIP benefits. Coordinate clients' medical care. Find appropriate providers for clients' care and attend all medical appointments. Communicate with adjusters, attorneys, physicians, clients and their families. Educate clients on physician orders, referrals, and recommendations. Report monthly to auto insurance companies on the clients' status.

RN in a neurorehabilitation setting, specifically in group home setting. Worked with individuals with TBIs in the post acute recovery phase, specifically with the pediatric and young adult populations. Accompanied clients on medical appointments, ensured orders were carried out in the respective homes, educated rehab aides on individual care plans and medications. On call nurse for designated clients around the clock for any urgent or emergent medical issues. Telephonic triage and assessment of latter concerns with direction to group home staff on appropriate actions to be carried out. Communicated closely with nursing supervisor and with physicians as needed.