nurse case manager senior analyst team lead resume example with 14+ years of experience

Jessica Claire
  • Montgomery Street, San Francisco, CA 94105 609 Johnson Ave., 49204, Tulsa, OK
  • H: (555) 432-1000
  • C:
  • Date of Birth:
  • India:
  • :
  • single:
Professional Summary

Multi-talented Utilization Manager Senior Analyst Team Lead consistently rewarded for success in planning and operational improvements. Experience in policy development and staff management procedures positively impacting overall morale and productivity. Eager to contribute to team success through hard work, attention to detail and excellent organizational skills. Motivated to learn, grow and excel in leadership with the Medicare Advantage team.

  • Productive Team Management and Leadership
  • Excellent Problem Resolution Ability
  • Strong Medical and Personal Ethic
  • Flexible and rapidly adapt to change
  • Able to grasp new concepts quickly and efficiently
  • Analytical and Critical thinking, planning
  • Accuracy and Attention to detail
  • Effective Communication
Professional Experience
Nurse Case Manager Senior Analyst Team Lead, 02/2016 - Current
Mhm Services, Inc. Polk City, FL,
  • Promoted to Behavioral Health Case Manager Team Lead position overseeing 9 Senior Analyst since March 2019.
  • Improve quality processes for increased efficiency and effectiveness.
  • Develop and execute plans to monitor standard process adherence.
  • Identify and resolve process issues to encourage smoother procedures, more efficient workflow and overall business growth.
  • Offer data-driven recommendations aligned with overall company strategies and prioritize process improvement initiatives.
  • Determinedand recommend methods to address improvement opportunities.
  • Coordinate with manager and team lead in developing project plans for prioritizing initiatives.
  • Analyze current business plan, identifying inefficiencies in existing processes, and track performance following implementation of improvements.
  • Negotiate agreements between employees to clarify misunderstood directions and resolve conflicts affecting performance.
  • Develop team communications and information for Concurrent Review team meetings.
  • Conduct training and change management processes to improve operations.
  • Liaise with manager and team lead to organize and perform quality standard training for new and existing staff.
  • Collaborate with team to define business requirements for organizational processes, achieve productivity standards and adhere to accuracy standards.
  • Develop standard operating procedures and document workflows for current and future process steps.
  • Resolve conflicts between parties in order to reach win-win solutions to disagreements and clarify misunderstandings.
  • Complete expedited and standard preservice reviews as well as manage concurrent reviews and Outpatient requests per NCQA and CMS guidelines.
  • Manage and archive quality documentation and participate in internal audits.
  • Adhere to established policies, procedures and compliance for satisfactory audit rating.
Charge Registered Nurse, 05/2015 - 02/2016
Grane Fresno, CA,
  • Organized and developed patient care for new partial hospitalization and intensive outpatient programs.
  • Acheved departmental goals and objectives by instituting new processes and standards for outpatient care.
  • Maximized team performance by monitoring nursing care, including patient assessment processes and treatment implementations.
  • Built rapport with patients and family members to deliver exceptional care.
  • Strengthened unit care standards and policies with focus on patient safety and dignity.
  • Identified unit areas of inadequacy and adjusted procedures to close gaps and improve policies.
  • Delivered medications via oral, monitoring responses to address new concerns.
  • Educated patients and answered questions about health conditions and treatment.
  • Performed patient assessments and adjusted care plans accordingly.
  • Educated family members and caregivers on patient care instructions.
  • Completed clinical tasks in accordance with hospital policy.
  • Collaborated with doctors and staff members to ensure quality care.
  • Updated patient charts using Cerner with data such as medications to keep records current and support accurate treatments.
Registered Nurse Supervisor, 08/2006 - 07/2015
Health Alliance Of Hudson Valley Poughkeepsie, NY,
  • Began career as a charge nurse for BH IP hospitalization, soon rotating throughout many departments.
  • Soon thereafter being promoted to Hospital House Supervisor where responsibilites include advision other staff in their duties, setting priorities and demonstrating clinical judgment handling situations not covered in written or verbal instructions.
  • Direct day-to-day administrative and operational functions for 126-bed facility, providing guidance and leadership to over 25 employees across more than 10 departments.
  • Created customized care plans, working with hospital staff and families to assess and meet individual needs.
  • Delivered outstanding care to patients with various diagnoses and managed care from treatment initiation through to completion.
  • Facilitated therapeutic communication, conflict resolution and crisis intervention by redirecting negative behaviors and helping patients regain or improve coping abilities to prevent further disability.
  • Administered medications and treatment to patients and monitored responses while working with healthcare teams to adjust care plans.
  • Contributed substantially to successful department JCAHO accreditation by consistently operating to highest standards of care.
Registered Nurse, 11/2007 - 04/2008
NorthCrest Medical Center City, STATE,
  • Staff nurse for 26 bed Ortho/Med-Surg and Pediatric unit
  • Monitored patient condition, including interpreting and tracking EKG readings, identifying irregular telemetry readings and updating team members on changes in stability or acuity.
  • Delivered outstanding care to patients with various diagnoses and managed care from treatment initiation through to completion.
  • Provided direct patient care, stabilized patients and determined next course of action.
  • Collaborated with physicians to quickly assess patients and deliver appropriate treatment while managing rapidly changing conditions.
  • Monitored patient reactions to drugs and carefully documented progress of individuals participating in clinical trials.
Bachelor of Science in Nursing (BSN): Nursing, Expected in 05/2006
Austin Peay State University - Clarksville, TN
Status -
Associate of Science: Business Administration And Management, Expected in
Volunteer State Community College - Gallatin, TN
Status -
  • Registered Nurse in TN, License number RN0000154684, expires 2022
  • Advanced Cardiac Life Support (ACLS) Certification, expires 2021
  • AHA Healthcare Provider BLS Certification, expires 2021

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Resume Overview

School Attended

  • Austin Peay State University
  • Volunteer State Community College

Job Titles Held:

  • Nurse Case Manager Senior Analyst Team Lead
  • Charge Registered Nurse
  • Registered Nurse Supervisor
  • Registered Nurse


  • Bachelor of Science in Nursing (BSN)
  • Associate of Science

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