Jessica Claire
  • , , 609 Johnson Ave., 49204, Tulsa, OK 100 Montgomery St. 10th Floor
  • Home: (555) 432-1000
  • Cell:
Professional Summary

Compassionate Registered Nurse with background in home health case management and medical quality chart reviewing. 4 Years of experience in OASIS scoring and with CMS requirements. 1.5 Year experience in OASIS/quality chart reviews. Excellent time management and organizational skills. Strong communication skills. Works well with a diversity of people. Passionate and dedicated to delivering excellent service and care. Ready to work; eager to learn and grow.

  • Bachelor of Science in Nursing
  • Case Management Experience
  • OASIS scoring/reviewing
  • Knowledge on CMS requirements
  • Care Plan Development
  • Experience with geriatric, adult and pediatric population
  • BLS certification
Work History
Patient Care Coordinator/RN Case Manager , 07/2020 to Current
Country ManorSaint Joseph, MN,
  • Evaluate treatment plans against individual goals and healthcare standards.
  • Audit charts for CMS compliance and review for medical necessity.
  • Utilization review based off of documentation, diagnosis codes, patient's needs and HHRG/HIPPS scores.
  • Collaborate with physicians, social workers, therapists and RN case managers to develop and implement individualized care plans; documenting all patient interactions and interventions in electronic charting systems.
  • Develop and establish care plans based on nursing diagnosis and incorporate therapeutic, preventive and rehabilitative nursing methods.
  • Identify care needs of individual patients and coordinate responses based on physician advice, insurance limitations and procedural costs.
  • Collaborate with RN case managers from different insurance companies to ensure they are receiving needed documentation and to discuss patient statuses, changes in conditions, concerns and any improvements or recommendations.
  • Daily telephonic triage of patient situations including instructing patients on medical advise and recommendations, preventative teaching, medication education, disease process education and deciphering emergent from non-emergent situations.
  • Establish performance improvement and ensure core process measures are being met with each individual patient case
  • Work with Wellsky, Focura, TigerConnet and Gmail systems
Patient Care Manager (Supervisor), 10/2019 to Current
At Home HealthcareCity, STATE,
  • Evaluated treatment plans against individual goals and healthcare standards.
  • Audited charts for CMS compliance and review for medical necessity.
  • Performed Utilization review on charts and made necessary changes to discipline frequencies based off of documentation, diagnosis codes, patient's needs and HHRG/HIPPS scores.
  • Oversaw clinical staff consisting of RN, LPN, HHA, PT, OT, ST, PTA, COTA and MSW disciplines.
  • Performed weekly employee evaluations and supervisory visits with field clinicians; conduct weekly chart audits and provide constructive criticism and education to field Nurses and Therapists
  • Lead Team Case conference meetings weekly, create agendas, power points, establish and organize teaching topics to present
  • Managed high volume workflow and tasks daily and in a timely matter, view and update coordination notes, respond to emails and phone calls daily
  • Used HomeCare Homebase, Outlook Email, Fax, Scan and Telemed app
RN Case Manager, 05/2017 to 10/2019
At Home HealthcareCity, STATE,
  • Performed OASIS admission visits, recertifications, resumption of cares and discharge visits.
  • Evaluated patients in their homes, perform home safety assessments, fall risk assessments and determine homebound status.
  • Scored patients using OASIS D Functional assessment
  • Performed the following skills routinely and independently in patient homes: Wound care including wound vacs, PICC line care, Central line care, IV infusions, TPN administration, IV starts and dc's, Tracheostomy care, Foley catheter care, colostomy/urostomy/illeostomy care, INR checks, Medication management, Disease process education and monitoring for exacerbation
  • Applied knowledge and educate patients on COPD, CHF, AFIB, Pneumonia, Sepsis, Wounds, post CABG and TAVR surgery and Diabetic disease process
  • Managed care from admission to discharge, including patient assessments, care planning, health educations and discharging support to provide comprehensive care
  • Triaged after hours phone calls from patients, Used critical thinking skills to determine safe solutions
  • Closely communicated with therapists, physicians and family to ensure patient is receiving needed care
Pediatric Emergency RN, 02/2016 to 05/2017
  • Triage and Assess patients in timely and urgent matter
  • Provide care for neonates, infants, toddlers, school aged children and adolescents
  • Quickly recognize signs of Respiratory Distress, DKA, MI, Trauma and Sepsis and implement protocols
  • Follow hospital protocols and implement precaution requirements
  • Answered codes quickly and orchestrated efficient, skilled medical care
  • Assisted patients dealing with traumatic injuries or illnesses, including stroke patients, accident victims and cardiac patients
  • Collaborated with physicians to quickly assess patients and deliver appropriate treatment while managing rapidly changing conditions
  • Airway management techniques; Work closely with Respiratory Therapy in caring for intubated patients
  • Assist MD with patient sedations; responsible for airway management and ensuring vital sings are stable through procedure
  • Care for patients with Suicidal and Homicidal Ideation, Implement psychiatric care protocols
  • Delivered medications via oral, IV and intramuscular injections, monitoring responses to address new concerns
  • Accurately documented all elements of nursing assessment, including treatment, medications and IVs administered, discharge instructions and follow-up care
  • Iv starts, lab draws, straight caths, oxygen and medication administration
Bachelor of Science: Nursing, Expected in 2015
Grand Canyon University - Phoenix, AZ
High School Diploma: , Expected in 2007
Amphitheater High School - Tucson, AZ

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Resume Overview

School Attended

  • Grand Canyon University
  • Amphitheater High School

Job Titles Held:

  • Patient Care Coordinator/RN Case Manager
  • Patient Care Manager (Supervisor)
  • RN Case Manager
  • Pediatric Emergency RN


  • Bachelor of Science
  • High School Diploma

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