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per diem case manager resume example with 11 years of experience

JC
Jessica Claire
, , 100 Montgomery St. 10th Floor (555) 432-1000, resumesample@example.com
Professional Summary

Effective Care Management across the continuum of care. Utilization management,case management,culturally sensitive,enthusiastic caregiver trained in both in/out-patient care. Patient advocate that is experienced in managing patient care in hospital, rehabilitation facilities, skilled nursing facilities, Home-care, and Hospice. Knowledgeable in patient resources both inpatient and outpatient. Care coordination,Team leader, proven history of success in optimizing patient care as well-qualified and highly experienced Certified Case Manager. Minimize hospital stays through detailed focus on internal systems and individual patient needs. Focused on boosting utilization and department operational efficiency. Coordinated delivery of optimal patient care to diverse patients through effective monitoring and treatment organization. Skillfully conduct assessments, update clinical documentation and complete ongoing case reviews to strengthen support. Well-versed in enforcing strict controls to quickly identify and resolve concerns.

Skills
  • CERTIFICATIONS AND LICENSES
  • Certified Case Manager-CCM by Commission for Case Manager Certification. Certificate # 4208589
  • Basic Life Support (BLS) Certification exp.2021
  • American Heart Association (ACLS) Certification exp. 2021
  • Chronic disease management
  • Case Management
  • Utilization Management
  • Concurrent Review
  • Retrospective Review
  • Patient advocacy
  • Care Management
  • Discharge planning
  • Interdisciplinary collaboration
  • Patient management
  • Staff education and training
Work History
09/2021 to Current Regional Quality Outcomes Manager City Of Hope | , , Florida And Texas
  • Supervised, oriented, trained and counseled department employees to improve job performance and maintain high standards of patient care.
  • Established and tracked quality department goals and objectives.
  • Monitored staff organization and suggested improvements to daily functionality.
  • Applied coaching techniques and tools to support managers and team members in improving quality patient outcomes.
  • Promoted high quality, patient-centered care by providing clinical support in the prompt, accurate completion of the IRF-PAI (patient assessment instrument), to ensure accuracy in scoring of functional status and reflecting the patient's care needs.
  • Collaborated with care team to assist in ongoing monitoring of identified benchmarks for the inpatient rehab population.
  • Ensured correct coding, diagnoses and documentation to support appropriate length of stay.
  • Provided guidance and leadership to interdisciplinary team meetings.
  • Assist with covering for and training Program Directors, Case Managers, and supporting team during transition of leadership.
10/2019 to Current Per Diem Case Manager Gallagher Bassett Nz Ltd | , ,
  • Helped patients receive appropriate, high-quality care with reasonable results.
  • Educated patients and loved ones about different treatment options and outside care approaches, reducing burden on hospital resources.
  • Reduced care costs without sacrificing quality through effective service coordination and multidisciplinary collaboration.
  • Consulted with clinicians to devise and manage effective ongoing care plans for at-risk patients.
  • Worked with different disciplines to provide cohesive care to patients.
  • Private duty RN case management for VIP exclusive clients.
10/2020 to 09/2021 Independent Nurse Case Manager Bayhealth | , ,
  • Used first-hand knowledge and clinical expertise to advocate for patients under care and enacted prescribed treatment strategies.
  • Recorded details regarding all therapies, including PT and OT to keep patient charts updated.
  • Collaborated with all specialist involved in patient care to ensure positive patient outcome.
  • Advocated for catastrophic injured patient to ensure appropriate care plan, make home handicap accessible.
  • Led teams in driving successful patient outcomes by prioritizing standard of care and best practices.
  • Advocated for and strived to protect health, safety and rights of patient.
  • IDT meetings to coordinate care needs. Care coordinated with attorneys, insurance adjusters, surgeons, PT, OT, PCP etc.
  • Educated patients and caregivers on healthcare protocols and processes.
  • Gathered and recorded patient health information and data to assess, identify and manage characteristics that affect care outcome.
01/2017 to 12/2019 Case Manager Ardent Health Services | , ,
  • Completed initial assessment of patient to determine patient care needs
  • Developed plan of care and communicated/collaborated with all care disciplines
  • Educated patient and family members on disease process and effective management to prevent readmission's to hospital
  • Communicated with primary care physician as well as all specialists involved in patient care
  • Ongoing patient assessment and treatment applicable to patient care needs and adjusting plan of care as needed
  • Wound Care
  • Reduced care costs without sacrificing quality through effective service coordination and multidisciplinary collaboration
  • Identified care needs of individual patients and coordinated responses based on physician advice, insurance limitations and procedural costs
  • Addressed disruptions in patient care, including delays in discharge, postponed procedures and discharge equipment unavailability
  • Educated patients and loved ones about different treatment options and outside care approaches, reducing burden on hospital resources
  • Consulted with clinicians to devise and manage effective ongoing care plans for at-risk patients
  • Determined level of care on admission and outcomes on discharge.
01/2013 to 12/2016 Care Manager PEOPLE FIRST HOME-CARE | , ,
  • Monitor and manage patient's progress towards goals, advocate and recommend length of stay, treatment plans, and appropriate level of care
  • Conducted regular re-evaluations to address changes in needs and conditions, introducing revisions to care plans as needed
  • Identified care needs of individual patients and coordinated responses based on physician advice, insurance limitations and procedural costs
  • Advocated for patients by communicating care preferences to practitioners, verifying interventions met treatment goals and identifying insurance coverage limitations
  • Performed evaluations on consistent basis to address changes in patient needs, conditions and medications, altering care plans when required
  • Took active role in patient and family planning process, detailing instructions and responding appropriately and effectively to questions and concerns
  • Audited charts and reviewed clinical documents to verify accuracy
  • Educated patients, families and caregivers on diagnosis and prognosis, treatment options, disease process and management and lifestyle options
  • Addressed disruptions in patient care, including delays in discharge, postponed procedures and discharge equipment unavailability
  • Reported findings to quality departments after conducting routine restraint audits and worked with team to devise corrective actions for deficiencies
  • Managed care from admission to discharge, including patient assessments, care planning, health educations and discharging support to provide comprehensive care to over 25 patients daily
  • Coordinated individualized discharge plans to manage safe transition back into community and home environments
  • Coordinated program referrals for community-based resources
  • Documented case notes daily and coordinated follow-up for seamless case management
  • Developed team communications and information for interdisciplinary team meetings
  • Piloted a successful nationwide care management program
07/2010 to 01/2013 Nurse Case Manager Company Name | , ,
  • Completed initial assessment of patient to determine patient care needs
  • Developed plan of care and communicated/collaborated with all care disciplines
  • Educated patient and family members on disease process and effective management to prevent readmissions to hospital
  • Communicated with primary care physician as well as all specialists involved in patient care
  • Ongoing patient assessment and treatment applicable to patient care needs and adjusting plan of care as needed
  • Medication management and Utilization review
  • Worked to improve and enhance patient lives through effective and compassionate care
  • Oversaw and managed clinical and support staff in patient care activities while maintaining high level of staff morale and professionalism
  • Provided direct patient care, stabilized patients and determined next course of action
  • Leveraged feedback and process improvement opportunities to create safer and healthier environment and increase patient satisfaction
  • Communicated with healthcare team members to plan, implement and enhance treatment strategies
  • Led successful 10-person team comprised of RN's, LPNs and ancillary staff
  • Explained course of care and medications, including side effects to patients and caregivers in easy-to-understand terms
Education
Expected in 2014 Bachelor of Science | Nursing Care/Case Management Chamberlain College of Nursing , Downers Grove, IL, GPA:
Expected in 05/2011 Associate of Science | Registered Nursing Mount Wachusett Community College, Gardner, MA GPA:
Expected in 2009 Associate of Science | Licensed Practical Nursing Mount Wachusett Community College, Gardner, MA, GPA:
Certifications
Certified Case Manager-CCM by The Commission for Case Manager Certification. Certificate # 4208589, Basic Life Support (BLS) Certification exp.2021 American Heart Association (ACLS) Certification 2019
Affiliations

Many years of nursing experience with a focus on care /case management. Proven ability to decrease readmission rates for high-risk patients, increase patient satisfaction and increase positive outcomes. Effective in patient care management across all levels of care. Able to work independently and collaboratively with all healthcare members. Able to self-motivate, prioritize, and implement change to improve effectiveness and efficiency. Knowledgeable in reimbursement methods and regulations to promote cost effectiveness, preservation of patient's benefits, and manage clinically appropriate length of stay.

Additional Information
  • Registered Nurse in the state of Massachusetts License # RN2272345 Registered Nurse in the state of Florida License # RN9498738

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Resume Overview

School Attended

  • Chamberlain College of Nursing
  • Mount Wachusett Community College
  • Mount Wachusett Community College

Job Titles Held:

  • Regional Quality Outcomes Manager
  • Per Diem Case Manager
  • Independent Nurse Case Manager
  • Case Manager
  • Care Manager
  • Nurse Case Manager

Degrees

  • Bachelor of Science
  • Associate of Science
  • Associate of Science

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