Jessica Claire
  • , , 100 Montgomery St. 10th Floor
  • H: (555) 432-1000
  • C:
  • Date of Birth:
  • India:
  • :
  • single:

Dedicated and detail-oriented Registered Nurse Care Manager with extensive experience in the provision of member-centric care management services for a diverse and complex population. Committed to continuing to blaze the trail, to supporting the goals of a high-performing team, while seeking leadership opportunities for career advancement.

Physical Health Care Manager, 10/2015 - Current
South Georgia Medical Center Nashville, GA,
  • Provide care management services for a diverse, vulnerable, managed-Medicaid population, including members diagnosed with substance abuse disorders, psychiatric disorders and HIV, to meet their physical and behavioral health needs.
  • Participated in and trained Healthfirst Partners during the TruCare Mentor Activity initiative that included those on the supervisory level.
  • Collaborate with HARP supervision as needed to address unique situations.
  • Train and teach other Physical Health Care Managers in HARP team processes, systems, and best-practices in providing holistic, member-centric care management services.
  • Interdepartmental communication and collaboration to impart members with the appropriate information, services, supplies, and DME in an efficient and effective manner.
  • Seek information and inform team members of any resources that may enhance our productivity and ability to provide members with the best service possible.
  • NowPow champion/ point-person for HARP PH Team that entails training, trouble-shooting, and encouraging use of this community referral technology.
  • Review and utilize systems, such as TruCare, CCMS, and SharePoint to create and develop plans of care that provide members with optimal, member-centered care management services and meet state regulatory requirements.
  • Equip and empower members with free and low-cost community resources that will enhance their safety, support, and independence in the community.
  • Support members' PH and BH post-discharge needs, including acute rehabilitation, aftercare, DME, PCA, and Home Care services, to safely transition member back into the community and prevent re-admission.
  • Regular and as needed member follow up to meet acute and ongoing needs, while continuing to advance their plan of care.
  • Address and manage any member grievances and critical incidents to ensure member satisfaction.
  • Ensure HIPAA compliance and utilize active listening skills that include "teach-back" technique for providing health education to members.
  • Assess members who are in mental health crisis and initiate BH conference calls, EMS, mobile crisis, and APS referrals when appropriate.
  • Collaborate with HARP Behavioral Health Care Managers to ensure member's behavioral and mental health needs are met, thereby delivering a more holistic member care experience.
  • Facilitate Health Home referrals and encourage engagement.
  • Collaborate with Health Home CMAs to make certain member's ongoing physical, behavioral, vocational, and psychosocial needs are met in the community.
  • Prepare and present case reviews for ICT meetings.
On-Site Care Manager, 04/2013 - 09/2015
Wr Grace Lake Charles, LA,
  • Reviewed patient medical records to identify readiness for discharge and identify missing services in discharge planning.
  • Supported members' post-discharge to prevent re-admission, including DME and SNF Rehab.
  • Communicated and discussed opportunities for developing and executing discharge plans with hospital staff (Medical team, social workers) and, where applicable, facilitate and implement a timely and appropriate discharge plan for the member.
  • Visited HF members at the bedside to facilitate and support pre and post d/c plan.
  • Focused on psychosocial and socio-economic needs.
  • Communicated with assigned telephonic Care Manager to assure post-discharge interventions are in place.
  • Ensured HIPAA compliance.
  • Attended and participated in interdisciplinary care team meetings between Healthfirst and the on-site hospital.
  • Prepared and presented case reviews in Interdisciplinary Care Team meetings.
Senior Staff Nurse, 09/2009 - 02/2013
NYU-Langone Medical Center City, STATE,
  • Develop patient care plans, including assessments, evaluations, and nursing diagnoses for a 32-bed Neuroscience unit that includes ICU, floor, post-operative, stroke unit, and general medical-surgical patients.
  • Manage caseload of 3-6 clients per shift, providing education, advocacy, treatments, IV therapy, venipuncture and wound care.
  • Coordinate with doctors and registered nurses to develop care plans for patients.
  • Ensured efficacy of treatments through monitoring of treatment regimens.
  • Monitor patients' vital signs, blood glucose levels, fluid intake,output levels.
  • Collect blood and other laboratory specimens and prepared them for lab testing.
  • Manage care of post-operative brain and spine patients.
  • Treat patients with strokes, head traumas, intracranial hematomas and other neurological diseases.
  • Experience with various medical conditions including COPD, asthma, Parkinson's, Dementia, Diabetes, Cancer, Alzheimer's and Paget's diseas.
  • Partner with team of Registered Nurses to ensure over all well-being of all patients.
  • Assist physicians examine and treat patients, assisting with instruments, injections and suture removal.
  • Evaluate health education needs of patient and family and provided necessary training and discharge instruction.
  • Accurately document all elements of nursing assessment, treatments, medications, discharge instructions, and follow-up care.
  • Achieve departmental goals and objectives by instituting new processes and standards for in-patient care.
  • Train new staff on quality control procedures.
  • Follow infection control procedures.
  • Provide treatment within scope of practice as defined by state law.
Intern, 12/2005 - 12/2008
Welfare Rights Initiative City, STATE,
  • Guided over 100 public assistance students seeking higher education by recommending and coordinating child care, food stamps, housing and legal services.
  • Organized and implemented weekly outreach advisement services for 250 students within 24 months.
Education and Training
: , Expected in 2010
NYU-Langone Medical Center - New York, NY
  • Nurse Residency Program
  • Completed 1-Year Residency
  • Bachelor's of Science: Nursing, Expected in 2009
    Hunter College - New York, NY
    Activities and Honors
  • Sigma-Theta-Tau, Alpha-Phi Chapter, Inducted, May 2009
  • National Association of Hispanic Nurses
  • Skills
    • Proficient in systems/ databases: TruCare, CCMS, Psyckes, ePaces, MAPP, Lenavi, EPIC
    • Can type 50 WPM; Microsoft Word, Excel, & PowerPoint

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    School Attended

    • NYU-Langone Medical Center
    • Hunter College

    Job Titles Held:

    • Physical Health Care Manager
    • On-Site Care Manager
    • Senior Staff Nurse
    • Intern


    • Bachelor's of Science

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