, , 609 Johnson Ave., 49204, Tulsa, OK100 Montgomery St. 10th Floor
H: (555) 432-1000
C:
resumesample@example.com
Date of Birth:
India:
:
single:
Professional Summary
Accomplished Registered Nurse Case Manager with 20+ years of experience dedicated to coordinating quality care of diverse patients. Work effectively with all levels of healthcare providers, physicians and administrators to address patient needs. Minimize hospital utilization through detailed focus on internal systems, outside resources and individual patient needs. Team oriented and focused on boosting utilization and department operational efficiency. In-depth knowledge of case research and relevant regulatory standards. Consistently developing strong relationships with patients, families and healthcare providers through empathetic communication, respectful attitude and excellent customer service.
Skills
Managed Care
Excellent Customer Service
Case Management
Staff Management
Insurance Knowledge
Patient Care
Treatment Planning
Health Education
Patient Care Coordination
Patient Information Collection
Work History
Registered Nurse Case Manager II, 05/2017 - Current Benedictine Health System – Bismarck, ND,
Coordinate care utilizing multiple systems, referring member to plan benefits and community resources, reviewing and assisting with facilitation of authorizations.
Connect members to alternate resources and funding sources for needed services and supplies not covered.
Preceptor and mentoring new employees, assisting team members with issues and solutions.
Function as lead for manager when assistance needed and assist with audits.
Participate in special projects and initiatives.
Work with suppliers and vendors on provision of medical equipment, items and services.
Perform evaluations on consistent basis to address changes in patient needs, conditions and medications, altering care plans when required.
Author initial assessments of patients and family to develop plans for individual home care needs.
Reduced care costs without sacrificing quality through effective service coordination and multidisciplinary collaboration.
Educate patients and loved ones about different treatment options and outside care approaches, reducing burden on hospital resources.
Advocate for patients by communicating care preferences to practitioners, verifying interventions met treatment goals and identifying insurance coverage limitations.
Complete an average of 20 calls daily and 4-5 health risk assessments weekly. Manage caseload of approximately 400 members of varying complexity.
Registered Nurse Case Manager, 04/2014 - 05/2017 Medstar Research Institute – Dundalk, MD,
Assessment of chronic wounds and co-morbidities affecting healing, product knowledge and recommendation, application of dressings and lymphedema wraps, wound vac certification and administration, administering medications, and assist physician with debridements and procedures.
Obtaining authorizations, timely documentation, and triaging. Risk assessment, implementation, administration and education of hyperbaric oxygen treatments.
Provided patient and family education and addressed question and concerns.
Coordinated with interdisciplinary professionals to develop plans of care, administer tests and monitor patient status.
Negotiated with suppliers and vendors to procure medical equipment, supplies and services.
Reduced care costs without sacrificing quality through effective service coordination and multidisciplinary collaboration.
Managed and streamlined referral queues by efficiently prioritizing patients and clearing insurance obstacles.
Advocated for patients by communicating care preferences to practitioners, verifying interventions met treatment goals and identifying insurance coverage limitations.
Managed an average of 15-25 patients daily in clinic or 2 -4 patients daily in hyperbaric treatment.
Clinical Manager, 04/2010 - 04/2014 Benedictine Health System – Duluth, MN,
Promoted high morale and staff retention through dynamic communication, prompt problem resolution, proactive supervisory practices and facilitation of positive work environment.
Managed daily operations of 12-person home care office supporting approximately 75-80 patients.
Implemented ongoing learning strategies such as tutorials, instructional modules, and supervised hands-on sessions to help nurses and staff improve understanding of medical equipment and care best practices.
Handled job duties for staff members which were unavailable or out of office.
Implement new policies and educate staff on changes. Worked with clinical director to develop nursing staff through education, evaluation, performance management and competency improvement.
Delivered effective onboarding and training to new and existing employees and cross-trained staff members in other job roles to maximize coverage.
Identified opportunities to improve clinical practices, devised strategies and implemented plans to increase patient care standards and enhance operational procedures.
Communicated effectively with patients, staff members, physicians and patients, employing active listening and interpersonal skills.
Assist with scheduling and coordination of staff, utilizing procedures, policies and regulations.
Accepted referrals and physician orders. ICD-9 coding, review of Medicare Oasis assessments for accurate documentation.
Registered Nurse Case Manager, 01/2001 - 04/2010 Amedisys Brookside Home Health – City, STATE,
Administered physical assessments and documented history of current and previous conditions, illnesses and injuries.
Connected patients and families to community resources or alternate funding sources for supplies and services not covered, or for additional needs.
Developed care plans based on nursing diagnosis and incorporated therapeutic, preventive and rehabilitative nursing methods.
Coordinated care of injured workers by liaising with employer case managers to organize treatments and program resources.
Advocated for patients by communicating care preferences to practitioners, verifying interventions met treatment goals and identifying insurance coverage limitations. Identified care needs of individual patients and coordinated responses based on physician advice, insurance limitations and procedural costs.
Delivered medications via oral, IV and intramuscular injections, and administered treatments, monitoring responses to address new concerns.
Reduced care costs without sacrificing quality through effective service coordination and multidisciplinary collaboration.
Worked with suppliers and vendors on provision of medical equipment, items and services.
Took active role in patient and family planning process, detailing instructions and responding appropriately and effectively to questions and concerns.
Participated in on-call rotations to deliver after-hours care. Managed on average 35-45 patients with weekly to monthly visits depending in co-morbidities and orders.
Education
Associate of Applied Science: Registered Nurse, Expected in - Rappahannock Community College - Saluda, VA GPA:
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