Livecareer-Resume
Jessica
Claire
resumesample@example.com
(555) 432-1000,
Montgomery Street, San Francisco, CA 94105
:
Professional Summary

Enthusiastic nurse educator eager to contribute to team success through hard work, attention to detail and excellent organizational skills. Clear understanding of client advocacy, client resolutuion and client satisfaction. Motivated to learn, grow and excel in the healthcare industry.

Skills
  • Documentation proficiency
  • Data Entry
  • Treatment planning
  • Interdisciplinary collaboration
  • Regulatory Compliance
  • Staff education and training
  • Patient Assessments
  • Chronic disease management
  • Case Management
  • Progress evaluations
  • Patient consultation
  • Patient and family advocacy
  • Preventative health
  • Fluent in Spanish
Education
Barry University Miami, Florida, Expected in 2003 Bachelor of Science : Health Services Administration - GPA :
Jackson Memorial Hospital School of Nursing Miami, Florida, Expected in 1988 : Nursing - GPA :
National Society of Health Coaches Tallahassee, Florida, Expected in 2019 : Certified Health Coach - GPA :
Solera Health National Diabetes Prevention Program Tallahassee, Florida, Expected in 2019 : Certified Lifestyle Coach - GPA :
Work History
Cvs Health - Retail Center Navigation Nurse
Bismarck, ND, 04/2020 - Current
  • Proactively manage prospective customers and members' experience through health care continuum and delivery system in a retail store environment by assessing needs, educating on benefit plans, costs, choices, tools and programs and referring to FB programs and resources as appropriate. Contacts and referrals can come from variety of internal and external sources, including member self-service, Case Managers, member contact center, third party vendors such as Health Dialog, wellness/health fairs and Company's retail stores
  • Present health education classes and programs to members/non-members
  • Perform Personal Health Assessments on members and provide education on ways to achieve better health
  • Perform prospective customer and member needs assessment in order to provide most effective and efficient customer service
  • Facilitate benefit savings for members by proactively educating them on benefit plan impacts and choices
  • Facilitate problem solving and issue resolution; e.g. assists with access to care issues
  • Provide referrals to community resources such as elder care
  • Educate prospective customers and members on benefits structure and care setting alternatives,
  • Educate prospective customers and members and helping them access and understand cost and quality comparisons
  • Provide appropriate referrals to other corporate programs such as Health Dialog and Case Management
  • Coordinating care for members as appropriate based on treatment plans
  • Led [Type] team in delivery of [Type] project, resulting in [Result]
  • Saved $[Amount] by implementing cost-saving initiatives that addressed long-standing problems
  • Handled [Number] calls per [Timeframe] to address customer inquiries and concerns
Prime Healthcare - Clinical Account Consultant RN
Odessa, MO, 02/2018 - 04/2019
  • Analyze existing and emerging medical trends of group populations resulting in specific clinical recommendations
  • Integrate clinical and financial analysis to develop and refine metrics and reporting to assist in determining the drivers of healthcare costs for client accounts
  • Data interpretation, customized strategy with recommendations and solutions
  • Evaluate opportunities regarding ways to improve health outcomes and reduce healthcare costs at the client level
  • Understand business processes and proactively identifies the need for creative and innovative solutions to support client needs
  • Continue to integrate new, innovative ideas, designs and approaches in a consultative, value driven message to the market
  • Consult with high profile external stakeholders and their consultants to gain alignment with group decision makers on alternatives for enhanced future performance
  • Partner with client leaders and account management to identify product benefits and programs which reduce cost and improve quality outcomes
  • Report and present development competencies with delivery targeted to array of audiences
  • Utilize managed care experience, health care industry experience, data analysis, reporting, and consulting with and influencing large account decision makers and consultants for the purpose of account acquisition, retention, and relationship management
  • Validate, manipulate, analyze and interpret data and information from highly technical areas to make effective cost and process decisions resulting in increased client satisfaction and retention
  • Increased customer satisfaction by resolving issues
Florida Blue - Case Manager RN
City, STATE, 07/2017 - 02/2018
  • Engage Members telephonically or face to face at Florida Blue Retail Centers, hospitals, etc. with focus on health coaching and member education. Facilitate access to care and resources to meet member’s health care needs
  • Provide education and tools to promote self-management
  • Plan, implement, coordinate and monitor Case Management activities that may include acute and non-acute services, outpatient services and community resources
  • Facilitate care for high risk members across continuum of health care experience, including care transitions, coordination of community and social service and coordinating with other value-based organizations, providers as needed
  • Close gaps in care
  • Conduct Medication Reconciliation
  • Collaborate with Member, Member’s Physicians, Plan Medical Directors, Managers, Local, Regional and Specialty team members as well as other functional areas to assist members to meet their health care goals
  • Promote healthy lifestyles, assist in strengthening patient-physician relationship, encourage behavior and lifestyle changes to realize better quality of life, for individuals with identified chronic conditions, costly and/or catastrophic illnesses
  • Assist Members and their physicians to navigate through health continuum, educate regarding benefits, identify candidates for Care Programs and provide information pertaining to network and network access
Florida Blue - Nurse Educator RN
City, STATE, 03/2014 - 07/2017
  • Responsible for the education of members through health fairs, community outreach programs, and presentations to promote healthy lifestyle
  • Support health fairs, Personal Health Assessments (PHA) and educational activities for large, mid-size, and small groups, including health coaching as needed
  • Develop and coordinate educational programs and activities based on aggregate data from PHA, claims, predictive modeling, and regional demographics
  • Provide educational information at health fairs to educate members with at risk values and lifestyles based on personal health assessments and/or biometric screenings
  • Provide telephonic/onsite health coaching to members with at risk values and lifestyles to assist them in modifying their lifestyle and reduce their risk for disease
  • Provide telephonic outreach to members with critical values identified through the biometric screening process
  • Provide member referrals to disease management vendor, case management, and/or local community resources
  • Implement educational programs to support local presence and sales strategies for retention and attraction of new accounts
  • Moderate to heavy keying

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Resume Overview

School Attended

  • Barry University
  • Jackson Memorial Hospital School of Nursing
  • National Society of Health Coaches
  • Solera Health National Diabetes Prevention Program

Job Titles Held:

  • Retail Center Navigation Nurse
  • Clinical Account Consultant RN
  • Case Manager RN
  • Nurse Educator RN

Degrees

  • Bachelor of Science

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