RN Care Manager Resume Example Health Force - Summerville, South Carolina

Work History

RN Care Manager09/2015 to Current
Health Force – Columbia, SC

Manage Members of Humana Health Care Needs
Assist members with obtaining community resources
Develop and implement individual plan of care
Provide education on multiple medical/safety topics
Assist with coordination of care
Provide emotional support and education to families of member
Review and reconcile medications
Assist with Medicaid/Medicare/Insurance issues.
Perform Member Surveys, Life plans, Insurance assessments for different companies contracted with health force. (Humana, John Hancock and Absolute Total Care and many others)

Director of Operations/RN Patient Care Coordinator04/2012 to 10/2015
Transitions Hospice Care – Charleston, SC

Transitions Hospice Care Charleston-North Charleston SC Manage daily functions of hospice office Manage Medical Directors, RN Case Managers, Hospice aides, Social Workers, Chaplains, Bereavement Coordinator, Volunteer Coordinator, Marketers, Quality Assurance Coordinator and Office Support Staff.
Responisble for Hiring staff, staff evaluations, disciplinary actions as well as terminating employees when needed.
Responsible for reviewing all incoming referrals information, medical records and ensuring potential patient meets CMS Hospice Criteria for admission.
Responsible for coordinating informationals and or admissions.
Responsible for coordinating staff to provide daily patient care according to Plan of Care.
Assist Field staff with patient admissions, patient assessments, plan of care, pain and symptom management.
Provide patient, family and staff education Responsible for ensuring company policies and procedures are followed.
Responsible for ensuring the office and its employees are following CMS(Medicare), State Medicaid and State of SC Hospice guidlines and regulations.
Responsible for assessing patients payor source and obtaining authorizations.
Coordinate patient care with patients, families, Physicians, contracted providers and insurance companies.
Responsible for Incident and Infection control reporting Responsible for Quality Assurance Data Collections, reporting and quarterly meetings.
Review, approve and or deny invoices,explanation of benefits, weekly timesheets and payroll.
Responsible for managing and ordering patient medical supplies and office supplies.
Resposible for reviewing all documentation and perform chart audits.
Review and implement changes according to the profit and loss reports.
Develop and implement marketing and annual business plans.

RN Branch Manager/Patient Care Coordinator01/2010 to 04/2012
VNA-TIP HEALTHCARE – Murphysboro, IL

Managed three Hospice offices simultaneously.
Traveled from location to location on a weekly bases.
Overseeing staff, office's daily duties, electronic medical records, Quality Assurance Programs, Accounts Receivable and Payable.
Reviewing and approving payroll.
Staff hiring, staff evaluations, disciplinary actions and terminating staff.
Responsible for tracking Profit and Loss for the offices Responsible for Developing Annual Business Plan.
Staff included Nurses, Social Workers, Chaplains, Nursing Assistance, Medical Directors, Volunteer and QAPI Coordinators.

RN Case Manager PRN01/2010 to 01/2011
SOUTHERN ILLINOIS HEALTHCARE SIH – Herrin, IL

Patients from Pediatrics up to geriatrics) Ordering DME/Supplies/Community Services/Medications that patients may require.
Patient/Family Education Provide Education In services to Staff as well as all our contracted providers.
Responsible for Hiring/Terminating Employees, Staff Evaluations Contacting Insurance Companies, Medicare and Medicaid for Authorization Billing, Accounts payable and Payroll Assist with Marketing Plans Develop Annual Business Plan.
Prepare patients and family for discharge from Hospital to Home/Nursing Facility Ordering of DME/Supplies /Medications/Community services/ Therapy Services that patients may require upon discharge Working with Doctors, Therapy,Nurses and Dietary to develop plan for patients being dishcarged.
Case Managed variety of patients from Admission to Discharge.
Areas of Case Management (ICU,ER, MED/SURG, ORTHO,OBSERVATION and REHAB UNIT) Attended Case Management Daily Planning Meetings and Inservices Utilization Review (at times in absence of Full Time UR Nurse)

RN Case Manager01/2002 to 01/2010
Hospice of Southern Illinois – Marion, IL

Manage client care with specific knowledge and experience in bedside care, symptom management, crisis intervention and family intervention are feature assets for this high-profile nursing position.
Maintain excellent written/verbal communication, problem solving and decision making abilities.
Develop and maintain rapport with patients and families.
Maintain electronic medical records
Develop and implement Plan of Care
Provide information on patients with an interdisciplinary team.
Provide end of life care and support to patient and families.
Obtain and implement orders from patient's MD's.
Report to patients care team weekly.
Oversee Hospice aides and LPN's

Staff Nurse01/1999 to 08/2002
REA CLINIC – Christopher, IL

Room patients for physicians( Pediatrics/OB/GYN/Endocrinology/General Practice/Geriatrics) Perform patient history/assessments Administered Immunization/Medications.
Schedule referrals and appointments.
Contact insurance companies about benefit coverage Educate patient and family.
Set up and assist with procedures.
Order medical supplies/medications/therapy and community services for patients.

Resume Overview

Companies Worked For:

Health Force
Transitions Hospice Care
VNA-TIP HEALTHCARE
SOUTHERN ILLINOIS HEALTHCARE SIH
Hospice of Southern Illinois
REA CLINIC

School Attended

John A. Logan College

Job Titles Held:

RN Care Manager
Director of Operations/RN Patient Care Coordinator
RN Branch Manager/Patient Care Coordinator
RN Case Manager PRN
RN Case Manager
Staff Nurse

Degrees

Associate of Science : Nursing 2000

RN Care Manager Resume Example

Resume Score: 60%

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