RN Case Manager Resume Example Company Name

RN CASE MANAGER

Professional Summary

Organized and personable RN Case Manager with 11 years of experience in healthcare. Frequently commended for consistent patient advocacy and proficient communication. In-depth knowledge of case research and relevant regulatory standards. Well-qualified RN with full IL credentials and extensive experience in Acute care settings. Open and clear communicator with analytical problem-solving abilities and advanced clinical expertise.

Dedicated and compassionate Registered Nurse (RN) with progressive career history in direct patient care, and care coordination in fast-paced environment. Proven ability to remain calm under pressure and skillfully handle difficult patients and high-stress situations. Consistently developing strong relationships with patients and families through empathetic communication, respectful attitude and excellent customer service.

Skilled at Minimizing hospital stays through detailed focus on internal systems and individual patient need. 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

Case Management
Patient Care
Medication Administration
Discharge Planning
Medication Management
Insurance Knowledge
Managed Care

Health Education
Disease Management
Patient Care Coordination
Patient Evaluation
Acute Care
Staff Management
Treatment Planning

Work History

RN Case Manager, 05/2019 to Current
Company Name – City, State

Evaluate healthcare needs, goals for treatment and available resources of each patient and connect to optimal healthcare providers and care.
Took active role in patient and family discharge planning process, detailing instructions and responding appropriately and effectively to questions and concerns.
Used Meditech, Midas, Interqual, and Allscripts to maintain databases of relevant patient information for multidisciplinary teams to access and coordinate patient care.
Completed initial assessments of patients and family to determine and address individual home care needs.
Performed evaluations though daily rounds with multidisciplinary team members to address changes in patient needs, conditions and medications, altering care plans when required.
Acquired Insurance Precertification for medical treatment, transportation and Pre-authorization for transition of care facilities via clinical review.
Identify ICD 10 payor codes, procedure codes, and DRG.
Lead multi-disciplinary care plan teams and collaborations to including insurance, workman comp payers, patients and families.
Analysis of under/over utilization acute care by use of concurrent review/Interqual.
Educate providers on payor clinical documentation guidelines to positively impact the institutions financial reimbursement.
Coordinate high acuity Hospital transfers, DME, Home Health, SNF, LTACH and Hospice care services.
Identifying gaps or barriers to care plans and providing solutions to reduce re-admission.
Assign patient screens to CMA's, follow up with homehealth orders and Inform patients of their Medicare rights.

Pediatric Infusion/ Research RN, 05/2017 to 08/2020
Company Name – City, State

Initiated patient care meetings with multidisciplinary team to revise plan of care as patient condition warrants.
Educated patients on proper nutrition and medication side effects.
Educated family members and caregivers on patient care instructions.
Performed ongoing assessments to evaluate mental health needs, working with multidisciplinary team to develop, initiate, manage and modify individualized plans of care.
Adhered to strict safety measures by carefully determining proper dosages before administering medications.
Implemented care plans for patient treatment after assessing physician medical regimens.
Monitored patient reactions after administering medications and IV therapies.

Medical Surgical Telemetry Staff Registered Nurse, 09/2012 to 05/2018
Company Name – City, State

Monitored patients' conditions and reported changes in physical ability, appearance and behavior to discuss treatment with physicians.
Used first-hand knowledge and clinical expertise to advocate for patients under care and enacted prescribed treatment strategies.
Explained course of care and medications, including side effects to patients and caregivers in easy-to-understand terms.
Participated in education activities, including evidence-based practice project implementation, nursing competency development and nursing simulation activities.
Monitored patient condition, including interpreting and tracking EKG readings, identifying irregular telemetry readings and updating team members on changes in stability or acuity.
Vaccinated patients to protect individuals from measles, pneumonia, influenza and other illnesses of concern.

Medical Surgical Staff Registered Nurse, 04/2011 to 09/2012
Company Name – City, State

Managed caseload of 8 patients simultaneously by providing bedside care, treatments, IV therapy and wound care.
Started intravenous fluids, administered medications and documented patient charts by recording food and fluid output and intake.
Used Epic to document patient plan of care by taking into account nursing interventions, diagnosis and expected patient outcomes.
Accurately documented all elements of nursing assessment, including treatment, medications and IVs administered, discharge instructions and follow-up care.
Conveyed treatment options, diagnosis information and home care techniques to patients and caregivers to continue care consistency.
Provided skilled, timely and level-headed emergency response to critically-ill patients.
Followed all personal and health data procedures to effectively comply with HIPAA laws and prevent information breaches.

Education

Bachelor of Science: Nursing, 05/2010
Loyola University Of Chicago - City, State

Bachelor of Science: Psychology, 05/2010
Loyola University Of Chicago - City, State

Certifications

Licensed RN - 2010-2022
Basic Life Support Training - 2010-2022

Resume Overview

School Attended

Loyola University Of Chicago

Job Titles Held:

RN Case Manager
Pediatric Infusion/ Research RN
Medical Surgical Telemetry Staff Registered Nurse
Medical Surgical Staff Registered Nurse

Degrees

Bachelor of Science : Nursing , 05/2010
Bachelor of Science : Psychology , 05/2010

RN Case Manager Resume Example

Resume Score: 80%

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