Dedicated RN Case Manager with 20+ years of experience. Quality driven and efficient with strong interpersonal skills. Channels knowledge and leadership skills to provide training and support to all members of the healthcare team. Ensures continuity of care using optimal clinical resources to deliver exceptional patient care.
Professional Case Mgt. Exp. 20 yrs.
Management / Leadership Exp. 3+ yrs.
Acute Care Case Mgt. Exp. 7 yrs.
Utilization Review Exp. 7 yrs.
Staff Education / Teamwork
Problem Solve / Multi-Task
Strong Communication Skills
Accomplished Computer Skills
Policies & Budget Mgt.
Provide case management services to active duty service members, families, and retirees at a Level II Trauma Military Teaching Hospital in the internal medicine clinic, specialty clinics, MSW, and discharge planning. Perform comprehensive assessment of the physical and psychosocial needs of patients in order to provide age-specific care and services. Coordinate with patients, families, members of the health care team, and community. Helped patients/family navigate the healthcare system and care options by educating on relevant subject areas and answering questions throughout the treatment process. Discharge planning includes focusing on transitioning the patient from the MTF by arranging care needed that may include: skilled nursing/rehabilitation facilities, home health/hospice, durable medical equipment, and other community resources. Clear understanding of federal, state, and local guidelines. Direct experience working with Tricare, Medicare, Medicaid, and third party payors. Multi-task through prioritizing and planning. Knowledge to junior staff, supporting personal growth and enhancing professional development. Oversee monitoring of monthly of census in internal medicine and specialty clinics with average of 15 new referrals per month. Perform monthly utilization chart reviews using CMS, InterQual Level of Care, and Millman guidelines. Working knowledge of NCQA, HEDIS,and other regulatory standards. Electronic charting through AHLTA, CHCS, and Essentris. Accomplished computer skills include: Microsoft Word, Outlook, Excel, PowerPoint, Internet, and Intranet.
Focus on patient progress to decrease probability of re-hospitalization and providing care in the most cost effective manner with the goal of patient being independent with understanding and managing care. Collaborate with physicians on patient medical needs and treatment plan. Update and maintain discharge plan of care with physician, members of the healthcare team, patients, and families. Train, guide, and mentor home health team members to ensure all objectives were met. Utilization chart reviews to meet QI standards using the UM model. Ability to meet productivity and time management with minimal supervisory intervention through electronic charting using Meditech/PTCT and Cerner.
Nursing Administrator of the In Home Aide Department and the Adult Day Care Program supervising a staff of over 100 consisting RNs, LPNs, CNAs, and office staff. Responsible for the daily assessment, planning, implementation, coordination, and monitoring of the adult day care, PCS program through Medicaid, and the Block Grant program through Onslow County. In charge of hiring, orientation, and on the job training. Daily supervision of staff, mentoring, delegation of tasks, and conflict resolution to make recommendations and motivate employees to achieve peak performance and productivity. Serve as a conduit for positive patient and employee relations. Identify, resolve, and provide follow up on problems involving patients, employees, and or unit operations. Participate in long range planning, resource allocation, and marketing of services. Continue growth of patient census through patient surveys and the CAP and PCS programs through Medicaid to maintain and possible increase funding for staff and hours allocated for care. Model leadership behavior, for all employees, set expectations for teamwork, and hold staff accountable for job performance.
National Honor Society Inductee Fall 2018
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