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JC
Jessica Claire
, , 100 Montgomery St. 10th Floor (555) 432-1000, resumesample@example.com
Professional Summary

Compassionate, accomplished and knowledgeable Nurse Case Manager offering 20 years of experience working with patients and families to facilitate smooth transitions following discharge from medical facilities. Good at troubleshooting care coordination and transitions problems and building successful solutions. Dedicated and committed to working collaboratively with health plan, leadership and the healthcare team to achieve highest quality of patient satisfaction. Well versed in developing individualized patient centered care plans and advocating patient welfare. The total sum of experience has been invaluable and afforded opportunities to serve the community, utilizing skills in the private, public, state and faith-based arenas.

Skills
  • Care Coordination, discharge planning and resource management
  • Communication both written and verbal
  • Multidisciplinary team collaboration
  • Problem Solver and critical thinker
  • Detail-oriented
  • Organized able to set priorities and meet deadlines
  • Special sensitivity and cultural competency to meet
    needs of diverse populations
  • Proficient in Microsoft Word, PowerPoint and Epic
Work History
03/2007 to Current RN Case Manager - Kaiser Foundation Rehab Center Centene Corporation | Mooresville, NC,
  • Assessed, planned organized, coordinated, implemented, monitored evaluated patient care plans, services and resources, responding to patients healthcare needs in acute inpatient rehabilitation setting.
  • Established realistic, patient-centered goals to achieve optimal outcomes for patients who require 24/7 care that will be at home as well as realistic goals for caregiver education
  • Collaborated with patients and families, physicians, alongside multidisciplinary team of healthcare professionals, to meet goals of care.
  • Coordinated appropriate transitions in care including discharge to other health care settings or community, in collaboration with healthcare team and providers.
  • Contributed to 4 successful Commission on Accreditation of Rehabilitation Facilities (CARF) accreditation surveys, specifically working on Brain Injury Program Team
  • Provided support in pre- admission liaison role, screening for medical stability, readiness for program participation, and that services were medically necessary. This was achieved by utilizing Center for Medical Services ( CMS) criteria including plan for discharge to community . This is done in collaboration with physical medicine and rehabilitation physician
  • Represented case management in Quality Improvement project's working within multidisciplinary team and committees as part of Kaiser Foundation Rehabilitation Center continuous quality improvement initiatives.
11/2006 to 03/2007 RN Case Manager - Kaiser Foundation Rehab Center Discharge Resource Group Staffing Agency | City, STATE,
  • Assessed, planned organized, coordinated, implemented, monitored evaluated patient care plans, services and resources, responding to patients healthcare needs in acute inpatient rehabilitation setting.
  • Established realistic, patient-centered goals to achieve optimal outcomes for those individuals who require 24/7 care that will be at home, establishing realistic goals for caregivers education
  • Collaborated with patients and families, physicians, alongside multidisciplinary team of healthcare professionals, to meet goals of care.
  • Coordinated appropriate transitions in care including discharge to other health care settings or community, in collaboration with healthcare team and providers.
11/2002 to 11/2006 Manager - Utilization Management Children's Hospital And Research Center Oakland | City, STATE,
  • Directed and managed utilization review activities for 180-bed acute pediatric facility.
  • Obtained authorizations from multiple insurance carriers for various levels of care.
  • Oversaw and managed 3 clinical and support staff who prepared documentation for commercial and federal payors.
  • Produced monthly reports used to track and manage department productivity.
01/2002 to 03/2022 Discharge Planner - ICU/CCU Marin General Discharge Resource Group Staffing Agency | City, STATE,
  • Performed hospital admission and concurrent clinical review using InterQual medical management criteria for 235 bed facility
  • Developed, coordinated and facilitated comprehensive discharge plans in collaboration with patient/families
  • Coordinated and participated in family meetings to assist patient/families in defining goals of care.
08/2002 to 12/2002 RN Case Manager- KP National Transplant Network Discharge Resource Group Staffing Agency | City, STATE,
  • Assessed need for, ordered, obtained and interpreted lab and imaging in preparation for patients needing solid organ transplantation
  • Liaison between patients and physicians to ensure patient understanding of treatment plans.
  • Collaborated with clinicians to manage effective ongoing care plans.
  • Managed 10-15 patients/day
Education
Expected in 2017 Bachelor of Science | Nursing Grand Canyon University, Phoenix, AZ GPA:
Expected in 1982 State Registered Nurse | Bromley Area School of Nursing, Farnborough, GPA:
Certifications
  • California Registered Nurse License # 405411
  • Certified Rehabilitation Registered Nurse (CRRN)
  • Certified Case Manager (CCM)
  • Basic Life Support (BLS)
Affiliations
  • Association of Rehabilitation Nurses Northern California Chapter Treasurer (2014- 2020) – Current President 2021
  • American Nurses Association (ANA)
  • Case Management Society of America (CMSA)
  • Brain Injury Association of California ( BIACAL)
  • Ability Now Bay Area (ANBA) Secretary 2017 to present
  • Ala Costa Centers - 1998 - 2013 Board Member, President 15 yrs.
  • Liberty Church Fairfield Ca - Caring Hands (Champions Club) - Special Needs Ministry Lead – 12 yrs. – Critical Care Ministry Lead – Short Term Case Management Services – 2009 to present

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Resume Overview

School Attended

  • Grand Canyon University
  • Bromley Area School of Nursing

Job Titles Held:

  • RN Case Manager - Kaiser Foundation Rehab Center
  • RN Case Manager - Kaiser Foundation Rehab Center
  • Manager - Utilization Management
  • Discharge Planner - ICU/CCU Marin General
  • RN Case Manager- KP National Transplant Network

Degrees

  • Bachelor of Science
  • State Registered Nurse

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