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

Case Manager with 24 years in healthcare.Ten years as a Case Manager skilled in providing assessment and coordinating discharges to skilled nursing facilities, sub acute units, LTAC's, dialysis, home infusion, home tracheostomy and tube feeding, home health care, all durable medical equipment and hospice care. Review charts for medical necessity utilizing Interqual Criteria.

Licenses

License # (provided on request)RN California and Tennessee; Expires 2016; Licensed Registered Nurse RN; CERTIFIED LEGAL NURSE CONSULTANT Vickie Milazzo Institue, Houston, Tx

Skill Highlights
  • Certified Legal Nurse Consultant
Professional Experience
06/2008 to Current RN HOSPITAL CASE MANAGER/DISCHARGE PLANNER Methodist Rehabilitation Hospital | Dallas, TX,

Assessment of discharge planning needs, placement for skilled nursing, long-term care, home care or hospice. Utilization review per InterQual criteria. Coordinated all aspects of discharge planning for patients including durable medical equipment, home care, hospice, SNF, and home infusion.

to 06/2008 HOSPITAL PATIENT CARE COORDINATOR Methodist Rehabilitation Hospital | Dallas, TX,

Assess and plan for discharge needs, placement; infusion; home health; snf; hospice; long term care;Utilization review per Interqual Criteria. Travel Assignment

08/2007 to 11/2007 RN HOSPITAL CASE MANAGER/DISCHARGE PLANNER Methodist Rehabilitation Hospital | Dallas, TX,

1555 Soquel Dr., Santa Cruz, Ca; HOSPITAL CASE MANAGER/DISCHARGE PLANNER Assessment of discharge needs, plan admit to SNF, long term care, home care, home infusion, and hospice. Coordinate plan for discharge home, durable medical equipment, home infusion, skilled nursing facility, and hospice.

08/2006 to 03/2007 RN HOSPITAL CASE MANAGER/DISCHARGE PLANNER Ascension (System Office) | Whitwell, TN,

Assessment of patient discharge planning needs, placement for skilled nursing, custodial, long-term care, board and care facilities. Coordinate home health, hospice, palliative care, and transportation. Ordered durable medical equipment for patient discharge home and any other discharge planning needs. Travel assignment.

10/2005 to 08/2006 Registered Nurse OUTPATIENT UTILIZATION MANAGER Victory Management Group | City, STATE,

Precertification of all outpatient surgery and radiology/diagnostic testing per InterQual criteria and Medicare guidelines.

03/2005 to 10/2005 RN GASTROENTEROLOGY/ENDOSCOPY Heritage Medical Group | City, STATE,

Admissions of clients health history, start and dc'd IV's, administered conscious sedation, GI/ENDO procedures including colonoscopy, EGD's, polypectomy, biopsy, dilatation, cleaned scopes, recovery of clients and discharge.

06/2001 to 01/2005 Registered Nurse DME COORDINATOR HEALTHSPRING, LLC | City, STATE,

UTILIZATION REVIEW Precert and authorize all DME for members within company policy and Medicare guidelines. Provides frontline service to DME vendors. Precert all power wheelchairs and specialty equipment, infusions, and enteral feeding. Also help to provide inservice information to new providers and customer service as well as co-workers and case managers. Review appeal charts with medical directors when requested, review ER charts for retro payment for appeals unit and other retro/appeal charts for medical directors.

06/1999 to 06/2001 Registered Nurse Baptist Hospital, Church Street | City, STATE,

EARLY MORNING ADMISSIONS Admission assessment through patient history and physical assessment.Notify appropriate staff member, MD, or Anesthesiologist of abnormal labs or pertinent history. Administer preop medications and manage all care prior to surgery. Receive post-op patients, assess, plan discharge and manage post-op recovery. Teach patient and family discharge care.

05/1998 to 04/1999 Registered Nurse Xantus Corporation | City, STATE,

(Formerly Phoenix HC), 3401 West


End Ave., Nashville, Tn.DME COORDINATOR Preauthorize and recert all durable medical equipment within guidelines and criteria set by company policy as well as per Medicare/Medicaid guidelines. Precert and verify member eligibility for members in the state of Tennessee. Provide frontline service to DME vendors, physicians, and members. On 24 hour call every 5 weeks. Data entry in AS400 and First Stepp and certified in Interqual training.

07/1997 to 02/1998 Registered Nurse Home Technology Health Care | City, STATE,

Mt. Juliet, Tn


R.N. INTAKE COORDINATORProvided front line service as well as back line service to providers.Verified insurance and precertification. Provided recerts and authorization for providers and case management. Reviewed and authorized managed care cases. Also coordinated patient care with affiliates for the state of Tennessee. MBI and data entry. On 24 hour call every 4 weeks. 08/31/2012 9/30/12

05/1995 to 07/1997 Registered Nurse House Supervisor MCKENDREE VILLAGE | City, STATE,

include supervision of CNA's, LPN's, and RN's. Coordination of shifts and assignments for flex shift personnel, current assessment of census, notification of families and physicians regarding changes in residents condition and/or emergency situations, monitoring of emergency equipment, evaluation of residents on restraint programs. Also includes coverage of units as needed, filling in as Charge nurse when needed, as well as functions of supervisory nature. Duties also include assessment of geriatric residents, individualized care planning, MDS, Quarterly Assessments, and RAPS, as well as filling out all insurance forms for residents in accordance with Medicare guidelines. Responsible for filling out PAE's (preadmission assessment) to qualify residents for Medicare.

Education and Training
Expected in ASSOCIATE | NURSING Central Texas College, Killeen, Texas GPA:
Skills
UTILIZATION REVIEW, MEDICARE, CUSTOMER SERVICE, RECEPTIONIST, RETAIL SALES, VANTAGE, R.N, R.N., GERIATRIC, RAPS, ASSOCIATE, DATA ENTRY, AS400, MEDICAID, TRAINING, DISCHARGE PLANNING, OUTPATIENT, RADIOLOGY, TESTING, CUSTODIAL, CLIENTS, GASTROENTEROLOGY, RN, CASE MANAGEMENT, CASES, MANAGED CARE, LONG TERM CARE, BOARD OF REGISTERED NURSING, REGISTERED NURSING, SAN, STORAGE AREA NETWORK, REGISTERED NURSE

By clicking Customize This Resume, you agree to our Terms of Use and Privacy Policy

Disclaimer

Resumes, and other information uploaded or provided by the user, are considered User Content governed by our Terms & Conditions. As such, it is not owned by us, and it is the user who retains ownership over such content.

How this resume score
could be improved?

Many factors go into creating a strong resume. Here are a few tweaks that could improve the score of this resume:

62Fair

resume Strength

  • Personalization
  • Target Job

Resume Overview

School Attended

  • Central Texas College

Job Titles Held:

  • RN HOSPITAL CASE MANAGER/DISCHARGE PLANNER
  • HOSPITAL PATIENT CARE COORDINATOR
  • RN HOSPITAL CASE MANAGER/DISCHARGE PLANNER
  • RN HOSPITAL CASE MANAGER/DISCHARGE PLANNER
  • Registered Nurse OUTPATIENT UTILIZATION MANAGER
  • RN GASTROENTEROLOGY/ENDOSCOPY
  • Registered Nurse DME COORDINATOR
  • Registered Nurse
  • Registered Nurse
  • Registered Nurse
  • Registered Nurse House Supervisor

Degrees

  • ASSOCIATE

By clicking Customize This Resume, you agree to our Terms of Use and Privacy Policy

*As seen in: