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rn ltss case manager ccm resume example with 15+ years of experience

Jessica Claire
  • , , 609 Johnson Ave., 49204, Tulsa, OK 100 Montgomery St. 10th Floor
  • H: (555) 432-1000
  • C:
  • resumesample@example.com
  • Date of Birth:
  • India:
  • :
  • single:
Professional Summary

Certified Registered Nurse Case Manager with 6+ years MCO experience Case Manager Looking for a position in Case Management with an opportunity to transition into Utilization Management. Excellent communicator when interfacing with other teams, Interdisciplinary personnel, vendors and suppliers. Capable in troubleshooting complex problems and developing individualized resolutions.

Skills
  • Managing Member Cases
  • Disease Processes
  • Member Health Care Assessment
  • Preventive Healthcare
  • Compassionate and Caring
  • Medical Recordkeeping
  • Clear Patient Communication
  • EMR Systems
  • Personnel Supervision and Oversight
  • Delegation and Motivation
  • Active Listening
  • Alternative Therapies
Work History
RN LTSS Case Manager, CCM, 05/2016 - Current
University Village Tulsa, OK,
  • Managed Caseload of up to 62 community based MCO members to provide individualized health care plan and implementation.
  • Performed assessments on regular basis to address changes in member needs, conditions and medications, altering care plans when required.
  • Completed initial assessments of members incorporating family and caregivers to determine and address individual home care needs.
  • Participated in member and family planning process, as well as provided instructions and addressed question and concerns.
  • Assessed members and documented history of current and previous conditions, illnesses, injuries and current medications.
  • Evaluated treatment plans against individual goals and healthcare standards.
  • Worked with suppliers and vendors on provision of medical equipment, items and services.
  • Trained new Case Managers in proper techniques, care standards, operational procedures and safety protocols.
  • Conferred with physicians to discuss diagnoses and devise well-coordinated treatment approaches.
  • Reviewed and enforced education on proper wound management, discharge plan objectives, safe medication use and disease management with member and caregiver following facility discharges.
  • Updated member electronic medical records with data such as medications to keep records current.
  • Advocated for members by communicating care preferences to practitioners, verifying interventions met treatment goals and identifying insurance coverage limitations.
  • Educated members and loved ones about different treatment options and outside care approaches to reduce burden on hospital resources.
  • Evaluated healthcare needs, goals for treatment and available resources of each member and connected to optimal providers and care.
  • Educated members, families and caregivers on diagnosis and prognosis, treatment options, disease process and management and lifestyle options.
  • Managed support services and fostered communication among social workers, therapists, and physicians.
  • Oversight of 7 contracted case managers for specialized population to meet specific needs
  • Assess and address social determinants of health for improved individual health outcomes.
Charge Nurse, 06/2008 - 05/2016
Northshore Niles, IL,
  • Monitored nursing care, patient assessment processes and treatment implementations.
  • Trained new nurses in proper techniques, care standards, operational procedures and safety protocols.
  • Implemented quality patient care techniques to align with safety, health and organizational regulations.
  • Interacted smoothly with patients and loved ones, updated on care plans and advocated for needs.
  • Coordinated nursing care on unit through staff assignments, assisting and rounding with physicians, monitoring patient orders and communicating with ancillary departments.
  • Cared for patients' wounds and changed dressings.
  • Managed various medications and treatments such as peritoneal dialysis, IV push, oral, subcutaneous, IV infusion and and intramuscular injections.
  • Documented medications administered, treatments and patient procedures performed in appropriate records according to privacy requirements.
  • Supervised patient admissions and discharges from hospital to home care, rehabilitative facility or self-care.
  • Educated patients and caregivers of various available external resources to support wound management, disease management and medication administration.
  • Directed patient care activities, guided and trained RNs, LPNs and CNAs during shift.
  • Quickly responded to situations impacting safety and security to unit, actualizing crisis prevention interventions to control and de-escalate situations.
  • Cared for patients in 22-bed unit, supporting fellow nurses in delivering outstanding treatment to patients.
Staff Nurse, 06/2007 - 10/2008
Genesis Healthcare City, STATE,
  • Implementing nursing process to provide care to patients on 20 bed Long Term Care Unit.
  • Observe patients, document patient data and reporting changes in patient conditions, such as adverse reactions to medication or treatment, and taking any necessary action
  • Administer prescribed medications per prescribers orders and according to safety protocols and patients 5 Rights.
  • Provide patient care or treatments, such as taking temperatures or blood pressures, dressing wounds, treating bedsores, giving enemas or douches, rubbing with alcohol, massaging, or performing catheterizations
  • Measure and record patients' vital signs, and asses vitals for notable changes in individual patient trends and report as needed.
  • Directed patient care by initiating and following through with plan of care, continuing care, and transition of care.
  • Monitored patients' conditions and reported changes in physical presentation, appearance and behavior to discuss treatment with physicians.
  • Implemented medication and IV administration, catheter insertion, chest tube management.
Education
Associate of Applied Science: Nursing, Expected in 05/2008
-
Delaware Technical & Community College - Dover, DE
GPA:
Status -
Certifications

CCM: Certified Case Manager

Commission for Case Management Certification Mt Laurel Township, NJ

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Resume Overview

School Attended

  • Delaware Technical & Community College

Job Titles Held:

  • RN LTSS Case Manager, CCM
  • Charge Nurse
  • Staff Nurse

Degrees

  • Associate of Applied Science

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