Spinal Cord Stimulator Case Manager/ Pre-op-PACU RN, Nursing Supervisor Resume Example
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SPINAL CORD STIMULATOR CASE MANAGER/ PRE-OP-PACU RN, NURSING SUPERVISOR
Professional Summary
Highly experienced nursing professional with exceptional critical thinking and sound clinical judgment developed over a 30 year career. Self-directed, efficient nurse seeking position as Musculoskeletal Orthopedic Care Manager in your diverse healthcare company. Ready to use diverse knowledge base and experience to leverage resources, remove barriers and create quality outcomes in a cost effective manner.
Skills
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Work History
Spinal Cord Stimulator Case Manager/ Pre-op-PACU RN, Nursing SupervisorAug 2016 - Current
Humana Inc.Macon , GA
Humana Inc.Macon , GA
- Determined medical necessity for spinal cord stimulator trial/permanent implantation, kyphoplasty and Vertiflex procedures
- Reviewed medical records looking at physician/mid-level/physical therapy/radiology documentation for completeness and accuracy prior to sending to attorneys and/or insurance companies
- Concurrent and retrospective review of records for appropriate ICD-10 codes and CPT codes to reduce insurance denials, rejections and need for re-submits
- Planned and prepared for pre-operative nursing care of out-patient orthopedic and pain management patients
- Coordinate with physician's team to ensure all required documents were submitted for authorization in timely manner
- Made appointment for MD/PA for peer review
- Communicated status of pending auth cases with patient
- Educated patients and their families on orthopedic and pain management procedures
- Provided optimal post-op care during patient's recovery from anesthesia in outpatient surgery setting
- Functioned as both scrub and circulator in interventional pain management operating room including injections and surgeries such as kyphoplasty, spinal cord stimulator trials/implantations, and Vertiflex
- Evaluated and assessed patient medical status using histories, review of medical records, labs, and other tests to accurately determine current health status and appropriateness for outpatient surgery
- Delegated tasks and supervised activities of other licensed and unlicensed care providers
- Coordinated care with physicians and other clinical staff to prepare for treatment, perform interventions and enhance continuum of care to deliver comprehensive services
- Trained and mentored new RN's on best practices, surgery center policies and standards of care
- Recruited and hired intelligent clinical staff to bolster skills set of already talented team
- Collaborated with multi-disciplinary staff to improve overall patient care
- Evaluated employee job performance, and motivated staff to improve productivity
- Engaged employees in progressive discipline up to and including termination
- Developed and implemented staffing plans/schedules for shifts based on patient acuity, patient census, and available staff
Telephonic Nurse Case ManagerJul 2015 - Jul 2016
Raymond School DistrictRaymond , NH
Raymond School DistrictRaymond , NH
- Independently managed 250 Medicare clients telephonically assisting them to meet their health care goals while meeting company matrix (% reach, talk time, referrals, participation in program)
- Telephonically assess members functioning to evaluate their needs and requirements to achieve and/or maintain their optimal wellness state
- Utilized empathy and motivational interviewing along with assessment data to assist members to move health status along their health continuum
- Guide members and their families toward resources appropriate for their care and well-being
- Educate members regarding Medicare, their basic coverage, and how to resolve issues within the health care system
- Utilized advanced technological and PC skills with different Microsoft programs to document in electronic medical record systems
- Instructed members and caregivers on diagnoses, chronic disease management and prevention, as well as medication self-management to maintain continuum of care
- Collaborated with interdisciplinary healthcare professionals to create, implement and adapt individualized plans of care to restore patients' health and drive recovery goals
- Counseled members and caregivers, providing emotional, psychological and spiritual support
- Advocated for members needs with interdisciplinary team and implemented outlined treatment plans
School Registered NurseMar 2008 - Jun 2015
Beth Israel Deaconess Medical CenterHanson , MA
Beth Israel Deaconess Medical CenterHanson , MA
- Supervised three elementary school clinics comprised of a total of 2300 students, 260 teachers and staff
- Student and staff visits totaled over 25,000 annually
- Conducted student assessments and screening exams to identify high risk students in need of additional school, community or medical services
- Administered medications and performed procedures, according to physician orders, to students and monitored responses
- Monitored and recorded student condition, vital signs, recovery progress and medication side effects
- Counseled caregivers, families, and teachers on variety of health prevention/promotion/maintenance topics to ensure student could remain in school, if possible, with the goal of increasing learning time
- Coordinated with school team and parents to establish student's needs and develop plans to ensure those needs are met during all school activities
- Advocated for student needs with interdisciplinary team and ensured that plans were implemented appropriately
- Responded to emergency situations with speed, expertise and level-headed approaches to provide optimal care, support and life-saving interventions
Nurse Case ManagerMay 2006 - Aug 2008
Gentiva Home Care ServicesCity , STATE
Gentiva Home Care ServicesCity , STATE
- Managed a case load of 30-45 patients as case manager for a home health agency including scheduling all nursing and ancillary visit according to Medicare and commercial insurance guidelines
- Develop, implement, evaluate and revise the plan of care in accordance with the physician orders and Medicare guidelines
Education
MBA: Business AdministrationSacred Heart UniversityCity, State
Master of Science: NursingSacred Heart UniversityCity, State
Bachelor of Science: NursingRussell Sage CollegeCity, State
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Resume Overview
School Attended
- Sacred Heart University
- Russell Sage College
Job Titles Held:
- Spinal Cord Stimulator Case Manager/ Pre-op-PACU RN, Nursing Supervisor
- Telephonic Nurse Case Manager
- School Registered Nurse
- Nurse Case Manager
Degrees
- MBA : Business Administration
Master of Science : Nursing
Bachelor of Science : Nursing
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