Livecareer-Resume
Jessica Claire
  • Montgomery Street, San Francisco, CA 94105
  • H: (555) 432-1000
  • C:
  • resumesample@example.com
  • Date of Birth:
  • India:
  • :
  • single:
Professional Summary

Registered Nurse and Certified Case Manager with over 20 years of combined Case Management and Utilization Management experience.

Licenses

Registered Nurse in Tennessee

Certified Case Manager

Education and Training
Bachelor of Science: Nursing , Expected in 1985
-
Western Kentucky University - Bowling Green, KY
GPA:
Diploma Degree : Diploma in Nursing , Expected in 1982
-
Kentucky Baptist School of Nursing - Louisville, KY
GPA:
Professional Experience
Utilization Management Specialist , 08/2002 - Current
Adventist Health System Naperville, IL,

Facilitate optimal reimbursement through accurate certification and complete chart documentation. Conduct admission and continued stay reviews based on utilization review criteria. Refer and consult with the case manager and social worker to promote appropriate continued stay or discharge in the absence of definitive documentation and/or review criteria to support hospital stay. Experience with ICD 9 coding.

Healthcare Assessment Nurse and Disease Management Specialist , 04/1997 - 08/2002
Blue Cross, Blue Shield Of TN City, STATE,

On Site utilization review for acute hospital confinements for adults and pediatric members. Monitored utilization for HMO and PPO products, Utilized Milliman Criteria as management guideline

Case Manager for catastrophic cases for a managed Medicaid population, Coordinated health education and resources for members, Monitored and evaluated cost effectiveness and outcomes,

Director of Intake Coordination and Rehabilitation Nurse Coordinator, 09/1990 - 03/1997
Home Technology Healthcare City, STATE,

Implemented and managed a statewide central intake process for home care referrals, Managed growth of a referral base by an increase of 600% over 2 year period, Managed work flow of 13 staff members.

Registered Nurse in the Post Anesthesia Care Unit , 10/1986 - 09/1990
McFarland Hospital City, STATE,
Charge Nurse in the Emergency Department , 03/1986 - 10/1986
St Thomas Hospital City, STATE,
Charge Nurse in the Critical Care unit , 04/1985 - 03/1986
Tristar Hendersonville Hospital City, STATE,
Registered Nurse in Post Anesthesia Care Unit , 10/1982 - 04/1985
University Of Louisville Medical Center City, STATE,

,

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:

64Fair

resume Strength

  • Personalization
  • Target Job

Resume Overview

School Attended

  • Western Kentucky University
  • Kentucky Baptist School of Nursing

Job Titles Held:

  • Utilization Management Specialist
  • Healthcare Assessment Nurse and Disease Management Specialist
  • Director of Intake Coordination and Rehabilitation Nurse Coordinator
  • Registered Nurse in the Post Anesthesia Care Unit
  • Charge Nurse in the Emergency Department
  • Charge Nurse in the Critical Care unit
  • Registered Nurse in Post Anesthesia Care Unit

Degrees

  • Bachelor of Science
  • Diploma Degree

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

*As seen in: