Workers' Compensation Medical Case Manager Resume Example NJM Insurance

WORKERS' COMPENSATION MEDICAL CASE MANAGER

Professional Summary

Dedicated Workers Compensation Case Manager with over 24 years of experience providing compassionate healthcare for injured workers in a cost effective manner with the goal of returning patients back to work. Proficient in assessing patients' health issues and needs. Helpful and highly-skilled with creating individualized treatment plans to assist patients and families. Ready to bring excellent communication skills in order to work with multidisciplinary medical team for individualized patient care. Able to accurately document patient care, treatment, goals. Demonstrates the ability to assess patient needs, direct to appropriate medical providers and work effectively with medical team and families in order to obtain successful return to work. organization talents and a strong work ethic.

Skills

Conflict resolution
Detail-oriented
Teamwork
Relationship-Building
Written Communication

Computer skills
Critical thinking
Multitasking abilities
Collaboration

Work History

Workers' Compensation Medical Case Manager, 07/2009 to Current
NJM Insurance – Trenton, NJ

Helped patients receive appropriate,high-quality care with reasonable results.
Partnered with physicians, social workers, activity therapists, nutritionists and case managers to develop and implement individualized care plans and documented all patient interactions and interventions in electronic charting systems.
Reduced care costs without sacrificing quality through effective service coordination and multidisciplinary collaboration.
Took active role in patient and family planning process, detailing instructions and responding appropriately and effectively to questions and concerns.
Addressed disruptions in patient care, including delays in discharge, postponed procedures and discharge equipment unavailability.
Worked with different disciplines to provide cohesive care to patients.
Coordinated care of injured workers by liaising with hospital staff to organize treatments and program resources.

Senior Workers' Compensation Nurse Case Manager, 04/1995 to 07/2009
Liberty Mutual Insurance – Marlton, NJ

Established realistic, measurable and observable goals consistent with patients' diagnosis.
Educated patients and caregivers on disease processes, medications, plans of care and individualized treatment plans.
Coordinated care of injured workers by liaising with hospital staff to organize treatments and program resources.
Addressed disruptions in patient care, including delays in discharge, postponed procedures and discharge equipment unavailability.
Consulted with clinicians to devise and manage effective ongoing care plans for at-risk patients.
Worked with different disciplines to provide cohesive care to patients.
Identified care needs of individual patients and coordinated responses based on physician advice, insurance limitations and procedural costs.
Reported plans, findings and results to employers and insurance carriers.

Nurse Manager, 02/1987 to 05/1995
Virtua Memorial Hospital – Mt. Holly, NJ

Established and continuously optimized unit schedules and individual work assignments.
Supervised, directed and motivated high-quality performance from nursing staff.
Trained new nurses in proper techniques, care standards, operational procedures and safety protocols to optimize performance and safety.
Reviewed department performance and adjusted coverage to compensate for changing conditions.
Evaluated skills of all nursing personnel and verified staff certifications for validity.
Investigated and independently resolved complaints from staff, physicians and patients by leveraging clinical judgment and unit management expertise.
Advised caregivers and family members in providing emotional and psychological care to support patient needs.
Exercised exemplary clinical judgment when making care decisions.
Actively engaged and participated in consults, patient care plan development and patient monitoring.
Effectively communicated with physicians regarding patient needs, performance, medications and changes.
Strengthened unit care standards and policies with focus on patient safety and dignity.
Guided and led RN's, CNA's,Telemetry Tech's and Unit Secretaries in 42 bed acute care unit and coordinated, delegated tasks.
Worked within interdisciplinary health care team to develop, implement and make adjustments to patient care plans, individualizing strategies and methods to improve health and meet recovery goals.
Conferred with physicians to discuss diagnoses and devise well-coordinated treatment approaches.
Worked within interdisciplinary health care team to develop, implement and make adjustments to patient care plans, individualizing strategies and methods to improve health and meet recovery goals.
Effectively prioritized assignments, executing care based on each patient's relative condition and delegating tasks to available personnel deliver safe and efficient care.
Monitored patient condition, including interpreting and tracking EKG readings, identifying irregular telemetry readings and updating team members on changes in stability or acuity.
Delivered outstanding care to patients with various diagnoses and managed care from treatment initiation through to completion.
Observed and reported patient condition, progress and medication side effects to accurately document updates.
Educated patients and answered questions about health condition, prognosis and treatment.

Medical Telemetry Unit Registered Nurse, 06/1980 to 02/1987
Virtua Memorial Hospital – Mt. Holly, NJ

Implemented care plans for patient treatment after assessing physician medical regimens.
Educated patients, families and caregivers on diagnosis and prognosis, treatment options, disease process and management and lifestyle options.
Trained new nurses in proper techniques, care standards, operational procedures and safety protocols to optimize performance and safety.
Provided exceptional care to 4 high-acute patients needing complex care such as ventilator management, extensive wound care and rehabilitation.
Communicated with healthcare team members to plan, implement and enhance treatment strategies.
Adhered to strict safety measures by carefully determining proper dosages before administering medications.
Collaborated with physicians to quickly assess patients and deliver appropriate treatment while managing rapidly changing conditions.

Education

High School DiplomaJohn F Kennedy High School - Willingboro, NJ

Associate of Science: Registered NurseHahnemann University - Philadelphia, PA

Resume Overview

Companies Worked For:

NJM Insurance
Liberty Mutual Insurance
Virtua Memorial Hospital

School Attended

John F Kennedy High School
Hahnemann University

Job Titles Held:

Workers' Compensation Medical Case Manager
Senior Workers' Compensation Nurse Case Manager
Nurse Manager
Medical Telemetry Unit Registered Nurse

Degrees

High School Diploma
Associate of Science : Registered Nurse

Workers' Compensation Medical Case Manager Resume Example

Resume Score: 80%

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