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Nurse Case Manager Resume Samples
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Candidate Info
years in workforce
years at this job
Management
Health Care Administration
Nurse Case Manager
- Improved quality of member care and lowered costs by providing coordination of services through collaboration with health care team.
- Prevented unnecessary hospital admissions when at-home care or nursing facility would best serve the member's needs through utilization of a broad range of resources.
- Proactively assessed potential problems and initiated solutions utilizing Best Nursing Practices.
- Provided a Case Study which was highlighted in the 2010 Annual Report.
Candidate Info
years in workforce
years at this job
Nursing
Telephonic Nurse Case Manager
Managed Short Term Disability and FMLA leaves of up to 350 of our client's (corporations and hospitals) employees.
- Established and maintained communication via telephone with clients and their employees regarding their STD/FMLA cases.
- Ensured that employees were in compliance with their company's leave policies and procedures.
- Consulted with physician medical reviewers to determine if medical documentation substantiated the leave requested - initially and throughout the course of the case.
- Maintained complete and accurate computerized management notes on each case.
- Clarified and coordinated return to work to ensure employee returned to work in a safe and timely manner.
- Assisted with quarterly QA.
Candidate Info
years in workforce
years at this job
Nursing
Public Health Nursing Administration
Nurse Case Manager
Provide behavior health related care to military child, adolescent, and adult dependents
- Manage clinic's referral queues which average approximately 400 referrals per month
- Provide case/disease management services to high risk families (children/adolescents diagnosed with autism, bipolar D/O, MDD, etc.) and to families enrolled in TRICARE special programs
- Developed six tracking tools for clinic pertinent data
- Collaborate with clinic providers to develop appropriate care plans for high risk families
- Coordinate and facilitate services with internal and external resources
- Created and managed patient satisfaction program (TJC PI project)
Candidate Info
years in workforce
years at this job
Nursing
Nursing-nurse Administration
Delegating Nurse Case Manager
Complete initial and forty-five day ongoing assessment to Assisted Living Facility Residents
- Instruct board approved Medication Administration Training Program for qualified Assisted Living staff
- Continually assess the competency of the Medication Technician Participated in the quality improvement pharmacology process
- Provide onsite staff in-services, initial and ongoing trainings as it relates to the care of the assisted living patient population
- Train students for Board approved 20 clock hour Medication Administration Training Program; through lectures, role-playing, group activity, and laboratory practice Ensuring program meets federal and state training requirements of Certified Medication Technician in the state of Maryland.
Candidate Info
years in workforce
years at this job
Nursing
Nurse Case Manager
Utilization Management - initial review, Concurrent review, Pre determination, Pre-certification.
- Case management ( managed over 80 members)
- Disease management
- Determine appropriate level of care while consulting with Medical Director as needed.
- Outreached to members and performed pre-admission counseling and post discharge assessment to promote optimal health and prevent re-hospitalization.
- Ensured compliance to rules, regulations and policies established by the organization.
Candidate Info
years in workforce
years at this job
Associate of Applied Science
Nursing
Registered Nurse Case Manager/team Manager
Assigned to a hospice/palliative care team as a home care nurse. Play a key role on an interdisciplinary team that includes a Chaplain, social worker, registered nurses, nurse aids and physician. Treat an average of 18 patients weekly. Assists in providing medical and non-medical interventions to patients to ensure the last days of life are as comfortable as possible. Assess patients for hospice appropriateness for admission into the hospice program and recertification. Provide education to patients and families about the differences between curative and palliative care, insurance coverage, and medications for end-of-life care.
- Chosen over peers for the position as Team Manager.
- Supervise a staff that includes 1 physician, 4 RN Case Managers, 1 Chaplain, 1 Social Worker and 6 Nurse Aides.
- Awarded the Vitas Leadership Council award for outstanding service in 2010.
- Recognized member of the mentor group chosen to train new nursing staff and mentor new and existing team members.
Candidate Info
years in workforce
months at this job
Registered Nurse Case Manager
Assessed need for, ordered, obtained, and interpreted appropriate lab tests
- Responsible for patient care plans, as well as educating patients and their families on home and overall health care
- Supervised, scheduled, trained and motivated ancillary staff
- Educated patients and families in medical diagnosis, treatment, and prognosis
- Collaborate with physicians and the agency in patient care planning, management, and implementation
- Medical record input and documentation
- Evaluates and documents the progress of indivdual therapeutic programs and makes modifications as required
- Oversaw and managed case load of 40 patients
Candidate Info
years in workforce
years at this job
Nursing
Registered Nurse Case Manager
Managed care of up to 15 patients at end of life with interdisciplinary hospice team
- Provided individualized symptom management for patients with various diagnoses and end of life symptoms
- Evaluated patient appropriateness for hospice level of care in accordance with Medicare guidelines
- Performed on call symptom management and bereavement visits after normal business hours
Candidate Info
years in workforce
years at this job
Nursing
Bilingual Telephonic Nurse Case Manager
Provided telephonic case management for high-dollar, chronically ill or end-stage patients, with a high percentage of oncology patients. Evaluated member's health needs to promote safe, quality care and identify medically appropriate and cost-effective care. Utilized nursing method to develop a plan of care to meet patient needs and provide for best possible outcome.
- Assisted with access to required services via referral to social worker, primary care provider, and other medical personnel as needed. Followed up with member, client, caregiver, and/or PCP.
- Educated client on disease process and pharmacological changes.
- Encouraged self-care and empowerment of client as related to condition.
- Ensured that appropriate care and follow-up was provided by caregiver and providers, while attempting to reduce costs.
Candidate Info
years in workforce
years at this job
Nursing
Nurse Case Manager
Provided telephonic case management for clients of Professional Dynamics, including onsite at Athens Administrators, Irvine, CA and remote for BART (Bay Area Rapid Transit).
- Acted as liaison for injured workers, coordinating treatment, services and providing education. Communicated with claims examiners, physicians and health care providers.
- Prepared reports documenting file activity, keeping the account closely informed.
- Conducted embedded Utilization Review and coordinated referrals as indicated to the designated review organization.
Candidate Info
years in workforce
year at this job
Nursing
Registered Nurse Case Manager
Initialized/implemented plans of care for homebound clients through assessment and revision.
- Taught appropriate care, health practice, and treatment to family members/ caretakers.
- Supervised LPN/Home Health Aides according to regulatory protocol.
- Developed and maintained expected standards of quality client care within the scope of professional nursing practice.
Candidate Info
years in workforce
months at this job
Nursing
Fine Arts
Master of Arts
Nurse Case Manager
Passed Prophecy RN Case Manager Exam
- Worked in nine different computer programs
- Validated temporary physical profiles to ensure assessment accuracy
- Reviewed physical profiles and updated records based on research
- Communicated effectively with Soldiers, Commanders, Unit Authorities
- Reviewed and processed cases in collaboration with the RSC/MSC Surgeons for the US Army Reserve Command-Medical Management Center for wounded US Army Reserve soldiers, wounded veterans on active duty as they transitioned to US Army Reserve Soldiers after returning from active duty in Afghanistan and other Foreign Service locations.
- Received commendations from US Army Surgeon, LTC Jerry Tolbert MD and LTC Zandra Day, RN CCM, administrator for this program (see attached letter of Commendation) for recognition of outstanding reportage and accurate documentation for multiple Line Duty Incident reports for injured soldiers, which later served as examples for training other nurses.
Candidate Info
years in workforce
year at this job
Nurse Case Manager
- Coordinated appropriate services and resources to patients and families.
- Evaluated and facilitated discharge planning involving patients and families, physicians and staff working with skilled nursing home and home care liaisons.
- Coordinated and participated in patient family meetings involving physicians and staff planning patient plan of care such as hospice.
- Performed utilization reviews with insurance companies.
Candidate Info
years in workforce
year at this job
Nursing License
Math And Business
Registered Nurse Case Manager
Case managed [company name]'s insurance plan patients under Medicare Advantage Program
- Performed full assessment on patients' social, mental, and physical status
- Developed a plan of care that is unique to patients' needs
- Followed up with frequent monitoring of members' conditions and coordinated services that are applicable to each patient's needs
- Placed with appropriate services that are needed to assist member in advancing with health
- Collaborated with team (MSW, discharge planners, managers) to coordinate plan of care
- Worked with telecommunication, possess computer skills, and have experience with telephonic systems to engage with all aspects of the work place
Candidate Info
years in workforce
years at this job
Nursing
Psychology
Nurse Case Manager
Develops plan of care for 100 members individual health needs. Assesses, plans, implements, and evaluates effectiveness and revises plan as necessary
- Notifies MDs of changes in health status, hospitalizations, falls, accidents and maintains ongoing communication until issue/situation resolved
- Participates in Interdisciplinary case conferences to provide continuity of care and resolve new or ongoing issues
- Coordinates, integrates, and authorizes services with participating providers using cost effective manner
- Collaborates with family members, MDs, SWs, CMs, in other facilities to maintain smooth transitions of care
- Provides health education and disease prevention education through quarterly Wellness Initiatives and as needed
- Initiated Service Requests and TRSs after discussion with NCMS/Medical Director (TRS); Investigated situation, requested RNI from appropriate sources, forwarded findings to Medical Directors within the time frame allowed. Educated members on right to appeal, guidelines and time frame to follow for filing appeal
- Refers CHHA services such as telehealth monitoring, PT/OT/ST, wound care, dietary counseling as needed
Candidate Info
years in workforce
years at this job
Field Worker's Comp Nurse Case Manager
Contacted medical provider and injured parties on claims involving medical treatment
- Developed medical management strategies and gave provider information necessary to facilitate a return to work plan
- Attended medical appointments and discussed/suggested cost-effective treatments with the physician
- Helped to ensure that clients were on aggressive treatment plan to ensure optimal function on Return to Work
- Obtained medical records from providers telephonically and followed up with written correspondence, if necessary
- Facilitated constant flow of communication amongst all parties involved
- Educated client and client's family of the importance of adherence to treatment plan and their understanding of the injured worker's diagnosis
- Electronically documented all contacts and outcomes related to case
- Reviewed Nurse Case Management action plans monthly to identify if goals and outcomes were met
Candidate Info
years in workforce
years at this job
High School Diploma
Nursing
Nursing, Communtiy / Public Health
Nurse Case Manager, Complex Care and Quitcare
Nurse Case Manager for health management of members with complex medical conditions, advocating for members and coordinating care to treat members wholistically
- Responsible for providing education and support to members about disease process and teaching members in managing their disease
- Expert in motivational interviewing to help guide members in disease management and smoking cessation
- Collaborated with other members of the health care team to achieve optimum patient care
- Provide health education and support to children and adults, incorporating evidence based medicine and national guidelines
- Ensure respect, quality care and meeting needs of diverse cultural populations
- Improved Hedis rates for asthma in 2011and decreased hospital stays
- Developed letter for overuse of rescue inhalers and improved communication of emergency room events to primary care physicians
Candidate Info
years in workforce
year at this job
Nursing
Associate of Science
Registered Nursing
Registered Nurse Case Manager
Functioned as a Registered Nurse Case Manager - Assessed individuals in the home, hospital, and long term care facility for appropriate candidacy to receive hospice services based on Medicare guidelines.
- Acted as a patient advocate assessing pt. medical, psychosocial, and physical needs and collaborating with social work, durable medical equipment supply, chaplain, physician, medical director, dietician, physical therapy, LPN, and CNA to provide efficient and compassionate care.
- Performed in home, hospital, and long term care visits per pt. request/ needs with a minimum of one visit every 14 days. Performed skilled nursing to include assessment, medication administration, wound care, ostomy care, IV therapy, NG tube insertion, tracheostomy care, ect. And assessed pt. satisfaction and efficacy of care provided by LPN and CNA.
- Reported changes in pt. condition to MD and obtained appropriate orders to address pt. needs.
- Provided pt. and caregiver education regarding all aspects of care in the home when necessary and assessed for further education needs every visit.
- Assessed pt. following suspected expiration, declare pt. dead, fill out death certificate, call county coroner, funeral home, and local police department to report death. Stay with the family to provide compassionate council and assess family for needs and bereavement risk.
Candidate Info
years in workforce
years at this job
Nursing
Social Work
Nurse Case Manager, Admission Nurse
Taught patients how to attain optimal outcomes and manage chronic health issues.
- Case managed patient load of up to 30 patients.
- Facilitated treatment plans by communicating with health care and DME providers.
- Responsible for admitting patients to service.
Candidate Info
years in workforce
years at this job
High School Diploma
Nursing
Hospice Registered Nurse Case Manager
- Initiated Plans of Care for an assigned caseload of 10-20 patients. Supervised and directed care of patients provided by the CNA and/or LPN.
- Determined and arranged appropriated level of care needed while collaborating with Interdisciplinary Team.
- Educated patient, family, and/or caregivers on end stage disease processes, safety, and symptom management.
Candidate Info
years in workforce
months at this job
Science
Nursing
Registered Nurse Case Manager
Manage approximately 15 clients that recently discharged to home with health issues
- Provide clients with education and material needed to stay home
- Draw blood and take cultures of wounds, urine and feces
- Applied wound vacs and performed wound dressings
Candidate Info
years in workforce
years at this job
Nursing
Workers Comp Field Nurse Case Manager
Coordinated, planned, implemented, monitored and evaluated return to work and medical treatment for injured workers.Conductedonsite visits, evaluate diagnoses, treatment and coordinate for home care, post op care and rehab.
- Worked with medical providers and suggest cost effective treatment alternatives, when appropriate
- Communicated during life of file with injured worked, medical team adjuster, and employer
- Completed job site evaluations and coordinate injured worker transportation and services
- Provided translation for Spanish speaking clients
Candidate Info
years in workforce
years at this job
Nursing
Nursing Candidate
Registered Nurse Case Manager
Facilitated patient care activities by providing advice, support, and assistance as needed
- Supervised Licensed Practical Nurses and hospice aides
- Responsible for ongoing patient/family evaluation and assessment
- Collaborated with attending physicians and Medical Director to identify and meet patients' needs
- Responded expeditiously when assuming on-call responsibilities
Candidate Info
years in workforce
months at this job
Science
Nursing
Registered Nurse Case Manager
Provide education to the patient, family, caretaker and care providers to support the established goals and objectives.
- Responsible for case presentation and communicate proper information to the interdisciplinary team members at team meetings and as patient conditions change.
- Give emotional support to patient and family as changes occur and needs arise.
- Plan, provide and evaluate patient-centered nursing care provided to meet hospice patient needs.
- Participate in educational programs about hospice and end of life care.
- Served as Alternate Supervising Nurse and Alternate Administrator.
Candidate Info
years in workforce
years at this job
Nursing
Nursing
Registered Nurse Case Manager
- Utilizing Medicare Oasis form performed comprehensive assessment.
- Assessed psycho/social needs of patient to develop individualized care plan
- Provided wound treatment and education following injury or surgery.
- Referred patient to social worker for community resources.
- Educated patients with multiple chronic diagnoses including COPD, Diabetes and Asthma.
Candidate Info
years in workforce
years at this job
Health Care Administration Completion
Lead International Nurse Case Manager
Responsible for managing medical cases worldwide, providing educational in-services and ensuring compliance of nursing practice with quality standards promulgated by the medical department.
- Reviewed medical reports to determine safe air medical travel needs. Medical case statistical analysis and reporting. Assisted with contract development and acquisition of new clients.
- Narrative reports for insurance companies
- Provide telephonic consultation with treating doctors/ patients /families.
Candidate Info
years in workforce
years at this job
Nursing
Registered Nurse Case Manager
Managed nursing care to homebound patients
- Provided health care to patients while keeping primary care staff informed of their patient's status
- Interacted with family members and caregivers regarding patient's progress
- Performed clinical services to patients such as physical assessments, wound care, Wound Vac, GT care, Foley care, diabetic management, IV administration, PICC line dressing changes, Medi-port dressing and needle changes, Trach care, blood draws, medication education, medication administration for infants to elderly patients.
- Liaison for patient's Physical Therapy, Occupational Therapy, Speech Therapy and Medical Social Worker, and Home Health Aide.
- Supervised and implement plan of care for Home Health Aide visits.
- Successfully chart patient's progress using Cerner and Homecare Home Base system for commercial insurance, Medicare, and Medicaid patients.
- Proficient in developing 485 medical record.
Candidate Info
years in workforce
years at this job
Nursing
Nurse Case Manager
Provide assessment, evaluation, and Plan of care for Warriors in transition and provide clinical insight regarding the care for the Warriors in transition (WTs).
- Coordinate with Physicians and Primary Care Physician with referrals to appropriate specialists for additional screening or treatment and provide appropriate medical services.
- Seek resolutions for identified problems, through individual or collaborative efforts.
- Alternate Senior Nurse Case Manager
Candidate Info
years in workforce
years at this job
Nursing
Business Administration
Nursing
Nurse Case Manager/wound Care Coordinator
- Initiated and F/U on clients from admission to discharge with multidisciplinary coordination
- Head-to-toe skin assessments. M.D. contact with impaired skin integrity with suggestions for treatment and/or received appropriate orders to proceed with rigorous therapy to improve client comfort and wound healing.
- Hospice intervention notified as needed.
- Ordered, interpreted, and evaluated diagnostic tests.
- Modified client treatment plans on a multidisciplinarian level.
- Directed and supervised less skilled nursing or health care personnel.
- Instructed clients, families and staff on health education and disease prevention.
- Prepared patients for, and assisted with M.D. examinations and treatments.
- Venipuncture for labs and IV infusions.
- Supervision of a 40-bed unit
Candidate Info
years in workforce
year at this job
Bachelor of Science in Nursing
Nurse Case Manager
Develop and implement proactive case management of medical treatment through assessment, planning, implementation, coordination and evaluation.
- Dual role of field case manager and telephonic case manager in a workers compensation environment.
- Engage in the interactive process with multiple business partners including adjusters, injured workers, physicians, employers, treatment providers, legal counsel and peers.
- Identify return to work barriers and develop a medically appropriate return to work plan
- Strong team player in addition to being able to work independently.
- Serve as workers compensation subject matter expert for injured workers, employers, physicians and treatment providers.
- Utilize disability guidelines for anticipated medical treatment and return to work goals.
- Basic experience with file audits and utilization review.
Candidate Info
years in workforce
years at this job
Allied Health
Nursing
Nursing
Nurse Case Manager/ Utilization Reviewer
Perform utilization management for various hospitals, including pre-service authorizations, concurrent reviews and post-service reviews.
- Assist in facilitation of discharge planning and served as liaison between health plan, hospital case management/ social work physicians and patients.
- Utilize Interqual Criteria in the utilization review process.
- Provide disease management and case management to DC Medicaid eligible population, including the development of initial assessment tools, stratification of patient into various care levels according to the severity of health condition and their medical needs and care coordination according to levels and stratification. Case management for members with HIV, Cardiac conditions, Children with Special Needs, Asthma and complex case management.
- Identify members appropriate for complex case management and develop accompanying plans of care.
- Provide Patient teaching and nursing advice on 24 hour Nurse care Line.
- Provide Automatic Call Distribution line coverage and process calls related to provider and member needs.
Candidate Info
years in workforce
years at this job
Nursing
Nursing
Nurse Case Manager
Coordinates will all members of the interdisciplinary team to facilitate care coordination and care delivery
- Coordinates and integrates utilization management functions and quality review
- Collaborates with all members of the health care team and external customers
- Participates in clinical performance improvement activities to achieve set goals
- Demonstrates positive and professional written, verbal and nonverbal communication skills
- Applies advanced critical thinking and conflict resolution skills using creative approaches
- Initiated the ED culture follow up program as well as reviews all ED cultures and provides the appropriate treatment per MD recommendations
- Reviews all ED Radiology over-reads and provides appropriate follow up per MD recommendations
Candidate Info
years in workforce
years at this job
Registered Nurse Case Manager
Assume responsibility for patient/family which includes assessing, planning, implementing and evaluating care.
- Initiate communication with attending physicians, other hospice staff members and other agencies needed to coordinate optimal care and use of resources for the patient/family.
- Maintain regular communication with the Interdisciplinary discipline team concerning patient/family care.
- Obtain data on physical, psychological social and spiritual factors that may influence patient/family health status and incorporate that data into the plan of care.
- Maintain up to date patient records so that problems, plans, actions and goals are accurately and clearly states and changes are reflected as they occur.
- Responsible for coordinating the physical care of the patient by teaching primary caregivers, volunteers, employed caregivers, or by providing direct care as appropriate.
Candidate Info
years in workforce
years at this job
Nursing
Psychology
Bachelor of Science
RN Nurse Case Manager
Responsible for ensuring high quality customer service in disability case management
- Acts as a liaison between all parties required in case management to facilitate continuous communication and consensus
- Provides documentation, feedback, and reports to diverse occupational populations with an underlying emphasis on returning medically able individuals to productive endeavor
- Manages caseload efficiently, organizes priorities, provides timely intervention and maintains sensitivity to confidential records
- Ensures quality standards for case management are met.
- Implements continuous quality improvement process whenever efficiencies or quality standards are not met
Candidate Info
years in workforce
years at this job
Nursing
Associate of Science
Nursing
Registered Nurse Case Manager, Telemetry
- Responsible for safe discharge of patients on a 26 bed telemetry unit.
- Utilization review.
- Acted as the patient's advocate, assessing and monitoring his or her condition, determining if the patient's needs are being met by their plan of care, and arranging for additional services as necessary to achieve the desired outcome.
- Worked closely with all members of the patient's health care team to create an individualized care plan that ensured care and services are appropriate for the needs of the patient.
- Preceptor to new case managers
Candidate Info
years in workforce
years at this job
Registered Nursing
Slavic Languages
Registered Nursing
Registered Nurse Case Manager
Provides comprehensive nursing evaluations and assessments
- Develops a detailed Plan of Care for assigned patients
- Provides direct patient care
- Conducts bi-weekly record reviews and communicates findings with other team members
- Attends case conference meetings with patients, families, team members and facility staff to facilitate coordination of patient care
- Provides orientation and training for newly hired employees
Candidate Info
years in workforce
years at this job
Nurse Case Manager
Manage health care services and needs for Medicaid recipients - from the time they are admitted to when they are discharged. Ensure efficient and prompt health care service as required.
- Patient intake.
- Coordinate with doctors andnurses to device care plans according to patient needs.
- Supervise LPN's, CNA's, and home health aids to ensure patient care and safety.
- Obtain authorizations from KePro.
- Sandata service tracking system.
Candidate Info
years in workforce
years at this job
Psychology
Registered Nurse
Nursing
RN, Hospice Nurse Case Manager
Responsible for admission, assessment, initiation of care, and symptom management of patients enrolled in Hospice, working collaboratively with physicians, hospitals, nursing facilities, team members and families to plan for patient's on-going care. Managed a case load of 16-18 patients, and supervised Nursing Assistants direct patient care.
- Visit private homes and nursing facilities to conduct routine assessments, communicate with physicians, and therapy support staff to manage symptom's of hospice patients.
- Conduct crisis intervention, problem solving and education of patient's families and facility staff members caring for dying patients.
- Follow-up and evaluate efficacy of interventions and communications with coordinating staff.
- Coordinate care and management of symptoms with physicians, facility staff, and caregivers of dying patients.
- Order appropriate durable medical equipment (DME) as needed, for symptom management.
- Communicate with physicians and hospital Case Managers to assess and arrange for transfer of patients to inpatient hospice facility, when appropriate.
- Daily use of Allscripts for documentation of assessments, communication with fellow hospice staff members, as well as creating and implementing patient care/treatment plans.
Candidate Info
years in workforce
years at this job
Licensed Practical Nurse
Applied Science
Sociology
Registered Nurse Case Manager
Nurse case manager responsible for 40-bed skilled nursing /rehabilitation unit within a 120-bed long term care facility. Ensure quality health care and rehab delivery in an efficient, cost- effective manner to residents as they move to various settings within and outside our continuum care facility. Lead & coordinate weekly interdisciplinary care plan team meeting which includes rehab, nursing, social service, life enrichment, dietary, resident, family or designated responsible party. Persuasive and articulate in dealing with management, peers, managed care insurance companies and diverse clientele. Identify physical, psychological, and placement barriers for resident. Meet weekly with rehab team to track resident's progress and re-evaluate goals as needed. Interface daily with medical team, nursing staff, rehab team, social services, residents and family/ responsible party. Provide reviews and update to managed-care insurance companies. Provide staff development & in-services
- Participated in transitioning a 120-bed nursing home, which had less than 20 skilled nursing beds scattered throughout the facility, to an active long term care unit with a 40-bed skilled nursing/ rehab unit. Our unit now averages more than 50 admissions per month.
- Developed and implemented numerous forms to promote smooth transition throughout rehabilitation process.
- Significantly improved reimbursement to facility from managed care providers
Candidate Info
years in workforce
years at this job
Nursing
Nurse Case Manager-palliative/hospice
Responsible for delivering high quality, compassionate hospice, oncology and palliative care for home hospice patients.
- Manage all client care services; develop plans of care including setting up and coordinating a variety of Agency secondary therapies.
- Work closely with Interdisciplinary team including Medical Social Worker, Pastoral Counselor, and bereavement team to assist patients and families through changing care needs.
- Oversee and manage patients on an inpatient level of hospice care. Determine hospice eligibility according to Medicare specifications.
- Proficient computer skills with consistent use of laptop software; Allscripts, OASIS.
Candidate Info
years in workforce
years at this job
Bachelor of Science in Nursing
Bachelor of Arts
Art And French Language
Nurse Case Manager
- Developed strong evaluation, treatment and planning skills.
- Skilled at medication administration, planning, coordination and delivery of all interdisciplinary team interventions.
- Known as a reliable, ethical healthcare provider with ability to stay calm and intervene during crisis on multidisciplinary teams.
- Proven ability to build positive relationships with patients, family members, physicians and other medical professionals.
- Responsible for 10-15 patient case load per week.
Candidate Info
years in workforce
years at this job
Nurse Case Manager
Telephonic reviews were done for initial, concurrent, prospective and retrospective acute inpatient stays for individual and small group policies.
- Reviewed Special procedures, such as plastics, DME, LTAC, SNF, Home Health care, ground and air transports, therapies and any high cost procedures/services.
- Was responsible for taking any questionable cases to MD for review. Then necessitated the call to the provider and patient with the outcome, informing of right to appeal and information on the appeal process if there was a denial.
- Was active in mentoring new Case Managers and completing special assignments as given.
Candidate Info
years in workforce
years at this job
Bachelor of Science
Health Sciences
Professional Nurse Case Manager
Assess injured or ill employee and provide nursing recommendations related to triage, medical treatment, and coordination of care
- Identify flexible cost effective options for the catastrophically or chronically ill or injured employee
- Facilitate quality individualized treatment goals, including timely return to work when appropriate
- Coordinate resources
- Make recommendations for benefit distribution when appropriate
Candidate Info
years in workforce
year at this job
Rn
Merchandising
Registered Nurse Case Manager
Responsible for large assigned caseload of [company name] clients in the State of California.
- Review and monitoring of medical records, medical related appointments and related care.
- Health Coach responsibilities, educating patients regarding selected aspects of health promotion and disease prevention.
- Utilization review of submitted claims and procedures for authorization.
- Working as a team with claims examiners, physicians and all of the client's healthcare team.
- Making referrals to appropriate agencies as needed to expedite return to work.
- Facilitate return to work releases and coordination of return to work with all parties involved in clients care.
- Obtaining and reviewing EMR's in order to guide care.
Candidate Info
years in workforce
years at this job
Paralegal
Nursing
Legal Studies
Psychiatric Registered Nurse Case Manager
Provides clinical assessment and medications to psychiatric patients in their homes
- Manages a variety of medical and mental health issues, including emergency services
- Work with inter-disciplinary team of care providers to develop a Plan of Care for each patient
- Coordinated care between doctors and social service agencies
- Juggled demanding case load and competing needs of patients and their care givers
Candidate Info
years in workforce
year at this job
Nursing
Business/accounting
Nurse Case Manager - Assurance Case Management
Conduct assessments to identify individual needs and all specific care management plant to address objectives and goals as identified
- Meet with injured workers and medical providers to assist with facilitation and assessment of plan of treatment
- Implement care plan by facilitating authorizations/referrals as appropriate
- Coordinate internal and external resources to meet identified needs
- Monitor and evaluate effectiveness of the case management plan and assist in problem solving
Candidate Info
years in workforce
years at this job
Nurse Case Manager
Case Manager, OIF/OEF Wounded Warriors, Active Duty Reservist: In a Medical Hold Unit. Maintain an effective Naval Force by ensuring the medical readiness and improving the health status of the fighting forces. I prospectively coordinated the overall interdisciplinary treatment plan for the patient once the identified health need is addressed.
- Supervise 5 Corpsmen, trained 2 Registered Nurses
- Weekly Case Load: (minimum of 40 to a maximum of 85 clients).
- Acts as a liaison between Discharge planning, Active duty servicemen and women. Ensure necessary care is provided promptly and effectively.
- Coordinate Medical Evaluation process for Active Duty and Reserve Active Duty.
- Discuss progress of Medical Evaluation Board with Providers during PEB process for submission of paper work.
- Guide Active Duty service personnel once determination of Medical Evaluation Board decision of TDRL or PDRL is completed.
- Promote quality, cost effective outcomes by ensuring appropriate access to quality care with identification of potential care gaps.
- Advocate for the patient and interject objectively where information is lacking. Ascertain the emotional, spiritual, and mental wellbeing as well as the physical dynamics of the Active duty patient.
- Participate in weekly round meetings with Commanding Officer and staff for ADSM status updates.
Candidate Info
years in workforce
months at this job
Culinary Arts
Nurse Case Manager
Home visits to clients. Start of care assessment, care plan development, discharges.
- Collaboration with Doctors, therapists, social workers for ongoing care conditions and needs.
- Manage Home Health Aides.
- Maintain client charts and medical records with OASIS and Axxess system.
Candidate Info
years in workforce
years at this job
Nursing
Practical Nursing
Nursing
Clinical Nurse Case Manager
Responsible for case management services to 100+ patients per month & utilization review
- Individualization of Nursing Care Plan/Goal setting with patients
- Assessment & Identification of healthcare barriers for patients
- Coordinate and Evaluate community resources, home health care, rehabilitation, and medical management
- Patient education on medication, self- care, home management, diet, exercise, and overall well-being
- Works as an advocate to promote the patients' best interest, addressing treatment alternatives, coordination of quality, cost effective health care and rehabilitative services.
- Monitors, evaluates, and documents case management activities and outcomes including, but not limited to, case management approaches, over or under utilization, inappropriate care, effective treatment, permanent or temporary loss of function, and non-compliance.
- Adheres to all appropriate privacy, security and confidentiality policies and procedures.
- Performs other duties as assigned
Candidate Info
years in workforce
year at this job
Science / Nursing
Registered Nurse Case Manager/triage/admissions
- Case Manager for up to 25 patients in the Bakersfield and Kern County area.
- Work cohesively with Medical Social Workers, Spiritual Counselors, LVN, CNA and all members of the IDT.
- IDT presentation for all patients every 2 weeks
- Referrals and Admissions in Kern County Area for on call weekends and during week as assigned.
- Triage on call weekends and as assigned
- Patient, family, PCG and staff education.
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