Case Manager Rn Resume Samples

DS
D Schimmel
Destinee
Schimmel
816 Russel Squares
San Francisco
CA
+1 (555) 676 7480
816 Russel Squares
San Francisco
CA
Phone
p
+1 (555) 676 7480

Experience

Experience

06/2014

present
Houston, TX
Case Manager / RN
Houston, TX
Case Manager / RN
06/2014

present
Houston, TX
Case Manager / RN
06/2014

present

  • Work with team members to ensure discharge-planning goals and objectives are developed and discussed at the interdisciplinary team meetings
  • Assist with the completion of the MDS for managed care patients
  • Ensures thorough and timely communication with managed care/insurance case managers to coordinate certification and concurrent stay programs
  • Key communicator of discharge plans related to managed care patients
  • Provide concurrent review to third party payers
  • Perform all other duties, as assigned
  • Coordinate all services for each managed care patient, including in home and outside of the care center

01/2010

02/2014
Dallas, TX
Case Manager, RN
Dallas, TX
Case Manager, RN
01/2010

02/2014
Dallas, TX
Case Manager, RN
01/2010

02/2014

  • Provide patient education to assist with self-management
  • Develops and maintains relationships with both network and Out of Network hospital UM and ER staff
  • Works directly with AppleCare Hospitalists to develop and implements inpatient processes
  • Provides Vivitrol injections. May be asked to train practice nurses in providing the injection
  • Follow State and Federal guidelines in providing care to opioid dependent patients in collaboration with licensed, prescribing physicians and pharmacy
  • Outreaches to members telephonically and/or in-person and coordinates member’s case management services
  • Requests consultation and diagnostic reports from network specialists

02/2005

10/2009
Philadelphia, PA
Case Manager Rn
Philadelphia, PA
Case Manager Rn
02/2005

10/2009
Philadelphia, PA
Case Manager Rn
02/2005

10/2009

  • Provide patient education to assist with self management
  • Providing patient education to assist with self management
  • Tracks and trends barriers to care; makes recommendations and develops action plans to improve processes and systems
  • Providing patient education to assist with self-management
  • Knowledge of utilization/case management, reimbursement methods (prospective payment, per diem, etc), and performance improvement principles
  • Works closely with delegated or contracted providers, groups or entities (as assigned) to assure effective and efficient care coordination
  • Provide treatment updates to providers outside of the hospital and family members for each assigned case

Education

Education

Bachelor’s Degree in Nursing
Bachelor’s Degree in Nursing
University of San Francisco
Bachelor’s Degree in Nursing

Skills

Skills

  • Excellent computers skills and current knowledge of the electronic medical record
  • Ability to operate PC-based software programs including proficiency in Word, Excel, PowerPoint, Access and Project
  • Ability to be accurate, concise and detail oriented
  • Extensive knowledge of the management of chronic conditions
  • Ability to communicate both written and verbally across multiple levels
  • Ability to work independently
  • Demonstrates knowledge of patient rights, patient choice for post-acute services, “Important Message from Medicare” on the right to appeal discharge
  • Comprehensive health care, dental, vision, life and disability plans
  • Actively seeks ways to control costs without compromising patient safety, quality of care or the services delivered
  • Facilitates patient throughput with ongoing focus on quality and efficiency