Case Manager Nurse

Emily LaNelle Bowden

**** ****** **, **** *****, GA 30344

Phone: 404-***-****

Email: ad5ef8@r.postjobfree.com

Objective

To assist in coordinating appropriate, thorough and cost efficient healthcare.

Education

2000-2002 Masters of Health Administration, Central Michigan University, Ft.

McPherson, GA

1995-1997 Bachelor of Nursing, University of Pittsburgh, PA

1990-1992 Associate of Nursing, Community College of Allegheny County, Pgh., PA

1985-1986 License Practical Nursing, Maharry Medical College, Nashville, TN.

Employment

02/24-present Sadie Mays Health & Rehab

6/18-01/24 Grady Healthcare Nurse Case Manager

04/15-6/18 NE Ga Health Center, Nurse Case Manager

09/14-02/15 Spire Healthcare, Nurse Case Manager, N.E.GA Health system

06/09-9/14 Nova Pro Staffing: Nurse Case Manager, Cedars Sinai,CA

01-06/14 Nova Pro Staffing Nurse Case Manager, PAMC, Anchorage, AK

2012-2014 Nurse Case Manager, Homestead Hospice, Roswell, GA

2011-2012 Nurse Case Manager, Humana, Atlanta, GA

2009-2011 Nurse Case Manager, Wellpoint-Blue Cross, Atlanta, GA

2006-2009 Nurse Case Manager & Precertification Specialist, Atlanta

Medical Center

Skills

Utilization Review: Responsible for collection clinical data to justify the

utilization of insurance benefits. The Case Manager utilizes clinical skills and

experience to convey this data in obtaining a precertification.

Daily use of various computer programs (Windows,Midas, Epic, Canopy, McKesson, ECIN, Interqual) to access and document clinical data.

Coordinate direct patient care meetings in an attempt to review the

appropriateness of the level of care that is being provided.

Research of clinical data to present justification in obtaining precertification from

various insurance carriers.

Discharge Planning: Coordinating services to assisting the client and family in

transitioning to an alternate level of care, educating the patient and families

about various community resources, alternative care associations and

medications.

Precertification Specialist: responsible for obtaining Medicaid certifications.

Provide support to the Department leadership in performing Quality Improvements Measurements.

Nursing Supervisor within a Rehabilitation-Long Term Care Setting entails Scheduling, nurses’ shifts, Assign nurses to patients, Ensure nursing operational standards are met, Provide reports on productivity, quality and customer service metrics, Ensure all nurses follow policies and procedures, Train new team members, Evaluate nurses’ performance, Educate/Inform family members about medical procedures and doctors’ instructions, Handle complaints or other issues, Establish a compassionate environment by providing psychological support to patients & their families.

Languages: Fluent in Spanish after living and studying in Mexico for 2 years.

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