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Manager Case

Location:
Phoenix, AZ, 85016
Salary:
$85,000 Annually
Posted:
February 02, 2012

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Resume:

Mark Denman, RN, BSN , CCM

**** *. **** **. 602-***-****

Phoenix, AZ 85016 lma562@r.postjobfree.com

SUMMARY OF EXPERIENCE:

** ***** ** ********* *******, compassionate, cost effective care

Health Temp – 2007-present

Registry RN, RN Case Manager, Interim RN Director/Manager

Bed Placement, ER, Utilization Review (Milliman/Inter-Qual) & Discharge Planning.

Quality/Risk Management, Denials and Appeals Management

Recruited, Trained & Supervised Staff.

Acute, In/Out-Patient Psychiatric, LTAC facilities throughout Phoenix; (Phoenix/Tempe St. Luke’s/Mountain Vista, Heart Hospital, Maricopa Medical Center, Surgical Specialty, Kindred, Southwest Behavioral Health, People of Color-Comunidad) .

University Physician’s Health Plan – 2010

Consultant RN Case Manager

Develop & Implement Emergency Room Intervention Program

Case Manage Members who Frequent Emergency Room (Maricopa Medical Center)

Medication Reconciliation, Assistance Accessing PCP, Assist Health Appointments

Utilization Review – Milliman & Inter-qual.

Mercy Care Plan – 2010

Consultant/Supervisor, Special Programs

Administrative & Clinical Oversight of MCA Re-admission Program, CRS, Transplants, Informal Appeals & Quality Review

Developed & Implemented Case Management Program to Reduce MCR inpatient re-admissions. (Reduced re-admission rate from 30% to 14% x 3 months)

Recruited, Trained & Supervised Clinical & Non-Clinical Staff

Ensure Compliance with AHCCCS & CMS Guidelines.

BrightStar Home Health Care – 2009-present

Home Health RN

Direct Nursing Care in Patient Homes Including Home Infusion/PICC Care

Complex Wound Care including KCI Wound Vac Placement and Dressing Changes.

Blood Draws, Home Safety Evaluations/Cardiopulmonary Assessment

Patient/Family Education & Counseling.

St. Luke’s Hospital – 2007-2011

RN ICU & RN Case Manager

Direct patient care post CABG, Medically Complex Critically Ill Patients.

Utilization Review, Discharge Planning (Inter-Qual/Milliman), Denials & Appeals Management

Patient/family education & counseling.

Assessed for Behavioral Health/Chemical Dependency and Intervention.

John C. Lincoln Hospital North Mountain/Deer Valley– 2009 - Present

RN House Supervisor/ RN Case Manager

Provide administrative supervision of campus workflow, resource utilization, and operations for all clinical and non-clinical departments.

Responds to hospital emergency situations, initiates disaster notification processes, facilitates patient placement and communicates with media.

CIGNA - Clyde Wright – 2008-2009

RN Team Leader/Rapid Response Team Leader

Supervise Cardiology, General Surgery, ENT/Urology & Podiatry Departments and Nursing Staff (RN, LPN, MA, and EKG Tech).

Payroll, Maintained Budget & Staffing for Each Department.

Ordered Medical Equipment and Maintained Drug/Supplies.

Responded to Codes and Directed Team in CPR/Interventions

Perform Adenosine Stress Tests, Conscious Sedation, Chemo/BCG Live and Assistance in Surgery.

Assess for Behavioral Health/Chemical Dependency and Refer for Treatment.

Banner Health Services – 2008 - Present

Transplant RN/RN Case Manager -

Medically complex patient care kidney, liver and pancreas transplant patients.

Patient/family education & counseling.

Phoenix Memorial Hospital - 2002 - 2007

Case Manager/Weekend Supervisor

Bed Placement, ER, Utilization Review (Milliman/Inter-Qual) & Discharge Planning.

Quality/Risk Management, Denials & Appeals Management.

Behavioral Health/Chemical Dependency Assessment, Patient Education.

Community Resource Referral & Counseling.

Odyssey Hospice - 2001 - 2005

Social Worker –Skilled Nursing Facilities

Sign-on Admissions, Hospital Discharge Planning, Inpatient/Home Care.

Psychosocial/Behavioral Health Assessment, Intervention &Education *Patient/Family Counseling.

MARINER Post Acute/Skilled Nursing Facility - Desert Haven, East Valley Rehabilitation – 1998-2001

Director Admissions, Case Management & Social Services

Recruited, Trained & Supervised Staff, and Provided Direct Resident Care.

Maintained Regulatory Compliance per Guidelines (deficiency free).

CCN – 1997-1998

Workers’ Compensation - Associate Care Coordinator

Case Managed Claimants Onset of Injury through Return to Work.

Arizona Health Care Cost Containment System (AHCCCS) 1990-1994

Programs & Projects Specialist II

Administrative/clinical oversight of Title XIX Behavioral Health Delivery System.

Review of AHCCCS Health Plans, Regional Behavioral Health Authorities and Long Term Care Program Contractors for compliance with HCFA (CMS) regulations.

Phoenix Shanti Group Clinic and Skilled Nursing– 1989-1990

Administrator of Client Services

Responded to RFP and Developed & Implemented HIV Programs.

Recruited, Trained & Supervised Case Management, Behavioral Health & Education

Assessed Clients for Mental Health/Chemical Dependency & Referred as Indicated.

Facilitated Chemical Dependency Men’s Support Group

West Valley Camelback Hospital – 1988-1990

Behavioral Health Therapist

1:1/Group Counseling Inpatient Mental Health Unit – General Mental Health/Chemical Dependency

Facilitated Therapy Group, Patient/Family Education/Intervention

Monitored effect/s.effect of Medication, Coordinated w/Psychiatrist.

Maricopa County Long Term Care & Psychiatric Annex - 1985 - 1988, 1989

Case Manager

Case Managed Severely Mentally Ill Clients Court-Ordered as Danger to Self, Others & Grave Disability. Amended court orders/facilitated inpatient re-hospitalization.

Provided 1:1 Counseling, Education & Intervention as indicated.

Monitored Psychotropic Medication, Side Effects & Compliance with Treatment.

Phoenix South Mental Health a.k.a. – Southwest Behavioral Health – 1984-1986

Counselor II

Counseled Severely Mentally Ill/Chemical Dependency Clients – Residential

Crisis Intervention, Monitor Medication

EDUCATION

MSN Degree - in progress - Grand Canyon University - 2010 - pres

BSN Degree – Grand Canyon University

BS Degree – Arizona State University

AAS - Phoenix College

LICENSURE/CERTIFICATIONS

AZ RN 148417 - active, in good standing EXP - 04/01/2015

HI RN 62394 - active, in good standing EXP - 06/30/2013

Certified Case Manager (CCM) – CCMC #145036

BLS/ACLS Provider thru Sept-2013 – Am. Heart Assn.

CPI Certified through 7/1/2013

American College of Cardiovascular Nurses (ACCN) – member in good standing.



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