Manager Case

PERSONAL DATA

Joyce Smithson

**** ********-********** **** **********, Indiana 47122

Telephone: 812-***-**** or 502-***-****

*-****-**********@***.***

EDUCATION

University of Louisville, 1987 to 1988 BSN (overall GPA 3.7 out of 4.0)

Bellarmine College, 1984 to 1986 AND (overall GPA 3.2 out of 4.0)

Jeffersontown Vocational School, 1969 to 1970 LPN

Deans list at University of Louisville

Graduated with honors from University of Louisville

In the top 6% of graduating class

Member of Sigma Theta Tau Academic Sorority

WORK EXPERIENCE

January 2010 to February 2013

University of Louisville Hospital

Case Manager

Duties: Collaboratively work with physicians and other disciplines to

provide optimum care and implement discharge plans. Effectively communicate

with payers to insure authorization for hospitalization, initially and

concurrently. Monitor for cost effective utilization of resources by

maintaining and updating information.

July 2008 - December 2009

Anthem

Title: Utilization Management Nurse

Function: Ensure medically appropriate, high quality, cost effective care

is being given through the utilization review process.

April 2007 - April 2008

Curascript

Title: Case Manager

Duties: Effectively manage utilization of therapies and communicate with

payers to insure all therapies are covered, initially and concurrently.

November 1995 - April 2006

J & J Video & Tanning (Self employed)

Title: Owner

Duties: Assess, plan, budget, implement, monitor and evaluate the operation

of video stores and tanning salons.

May 2006 - October 2006

Norton Healthcare

Title: Clinical Information Analyst Associate

Duties: Design and oversees data collection and data quality control

processes to assure reliability and validity.

March 2004 - November 2005

Harrison County Hospital

Title: Manager, Care Coordination

Collaboratively work with physicians and other disciplines to provide

optimum

care and implement discharge plans. Effectively communicate with payers to

insure authorization for hospitalization, initially and concurrently.

Monitor for cost effective utilization of resources by maintaining and

updating information. Supervised employees.

December 1999 - September 2001

Baptist Hospital East

Louisville, Kentucky 40207

Title: Case Manager

Duties: Evaluate medical necessity, appropriateness of setting and

discharge planning. Perform concurrent reviews.

March 1999 - December 1999

Humana Louisville, KY 40201

Title: Case Manager

Duties: Coordinates care and services for members requiring a high

intensity of service and/or having complex needs. Required advanced

knowledge of benefit plan design, extensive knowledge of alternate care and

familiarity with community and national resources in order to support the

delivery of quality, appropriate health care to Plan members. Focused on

the reduction of unnecessary utilization of services, containment of cost,

and measurement of performance, while providing accessible, quality,

effective health care.

October 1995 - March 1999

ATC Healthcare Services

Title: Director of Nursing

Duties: Responsible for coordinating and supervising all branch activities

to ensure quality service to all clients and Healthcare Associates.

Responsible for recruiting, interviewing and hiring personnel and providing

training for branch personnel. Expanded market share and maintained

relationships with key external personnel and developed and utilized

effective sales and marketing strategies. Maintained compliance with all

state requirements for licensure and certification.

November 94 - August 1995

Kentucky Board of Nursing

Title: Nurse Investigator

Duties: Investigate complaints through personal interview, onsite visits,

telephone inquiry, and by obtaining information from law enforcement

agencies, legal counsel and others. Prepare proposed Agreed Orders and

Consent Decrees. Monitor compliance with disciplinary actions taken by the

Board. Answer telephone and written inquiries about investigations and

disciplinary matter. Prepare for scheduled Hearings; determine witnesses to

be subpoenaed in conjunction with Nurse Investigator Senior and General

Counsel. Prepare reports of investigations and probationary meetings.

October 1970 - October 1994

St. Anthony Hospital Louisville, KY 40202

Title: LPN from 1970 to 1986, RN 1986 to 1994

Duties: 1971 to 1973 worked medical-surgical and oncology unit giving

direct patient care and coordinating ancillary personnel assignments.

1973 to 1992 worked in surgery giving care to patients by either

circulating or scrubbing a variety of surgical procedures.

1992-1994 Assess, plan, implement and evaluate the care of clients of

varying ages and varying conditions in the emergency room.

Contact this candidate