Manager Case
Resume:
Cathleen Narramore, BSN, RN, CCM
Euless, Texas 76039
972-***-**** Work
Employment History
Mar. 2007 to Present- Case Manager. Baylor Medical Center Irving
Major Responsibilities:
• Review charts for medical necessity, appropriate level of care
• Determine admission status on all patients entering hospital
• Discharge Planning with patients, physicians,and team members
• Implement strategies to reduce length of stay.
• Communicate with payors, providing timely utilization review
Dec. 2002 to Mar. 2007- Case Manager. HCA North Hills Hospital
Major Responsibilities:
• Basically the same as above case manager position
June 1998 to Dec. 2002- Managed Care Specialist, National Healthcare
Review
Major Responsibilities:
• Audit paid claims to assure insurance paid per their contracted rate
• Initiate appeals to insurance companies for additional payments
• Maintain contact with insurance personnel until claim is paid correctly
Dec. 1996 to May 1998 – Case Manager II, Harris Methodist Health Plan
HMO
Major Responsibilities:
• Identify catastrophically ill HMO members
• Coordinate services to achieve quality care in a cost effective manner
• Negotiate payment rates
• Review medical necessity of services
July 1993 to Dec. 1996 – UR/Case Manager, Alliance Health Providers PPO
Major Responsibilities
• Oversee day to day operations of the UR/Case Management Program
• Utilization Review for emergency and elective hospital admissions
• Produce and interpret weekly, and quarterly reports of UR activity
• Obtained the Texas Utilization Review Agent Certificate
Dec. 1990 to July 1993 – Clinical Evaluator, Ethix Corporation
Major Responsibilities:
• Precertification and Concurrent Review Nurse
• Channel patients into their PPO network facilities
• Negotiate payment rates for out of network treatments
• Train new clinical evaluators
• Conduct quality assurance audits
Jan. 1987 to Dec. 1990 – Home Health Care Nurse Manager, Kimberly Home
Health Care
Major Responsibilities:
• Home visits to implement physician’s orders for teaching,IV meds,ect.
• Establish individualized Care Plans
• Supervise LVN's and Nurse Aides
• Participate in case conferences
May 1981 to January 1987 – Clinical Nurse Leader, Osteopathic Medical
Center
Major Responsibilities:
• Total patient care on Med/Surg floor
• Supervise staff nurses
• Supervise transcription of orders
• Participate on Code Team
Education: Graduated - May 1981 Bachelor of Science in Nursing,
University of Texas at Arlington
Additional Certifications: Certified Case Manager -current since 2004
Certified Professional UR
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