Manager Nurse
Resume:
Delfia Gibson, RN, BSN, CCM, CDI
Bronx, NY 10468
*************@*****.***
Registered nurse, certified case manager, utilizes Allscripts clinical applications daily, currently pursuing MA in Administration. Retired Army Nurse Corps – 2013, Combat Support Hospital, Utica, NY.
License – RN #441453 – NY State:
Certified Case Manager – 8/2014
Certified ABLS and Trauma Nursing Care – Exp. 8/2013
PRI Accessor - #75009 – 10/2014
UAS Role 45
Education:
2018 – MSN, Mercy College, Dobbs Ferry, NY
2008 – Bachelors of Science, Mercy College, Dobbs Ferry, NY
1990 – Associates of Nursing - Helene Fuld School, NYC, NY
Professional Experience:
September 2016 – present - Nurse Case Manager – St. Johns Riverside Hospital – fulfill discharge planning for patients transitioning from the hospital back to the community. Complete and clinical reviews for all patients admitted to their respective primary payors. Work alongside physician staff of all specialties to code, develop and facilitate a sustainable discharge plan. Rectify documentation for denial re-negotiation using Microsoft Excel spreadsheets. Report directly to the Director of Case Management.
April 2015 – September 2016 - Complex Nurse Care Manager – Elderserve River Spring @ Home, MLTC for Hebrew Home at Riverdale – responsible to authorize services for 150 members who have transitioned from adult homes to independent community living within the FIDA/MLTC, managed care model. Complete grievances, denials and appeals to ensure adherence to Medicaid regulations;
May 2013 – April 2015 - Nurse Care Manager – Schervier Home Care performs utilization review, care management for 107 members for MLTC-P program using Milliman/Interqual guidelines, delegate services per need evaluations based on Medicaid capitation; interfaces with hospital/snf discharge planners, physician groups, local pharmacies and licensed aide agencies;
April 2006 – May 2013 - Community Health Nurse/Case Manager – Beth Abraham Health Services; functioned as a community health nurse for a Pace program which is a long-term, residential and community based health care program that utilizes an approach to prevent hospital readmissions with a focus on treatment and management of chronic diseases. Functioned as a preceptor and mentor to community health nurses orientees;
June 2003 – April 2006 – Community health facilitator – Jacob Perlow Hospice of Beth Israel – functioned as palliative care provider rendering primary nursing care to patients with terminal cancer. Responsible for educating patients/families in end-of-life care and issues related to catastrophic and debilitating diseases.
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