Manager Registered Nurse
Resume:
ANTHONY D. PERELLA
Munroe Falls, OH 330-***-**** **********@*****.***
UTILIZATION MANAGEMENT REGISTERED NURSE HEALTHCARE MANAGEMENT Dedicated, motivated, leader offering over 17 years of experience as a Registered Nurse with a focus on case management, consulting and utilization management. Passionate about ensuring excellence in care, managing the hiring and training of staff per standards and guidelines. Highly organized, efficient and detail-oriented. Ready to take the next step within an established, growth-oriented company. CORE COMPETENCIES
Project Management
Case Management
Guideline Development
Performance Measurement
Administration Management
Quality Improvement
Team Leadership
Risk Management
Data Analysis
Problem-solving Skills
CAREER NARRATIVE
Cleveland Clinic, Cleveland, OH (2014 to Present)
UTILIZATION MANAGER, RN, 2016-Present
Responsible for managing the daily operations including concurrent and retrospective reviews, process improvement and project management. Collaborate with health care leadership regarding related outcomes and improvement activities and management of Utilization Specialists.
Assists with department cost budgeting and containment efforts as well as reviews and interprets patient population specific financial reports for analysis.
Solves complex issues within UM and report results effectively utilizing evidence-based practice framework.
Oversees Utilization Management Specialist team including workload and project management. Prioritizes tasks and delegates appropriately to ensure timely, successful completion.
Perform annual reviews for UM team and direct the hiring, training, and development of staff members. Successfully implemented a work at home program for 1/3 of staff.
Work independently to resolve UM issues. Provides assistance to the Senior Director as needed.
Successfully streamlined Medicare process to be in accordance with the 2 Midnight rule. CASE MANAGER, RN, 2014-2016
Responsible for the development, review and evaluation of individualized patient care plans.
Project lead for creating and implementing a new Case Management model for Cleveland Clinic Emergency Departments.
Works collaboratively with physicians, nursing and other members of the team to maintain effective communication and ensure effective, timely, appropriate patient management.
Addresses and resolves items pending diagnostic or treatment progress and participates in the gathering and inputting of data.
Assists in identifying and resolving any delays and barriers for patient discharge.
Expert in using MCG, EPIC and Allscripts Electronic Medical Records software. Aetna Insurance Co., Richfield, OH (2013-2014)
UTILIZATION MANAGEMENT, NURSE CONSULTANT
Responsible reviewing cases, evaluating clinical records and applying utilization guidelines to cases while maintaining adherence to company policies, procedures, and URAC standards and laws.
Reviewed 30-35+ cases daily.
Evaluated clinical records without physically seeing the patient and utilized set guidelines to eliminate non- compliant cases.
Conducted concurrent and retrospective reviews and recommended recertification and discharge plans. ANTHONY D. PERELLA
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Summa Healthcare System., Akron, OH (2009-2013)
STAFF NURSE, MANAGERIAL ASSISTANT, 2009-2010 and 2012-2013 Concurrent with pursuit of MBA. Responsible for the management and completion of administrative duties as well as on- floor rounds for 29-bed unit.
Coordinated physician orders between doctors and staff nurses as well as scheduled and assigned nurses and STNA’s to proper units.
Prioritized the needs of 6-10 patients at a time for the geriatric general medical floor.
Completed payroll, scheduling, audit charts and participated in management meetings. ASSISTANT UNIT MANAGER, 2010-2012
Responsible for managing a 34-bed respiratory unit in Level 1 trauma hospital including patient care and fiscal operations.
Oversaw the professional development of nursing staff in sync with nursing practice standards and HR protocol.
Improved patient satisfaction scores from less than 10% to over 60% by ensuring best practices and top-notch care.
Revamped job descriptions for nursing assistants as well as created accountability checklists to streamline work processes.
Assisted in the decrease of unit’s absenteeism rate from “worst” to “best” within 1- month span. EARLY CAREER HISTORY
STAFF NURSE/MANAGERIAL ASSISTANT, Summa Healthcare System, Akron, OH, 2009-2010 and 2012-2013 ASSISTANT UNIT MANAGER, Summa Healthcare System, Akron, OH, 2010-2012 STAFF NURSE, Akron General Medical Center, Akron, OH, 2000-2002, 2003-2008 CLINICAL NURSE MANAGER, Akron General Medical Center, Akron, OH, 2002-2003 EDUCATION AND PROFESSIONAL DEVELOPMENT
HEALTHCARE, MBA, Kent State University, Kent, OH
NURSING, BSN, University of Akron, Akron, OH
Ohio – RN-290934, Unrestricted
Certified Case Manager, CCM, 2017
ADDITIONAL HIGHLIGHTS
Award, Nursing Caregiver of the Year, 2001
Award, Patient Satisfaction Service Award, 2002
Member, Observation Steering Committee, 2017-Present Military, U.S Army Combat Leader, Desert Storm (30-month service)
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