TINA SIMPSON

**** ******** *****, ********, **, 37067 H: 615-***-**** C: 818-***-****

Email: ac397a@r.postjobfree.com

PROFESSIONAL SUMMARY

Licensed Registered Nurse and CCM certified

Telephonic experience in Case Management/Triage and Medical/ Insurance nursing, with a positive, calming, and personable tone. Over 20 years’ experience in workers compensation, clinical assessments, case management, medical record services, health plans, clinical nurse review, and consulting. Confident in telephonic evaluation and working remotely.

CORE QUALIFICATIONS

Registered Nurse licensed with states of TN and state of CA. CCM Certified

Post-Acute CM

Workers Comp CM

Medical/Surgical skills CM

Utilization Management reviewer

Strong Assessment skills

Excellent troubleshooting skills

Able to explain medical terminology Excellent organizational/interpersonal skills Customized patient education

Medical Insurance skills

MS Word and Excel

Home office available

Works well independently

Strong work ethic

PROFESSIONAL EXPERIENCE

Federal Workers’ Compensation Medical Case Manager

Managed Care Advisors from September 2017 to Present

Key Achievements

Perform telephonic case management for injured federal workers

Offers the combined skills, knowledge and experience of case management and the nursing profession within the Office of Workers’ Compensation Programs (OWCP).

Assists the injured employee and facilitate the employee’s return to work through identification of medical services needed and arrange for those services to be provided.

Advocate for the employee’s medical needs through communication with all medial providers and to educate the employee on their role in the recover process.

Workers’ Compensation RN Case Manager

Jackson Nurse Professionals from April 2016 August 2017

RN Field Case Manager

Key Achievements

Provide an outline and plan of action for each workers’ compensation medical visit.

Complete Case Management Plan for each patient after accompanying the patient to their medical visits.

Coordinate medical care for injured employees in order to return to work in a timely manner.

Case Management RN

Self Employed – Peak Wellness of Beverly Hills, California from 2005 to 2016

Oversaw daily operations for high-volume medical office. Performed medical case management, wellness case management, workers’ compensation and utilization for post-acute patients.

Management of medical offices and oversaw employees work environment

Resolved all internal conflicts.

Key Achievements

Clinical telephonic RN for workers compensation case management

Clinically reviewed medical records for all outstanding issues and performed assessments of patient care plans Acted as clinical nurse concierge for patients and staff

Coordinated Case Management to ensure appropriate post-op and rehab medical care

Performed Utilization Management review, supporting medically appropriate care with cost effectiveness.

Managed finances including cash flow, payroll, and accounts payable

Registered Charge Nurse, LePetite Ermitage

From 2000 to 2005

RN for Acute Care, Oncology, Post-Operative, ICU/CCU and Medical/Surgical Charge Nurse float. Guided all aspects of patient care medication and post-op orders from doctors.

Key Achievements

Instructed patients and family members on discharge care and post-op case manaagement

Developed and implemented patient care plans, work with insurance companies, and utilization review

Pharmaceutical Sales Representative, From 1986 to 1999

Bristol Myers Mead Johnson Pharmaceutical – Toronto, ON

Placed orders and delivered products to doctors' offices

Key Achievements

Successfully provided education to medical doctors on latest research and development on pharmaceutical drugs to best treat patients

Trained and facilitated in-service presentations to medical staff on proper usage and safety

EDUCATION

Bachelor of Science: Nursing,

Niagara College Mack School of Nursing - Ontario, Canada Currently licensed with Tennessee and California Nursing Association Licensed in Ontario, Canada with Canadian Nursing Association

Certified Case Manager CCM Certificate Number 4232483

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