Manager Care
Resume:
John Wright Sr., MSN, RN, WCC, BC
La Vergne, TN 37086
**************@*****.***
Objective
To obtain a full time management and leadership appointment with forward thinking organization: where clinical, managerial, leadership, and financial talents, knowledge and skills can serve to promote systemic change; professional growth and development provide quality patient care and services.
Experience
Manager of Clinical Operations (March 2017- Present)
Blue Cross Blue Shield- BlueCare CHOICES
Manages and assigns TPAES (TMED) team day to day production work flows
Coordinates and prioritizes service delivery to include screenings/referrals, health information requests, and PAE/PASRR submissions.
Participates in multifunctional leadership groups to develop and maintain process improvement and improve care delivery.
Continually assessing and evaluating team efficiencies, performance and production efforts
Hires, trains, coaches, counsels, and evaluates performance of direct reports.
Manager, Utilization Management and Care Coordination (October 2015- April 2017)
TriWest Healthcare Alliance
Manages corporate prospective and concurrent Veterans Administration Utilization Management programs
Oversee timely delivery of prior authorization, concurrent inpatient review and care coordination including authorization and management of selected post inpatient care
Provides leadership to ensure operational effectiveness and efficiency of UM and care coordination including discharge planning activities to meet and exceed production and service-level goals.
Oversees the program quality assurance and quality improvement processes related to UM and Care Coordination programs
Manages and conduct risk assessment studies, process improvement, implementation and evaluation and develop appropriate protocols/processes
RN Quality Improvement Advisor (January 2012- September 2015)
Qsource (ATOM Alliance)
Promotes care coordination among various community care settings, stakeholders by aligning, engaging collaborative efforts to reduce hospital admissions, readmissions, promotion of medication safety
Provide guidance, instruction, and resources to TN nursing homes to promote quality care and services
Collaborates with CMS, TDOH, THCA, THA and other stakeholders to align and enhance quality service to patient while containing cost and promoting patient choice
Partnered with long term care, acute care, federally qualified health centers, pharmacy schools and primary care to improve medication safety through collaboration in national Adverse Drug Events (ADE) and Patient Safety and Clinical Pharmacy Services (PSPC) initiatives
Provide wound and pressure ulcer support, resources, educational opportunities, data management and quality improvement patient care services to multiple care settings
Partner with community health care organizations to reduce incidence and prevalence of Clostridium Difficile and other health acquire conditions and infections.
Quality Assurance Performance Improvement (QAPI) initiative implementation and guidance to support system change and improvements among healthcare organizations
Nurse Manager/West and North Units: Interim Director of Nursing (November 2009-January 2013)
TN State Veterans Home
Manager/ oversee 60 bed skilled care unit/and 20 bed secure Dementia unit
Manager/ oversee unit charges, unit managers and unlicensed staff
Consultant for wound care program
Coordinate patient care related to care planning, wound care and daily licensed and non-licensed assignments
Conduct staff in service education and enforce state regulations
Conduct risk assessment studies and create appropriate protocols
Wound Care Specialist/Consultant (On Call)
Rolling Hills Hospital (November 2009- Present)
Provide comprehensive (on call) wound care recommendations and services to wound care population
Monitor and evaluate wound care delivery
Establish appropriate wound treatment and care plans
Provide current wound care knowledge and education to staff and patients
Wound care provided in accordance with National Pressure Ulcer Advisory Panel and National Alliance of Wound Care
Wound Care Nurse Team Leader (December 2009- February 2012)
Select Specialty Hospital, Nashville, TN
Plan and implement wound care treatment plans
Conduct new patient wound care assessments, risk assessment and document wound healing
Communicates with patients, families and physicians regarding patient’s needs and status
Communicates with clinical liaison and case managers to insure proper patient/ facility match
Case Manager/ Health Services (December 2008- October 2009)
Health Spring of TN, Nashville, TN
Provide telephonic case management services to plan members
Provide continuous surveillance of health services delivery
Attend weekly and quarterly medical director meetings to preserve quality of care
Communicates with plan members and health care providers to ensure optimum health care delivery
Serves as “point” clinician for all wound care cases to include treatment recommendations and initial referral consultation
Clinical Nurse Consultant/Regional Leader (June 2005- November 2008)
Medastat USA, Louisville, KY
Develop new and effective marketing strategies: maintain excellent customer relations, health care delivery and cost effectiveness
Communicates with various health care facilities to aid in placement of appropriate patient/facility match
Consult on difficult wound care cases in all health care settings in numerous territories
Sell, educate and conduct follow up consultation to clients Set appointments and deliver message through sampling, merchandising and visual aids
Planned and managed territory to increase market share for DME wound care division
Wound Care/ Infection Control Director: (March 2001-July 2005)
Home Quality Management of Nashville, Nashville, TN
Manage and supervise all wound care staff
Monitor and evaluate wound care delivery and quality improvement
Nursing care plan and initial wound/skin assessment and develop appropriate treatment wound care plan
Conduct risk assessment studies and create appropriate protocols
Conduct staff in service education and enforce state regulations
Monitor and maintain effective infection control program
Conduct weekly nursing rounds with clinical staff
Staff Nurse Orthopedics/Med-Surgical (January 1998- March 2002)
Centennial Medical Center, Nashville, TN
Assess and coordinate nursing care needs
Instruct patients on all aspects of orthopedic surgical process
Monitor vital signs and ensure safety and support and medication administration
Educate patients and family members in the area disease process, wound care, nutrition and diet
Education
Master Science Nursing-Leadership & Management
Walden University
Minneapolis, MN
Bachelor Science Nursing
Walden University
Minneapolis, MN
Registered Nurse
Columbia State Community College
Franklin, TN
Associate of Science Degree Health Care Management (1991)
Vincennes University
Ft Ord, CA (Military Program)
Licensed Practical Nurse (1989)
Academy of Health Sciences
El Paso, TX (US Army)
Emergency Medical Technician (1987)
Murray State University
Ft. Campbell, KY
Combat Medical Specialist (Combat Medic) (1986)
Academy of Health Sciences
San Antonio, TX (US Army)
Licenses
Registered Nurse/ Tennessee State License/ Multi state
Licensed Practical Nurse/ Tennessee State License/ Multi state
Certifications
National Alliance of Wound Care/ WCC- Wound Care Certified (2004- present)
Advanced Cardiovascular Life Support
Basic Cardiovascular Life Support- Heart Saver
Master Fitness Trainer
Activities and Honors
American Nurses Association member 2012- present
Tennessee Nurse Association member 2012- present
Black Business Professionals Association 2012- present
TeamSTEPPS Long Term Care
Wound Care Education Network/ President 2006- present
National Alliance of Wound Care Member 2004- present
Conducted state-wide in service/seminar cooperative with TN State Dept of Health
Instructor of the Cycle/ Combat Life Saver Program (US Army)
Air Assault School Graduate
Primary Leadership Development Course completion
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