Manager Case
Resume:
Kimberly Rodriguez
***** ******* ******, ********, ** 80602
*********@*****.***
OBJECTIVE
To secure a position with a stable and profitable organization, where I can be a member of a team and utilize my clinical experience to the fullest.
SKILLS
• Experienced registered nurse for 21 years
• Over 8 years hands experience in nurse case management
• Experienced in disability clams, work compensation claims and health insurance requirements
• Personally holds high standards in quality patient care WORK EXPERIENCE
Nurse Case Manager
2015 – Reed Group Broomfield, CO
• Experienced gained in STD/LTD/FMLA case management.
• Reviewed employee claims for STD/LTD/FMLA benefits, determined clinical necessity for approval or denial and ongoing plan of benefits.
• Assisted in employee’s return to work status in timely manner Nurse Case Manager
2013 –2015 Molina Healthcare Albuquerque, NM
• Nurse case manager for Medicaid
• Assisting the patient in seeking appropriate healthcare providers in a remote area.
• Established care for indigent individuals, advocated for patient care.
• Demonstrated the ability to interact with patients from diverse cultures and backgrounds MDS Coordinator/ Nurse Manager
2012 –2013 Autumn Heights Long Term Care Denver, CO
• Insured reimbursement from Medicare/Medicaid for each elderly patient in the facility.
• Established plan of care and case management for elderly residents.
• Served as facility manager, supervising nursing staff. Work Comp Nurse Case Manager
2008 – 2012 Coventry Healthcare Denver, CO
• Established treatment plan for worker’s compensation patients with low cost, effective options.
• Employee advocate to employer, assisted in timely return to work status.
• Worked with clinicians, physicians in establishing interdisciplinary procedures when necessary.
• Audited treatment plans for proper insurance reimbursement. Education
B.S Nursing
1992 – 1996 Mesa State College Grand Junction, CO
References
References available upon request
Contact this candidate