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Registered Nurse Manager

Location:
Delaware, OH
Salary:
$35.00/hr
Posted:
October 25, 2018

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Resume:

Professional Summary:

** ***** *** **********

Over 8 years of case management in a managed care setting

Registered Nurse in the state of Ohio

Monitored care plans and promoted quality and cost effective care in each role

Worked with Medicare and Medicaid patients

Professional Experience:

Buckeye Health Plan Oct. 2, 2017- March 16, 2018

Nurse Case Management

4349 Easton Way #200,

Columbus, OH 43219

866-***-****

Temporary 6 month position through agency “Health Care Scouts” out of Orlando, Fla.

Assisted all other Nurse Case Managers to complete assignments.

Worked with health care plan participants to navigate through the health care system

Coordinated care with health care providers, travel, obtaining medical durable equipment and medications

Ohio State University Hospital East April 17, 2017 – July 19, 2017

181 Taylor Ave.

Columbus, Ohio

Staff RN PCU Tower 3

Functioned as a comprehensive caregiver and liaison with patients and families

Accurately maintained and submitted clinical reports and progress notes regarding patient’s condition, including signs and symptoms, which may be indicative of change.

Buckeye Health Plan Feb. 2017- April 2017

Nurse Case Management Support

4349 Easton Way #200,

Columbus, OH 43219

866-***-****

Temporary 3 month position through agency “Health Care Scouts” out of Orlando, Fla.

Assisted all other Nurse Case Managers to complete assignments.

Worked with health care plan participants to navigate through the health care system

Coordinated care with health care providers, travel, obtaining medical durable equipment and medications

Optum – Eden Prairie, MN 2015 to 2016

Nurse Case Manager – Chronic Disease

Chronic care management of CHF, CAD, COPD, diabetes, Behavioral Health & asthma patients

Monitored care plans

Worked with physicians to optimize care planning

Promoted quality and cost effective care

Provided patient education

Assessed members’ health status and created short and long term goals for care plans

Alere, Inc. – Waltham, Maryland

2010 to 2015

Care Manager – Chronic Disease

Chronic Care Management of CHF, CAD, COPD, Diabetes, Behavioral Health & Asthma Patients Hospital compliance officer, reporting directly to the CEO

Monitored care plans

Worked with physicians to optimize care planning

Promoted quality and cost effective care

Worked with Medicaid patients

Provided patient education

Assessed members’ health status and created short and long term goals for care plans

Nationwide Better Health, Division of Nationwide Insurance – Columbus, Ohio

2009 to 2010

Nurse Case Manager – Short Term Disability

Went permanent after contract period with InnoSource Staffing

Conducted telephonic data collection of patient information for short-term disability claims

Educated patients on disability claim management

Determined & assigned responsibilities to other team members to process claims

Utilized provider resources to shorten disability and facilitate return to work outcomes

InnoSource Staffing – Dublin, Ohio

2008 to 2009

Nurse Case Manager

Nurse Case Manager for Nationwide Better Health on contract through InnoSource

Same responsibilities as above

Q2 Administrators (Blue Cross/Blue Shield of SC) – Westerville, Ohio

2007 to 2008

Utilization Review Coordinator/Medicare Claims Adjudicator (Contract)

Analyzed Medicare Cases to determine payment and liability

Prepared detailed report on each case outlining reasons for the decision

Utilized medical background in reviewing cases

Peoplelink Staffing Solutions (Raleigh Medical) – Sound Bend, Indiana

2006 to 2007

Nurse Researcher

Worked on Cigna project mandated by Federal Agency HEDIS

Conducted research project to determine healthcare outcomes of provider care

Determined if proper medical procedures were ordered

Evaluated that patient were given appropriate preventative care, Measured over-utilization of healthcare services

Dayton VA MEDICAL CENTER - Dayton, OH

4100 W. Third Street

Dayton, OH 45428

937-***-**** 800-***-****

RN -SICU Staff (Permanent position)

Administered medications, injections and treatment protocols for IV therapies

Treatment and/or prevention of infections and post-surgical treatments

Developed and facilitated proactive interventions to avoid potential problems and to ensure the safety of patients

SOUTHVIEW HOSPITAL, Centerville, OH

1997 Miamisburg-Centerville Rd

Centerville, OH 45459

P: 937-***-****

RN - ICU Staff (Permanent position)

Functioned as a comprehensive caregiver and liaison with patients and families

Accurately maintained and submitted clinical reports and progress notes regarding patient’s condition, including signs and symptoms, which may be indicative of change.

Education:

Chamberlain College of Nursing: Bachelor of Science in Nursing, Columbus, Ohio

Penn Foster Career School: Medical Coding and Billing Diploma,

Medical Transcriptionist Diploma, Scranton, Pennsylvania

Sinclair Community College: Associate Degree in Applied Science/Nursing

Licensure:

Registered Nurse: RN - 210646 (State of Ohio)

Certifications - BLS - 9/17/2015 – 9/17/2017

- ACLS - 9/21/2015 – 9/21/2017



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