Manager Case
Resume:
Barbara McDonald L.V.N.
Millbrae,CA 94030
*****************@*****.***
Objective
Nurse Case Manager: Extensive experience in Hospital, Skilled Facilities and Insurance environment doing Case Management.
Seeking a position with a Healthcare Facility, Health Insurance related field.
I want to be a part of a successful team of healthcare members who are focused on patients and other
customers.
Summary of Qualifications
● Strong critical thinking skills.
● Detailed, efficient work.
● Self motivated.
● Proficient with InterQual and Milliman software.
● Medi-Cal guidelines experience. Title 22.
● Hospice/POLST understanding.
● DRG/ICD.10 codes.
● Current L.V.N licence.
Education
Jackson High School; Jackson, Michigan
Jackson Community College, LPN degree
Central Michigan University; Liberal Arts Program
Work Experience
Brown & Toland Oakland, CA 2013-2019
● Nurse Case Manager-Skilled Level of Care and Acute Level of Care.
● Onsite visits to facilities and meeting with patients, family members and DPOAs.
● Interacted with facility Case Manager, Social Worker, Doctors, Speech, Physical and Occupational
Therapist and Ombudsman.
● Focus on successful discharge for patient to ensure transition of care to another level of care. The
transition could be; Acute Rehab,Home, Assisted
Living Facility or Board and Care.
● Monitor (using InterQual criteria) patients length of stay and ensure they are ready for next level of care. On Lok LIfeways San Francisco, CA 2008-2012
● Nurse Case Manager. Focus was for the patients that were in the Hospital and Skilled Level of Care.
● Interfaced with Hospital and Skilled Facility Case managers, social workers and doctors.
● Interacted with patients and family members to obtain the best level of care for patients.
Health Plan of San Mateo South San Francisco, CA
2002-2007.
● Reviewed and approved referrals that spanned the spectrum from Home Health, DME and Procedures.
In some cases, Medical Director involved in making decisions.
● From 2006-2007 I held the position of Manager of the Care Advantage Department (Medicare Part D).
Responsible for 15 staff members, Customer Service Department.
Letters of Recommendation upon request.
California L.V.N license.
Contact this candidate