Manager Case
Resume:
CAROLYN S. BURNS-FRAZIER, R.N.
New Windsor, Maryland, 21776
***********@*****.***
WORK EXPERIENCE:
American Mobile Healthcare
California Pacific Medical Center Davies Campus: San Francisco, California.
Travel Nurse Assignment February 2015 to present. 13 Week Assignment
Nurse Case Manager
As Nurse Case Manager I was responsible to Coordinate and monitor patient's individualized plan of care
which included discharge planning and utilization management. I conducted initial assessments for
admissions and document findings in all patients’ records assigned to my interdisciplinary team. Duties
also included utilization review on assigned patients to identify appropriateness of continued stay and
resource utilization based on established criteria. As Nurse Case Manager I acted as a liaison between in-
patient facility and referral facilities or agencies and provided case management to patients referred. This
may have included pre-admission through referral of patients to community resources to meet post
hospital needs such as coordinating transfer of patients to appropriate facilities; and maintaining and
providing required documentation.
I managed the patient’s care from admission to discharge as outlined in the Utilization Review Plan of the
hospital. I reported results of the Utilization Review Activities to appropriate persons and managed the
patients care from admission to discharge as outlined in the Utilization Review Plan of the hospital. I
collaborated with management of coders and other managers to analyze utilization trends within the
hospital.
American Mobile Healthcare
Kaiser Hospital San Francisco, California
Travel Nurse Assignment November 2014 – February 2015 13 week Assignment
Nurse Case Manager
As Nurse Case Manager I was responsible to plan, develop, assess and evaluate care provided to Kaiser
members. This was accomplished by collaborating with physicians, other members of the
multidisciplinary health care team and patient and or family in the development, implementation and
documentation of appropriate, individualized plans of care to ensure continuity, quality and appropriate
resource use. I was responsible for recommending alternative levels of care and to ensure compliance
with federal, state and local requirements. Among the Nurse tasks I assessed high risk patients in need of
post-hospital care planning. I developed and coordinated the implementation of a discharge plan to meet
patient's identified needs and communicated the plan to physicians, patient, family and or caregivers, staff
and appropriate community agencies.
Additionally I participated in Utilization Review by reviewing, monitoring, evaluating and coordinating
the patient's hospital stay to assure that all appropriate and essential services were delivered timely and
efficiently. I participated in the “Bed Huddles” and provided follow through on recommendations
congruent with the patient's needs. I worked with an assigned Discharge Planner to coordinate the
interdisciplinary approach to providing continuity of care, including Utilization management, Transfer
coordination, Discharge planning, and obtaining all authorizations/approvals as needed for outside
services for patients and when appropriate, their families. As a Nurse Case Manager with a role in
Utilization Review, I conducted daily clinical reviews for utilization/quality management activities based
on guidelines/standards for patients in a variety of settings which included outpatient, emergency room,
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CAROLYN S. BURNS-FRAZIER, R.N.
inpatient and non-KFH facilities.
As Nurse Case Manager I acted as a liaison between in-patient facility and referral facilities or agencies
and provided case management to patients referred. This may have included pre-admission through
referral of patients to community resources to meet post hospital needs such as coordinating transfer of
patients to appropriate facilities; and maintaining and providing required documentation.
In accomplishing these tasks I was responsible to adhere to internal and external regulatory and
accreditation requirements and compliance guidelines including but not limited to: TJC, DHS, HCFA,
CMS, DMHC, NCQA and DOL. I coordinated and educated members of the healthcare team concerning
their roles and responsibilities in the discharge planning process and appropriate use of resources.
This included providing patients with education to assist with their discharge and help them cope with
psychological problems related to acute and chronic illnesses. Per established protocols, I was responsible
to report any incidence of unusual occurrences related to quality, risk and or patient safety which may be
identified during case review or other activities. In doing so, I reviewed, provided analysis and identified
utilization patterns and trends, problems or inappropriate utilization of resources and participated in the
collection and analysis of data for special studies, projects, planning, or for routine utilization monitoring
activities. As Nurse Case Manager I also coordinated, participated and or facilitated care planning rounds
and patient family conferences as needed
Holy Cross Hospital
June 2010 to December 31 2013
Case Management Department Perm June 2010 to December 2013 - (Per Diem December
2013 – Present)
Utilization Review of patients from various units, i.e. CIC/CCU/High Risk Pregnancy/Joint & Spine.
Perform patient assessments of current living conditions and medical histories. I performed assessments
for discharge to include investigation of financial needs of patients which included Medicaid and
Medicare guidelines. I assessed the needs of patients for equipment necessary to sustain or improve their
condition and in cases where it was required, ordering of DME/equipment upon discharge with various
vendors.
I provided communication and alliance with Skilled Nursing Facilities. I was a liaison for patient
admissions. I performed Verification of Admission documents and assessed Insurance coverage for
discharge planning needs. When necessary, I obtained authorization for Skilled Nursing Facilities, Acute
Care Facilities, Long Term Care Facilities and group homes. I arranged for Ambulance Transport of
patients upon discharge. I collaborated with physicians and other practitioners to facilitate accurate
designations, Levels of Care, Care Coordination and Discharge Planning. Collaborated with
PT/OT/Speech for patient’s appropriate discharge placement. Performed Level of Care Assessments,
Observation status and Denial Reviews. I am Proficient in InterQual Software, Midas Software, and
Power Chart Software/Cerner Software. Among other duties, I collaborated with and referred to EHR’s
Clinical Support Team for Physician or Practitioner 2 nd Level Reviews. I was tasked with Preceptoring
New Case Manager’s within the Department. I participated in State and Local Case Management
Associations and provided feedback to the Case Management Department Supervisor and Staff.
University Maryland Medical Center
June 2008 to December 2008
Staff Nurse, Emergency Department
Performed stabilization and continuous monitoring of critically ill patients which included patients who
were maintained on ventilators, transvenous/cutaneous pacemakers, and IV cannulation. I possess
excellent assessment and treatment skills. I performed with accuracy in Drug Administration in Acute and
Critical Care Patients. I performed Patient Teaching. I preceptored new graduate nurses and oriented
established nurses to the Hospital/facility. Participated in evidence based practice. Due to my adept
critical management skills and my ability to adapt I was successful in rotating in different areas and on a
variety of cases throughout the emergency room where I assumed various roles as needed and assigned.
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CAROLYN S. BURNS-FRAZIER, R.N.
Carroll Hospital Center
September 2007- April 2008
Clinical Mentor/Educator
Emergency Department
AS a Nurse Educator I was responsible for coordination and for orientation for all new associates in the
Emergency Department, IV Therapy, and Transporters. Educator for Baltimore Metropolitan Area
Consortium on Pediatric Emergencies. Part of the Education Team for Hospital Orientation for all hospital
associates. Participate in teaching Basic Rhythm, IV therapy, Splinting, Initial Hazmat, Preceptor, and any
other miscellaneous classes needed for staff development. Develop competencies for ED staff, IV
Therapy and Transporters. Participate in hospital wide meetings to represent Emergency Department in
Behavioral Health, Pharmacy, Pain Management, Nurse Practice Review, Emergent Response Team,
Recruitment and Retention and Education Council. Coordinate continuing education for emergency
department.
American Mobile Healthcare Traveling Nurse November 2014 – Present
Progressive Nursing Staffers, ER/ICU Traveling Nurse. December 2006-Sept. 2007
Holy Cross Hospital, Assistant Nurse Manager, SICU/NCCU July 2006-December 2008
Holy Cross Hospital, ER/ICU Staff Nurse July 2003-July 2006
Doctors Community Hospital, ER/ICU Staff Nurse July 2000-July 2003
Greater Southeast Community Hospital, ER/ICU Staff Nurse February 1998 – June 2000
D.C. General Hospital, ER/ICU Staff Nurse September 1995-July 2000
* Certified: CPR, ACLS, PALS, TNCC and IV Therapy
* Education: Candidate for graduation from Columbia Union College.
** References available upon request
Contact this candidate