Manager / Case Manager

Regina Thomas, RN

Milwaukee,Wisconsin

********@*****.***/414-***-****

Professional Summary:

Regina has over 7 years of nursing experience in a variety of settings. She has over 2 years of experience

communicating with insurance companies on obtaining authorizations and performing utilization review duties.

She has working knowledge of CPT and ICD-9 codes for reimbursement of claims. She also has extensive

experience coordinating care plans and referring patients to community resources. Regina is looking to

continue as a RN and take her experience and become an asset as a Manager in a Nursing Home/ Hospital

setting.

Professional Experience:

Milwaukee Estates

Unit Manager

May 2014 - present

• Perform patient assessment and analyze patient data

• Oversee and train nursing staff

• Develop patient plan of care based on patients condition

• Provide education on disease management and infection control

•

Independent Nurse

Rn Case Manager

November 2013 - present

• Effectively uses the Nursing Process in the delivery of patient care.

• Assesses learning needs and implement teaching strategies appropriate for the diverse needs of the

patient, family and other groups or disciplines.

• Communicates, delegates and manages nursing team resources (human and fiscal)

• Utilizes data, information and knowledge to evaluate and promote change in order to achieve optimal

outcomes

Atlas Home Healthcare

RN Supervisor (PRN)

August 2013 - present

• Supervise and direct all client services

• Intake and coordination of a referral form an acceptable referral source

• Initial in home evaluations and/or assessment

• Establish the patients’ individualized treatment and client record baseline

• Collaborate with other agency staff: and contract services to coordinate and implement the POC

• Supervises the implementation of the POC and the quality of care delivered to the patient

• Provides in home supervision of Home Health Aide Services at least every 14 days for patient receiving

aide services and documents the visit in the client record

Seven Oaks

Admission and Discharge Planner

September 2013 - February 2014

• Identified and maintained relationships with hospital discharge planners

• Received referral from Physician, Hospital or Insurance based Case Manager on all Transitional or sub-

acute patients

• Posted ICD-9 and CPT codes for reimbursement of claims

• Ensured initial and ongoing fiscal appropriateness of patient admissions to the transitional care unit

• Determined patient Medicare, Managed Care and third party insurance coverage for potential and

newly admitted Patients

Village of Manor Park

Regina Thomas, RN

Milwaukee,Wisconsin

********@*****.***/414-***-****

Case Manager

October 2011 to May 2013

• Reviewed authorization request for insurance companies for medical treatment

• Confirmed the plan provides coverage for the patients’ medical services

• Performed utilization review duties with insurance companies on patient care

• Helped insurance companies minimize costs and determine if the recommended treatment is

appropriate.

• Confirmed that health plan provides adequate coverage for the patient particular condition

• Acted as liaison between patients and health care providers to provide accurate health care decisions.

• Served as a clinical resource to insure the safe, timely and appropriate use of home care, home

infusion therapy and home medical equipment

•

Brookfield Rehab Centers

Staff Nurse

March 2011 to September 2011

• Observed, recorded and reported to the RN supervisor on the general physical and mental conditions

of the patient;

• Assisted in the achievement of occupancy goals by monitoring the health, safety and well-being of

residents

• Managing Ivs

• Ensuring patients and their families understand release instructions

• Supervising CNAs (Certified Nursing Assistants)

• Admitting new residents

• Administering medications and doing treatments as order.

SouthPointe HealthCare

Staff Nurse ( Pool Staff)

August 2007 to January 2011

• Observed, recorded and reported to the supervisor on the general physical and mental conditions of the

patient;

• Assisted in the achievement of occupancy goals by monitoring the health, safety and well-being of

residents

• Monitored and participated in QI and Risk Management programs

• Managing Ivs

• Ensuring patients and their families understand release instructions

• Supervising CNAs (Certified Nursing Assistants)

• Admitting new residents

• Administering medications and doing treatments as order.

Education:

Concordia University Wisconsin: RN-BSN-MSN (current)

Milwaukee Area Technical College

Associate Nursing Degree

Contact this candidate