Registered Nurse Manager
Resume:
BILLY JOE SWEANEY
**** ***** **** *****, **********, TX 77423 (H) 713-***-**** (C) 713-295-038 **************@*****.****
RN,BSN,BS
**** ***** **** *****, **********, TX 77423 (H) 713-***-**** (C) 713-***-**** **********@*****.***
Professional Summary
Experienced RN Case Manager with strong clinical and people skills.
Professionally trained nurse case manager with experience ensuring high standards of culturally competent care for wide variety of patients with diverse needs. Registered Nurse with 8+ years experience in clinical settings providing nursing care to diverse populations. Nurse Case Manager with valid State RN License. Solid clinical, utilization review and case management experience within a managed care environment.
Skills
*Strong clinical judgment *Works well with interdisciplinary providers
*Neurology awareness * Knowledge of Medicare Advantage healthcare plans,
*Great team member * Knowledge of many types of healthcare plans
*Preceptor * Knowledge of Medicaid and other state programs
*High level of autonomy * Thorough assessments
*Patient/family focused * Adept at prioritizing/managing deadlines
*Patient evaluation/intervention * Acute care expertise
*Problem resolution capability * ICD9-ICD10 Coding awareness
*Professional bedside manner * Milliman's 8th, 9th, 10th Editions
*Patient and family advocacy * Meets eligibility for CCM Examination/Certification
*Advanced computer skills * Meets eligibility for Wholistic Nursing Exam/Cert
*History of numerous provider and members/patients
where goals were successfully met
*Emphasis on patient teaching to assist in goal setting to
improve healthcare knowledge and interventions
*Devised operational instructions on common computer
skills for team members
*Utilization management experience
*Cost containment and cost effectiveness strategies to ensure highest quality of care with cost and benefit
Appropriate and efficient usage
*Provides outstanding interpersonal communication skills
*Fun loving, flexible, and easy to work with
Work History
RN Case Manager 10/2012 to 12/2014
Aetna, Inc. – Sugar Land, TX
-Effective counseling in health maintenance and disease management.
-Liaised between patients and physicians to ensure patient comprehension of treatment plans.
-Diagnosed and treated patients with chronic and acute health problems such as MI, arrhythmias, asthma,
COPD, diabetes and pneumonia
-Developed and implemented nursing care plans.
-Developed patient care plans, including assessments, evaluations and nursing diagnoses.
-Documented patient information obtained from interviews.
-Ensured efficacy of treatments through monitoring of treatment regimens.
-Ensured HIPAA compliance.
-Contributed substantially to successful department JCAHO accreditation.
-Closely monitored acute conditions.
-Instructed patients and family members on proper discharge care.
-Liaised between patients and physicians to ensure patient comprehension of treatment plans.
-Self-directed with astute judgment skills. High level of personal accountability.
-Assisted with IT issues for team as well as devised printed instructions on procedures to provide effective and
efficient task completion
RN 06/2007 to 10/2012
The Methodist Hospital – Houston, TX
-Assessed need for, ordered, obtained and interpreted appropriate lab tests.
-Chronic patient care in med-surg unit, adeptly handling all aspects of treatment from medication to post-
surgical care.
-Self-directed with astute judgment skills. High level of personal accountability.
-Managed care for post-operative patients through discharge.
-Performed lab tests and communicated results.
-Liaised between patients and physicians to ensure patient comprehension of treatment plans.
-Instructed patients and family members on proper discharge care.
-Ensured HIPAA compliance.
-Contributed substantially to successful department JCAHO accreditation.
-Participated in unit-based Quality Assurance Program.
-Developed and implemented nursing care plans.
-Developed patient care plans, including assessments, evaluations and nursing diagnoses.
-Documented patient information obtained from interviews.
-Delegated staff nurse duties.
-Ensured efficacy of treatments through monitoring of treatment regimens.
-Assisted patients with daily functions.
-Monitored fluid intake and output levels.
-Collected blood, tissue and other laboratory specimens and prepared them for lab testing.
BF Terry High School teacher 08/2002-08/2005
-Geometry and Algebra teacher
-Worked with lower grade students to increase their excitement and involvement in improving their grade
point average as well as interest in furthering their education beyond high school.
-Improved student test scores on state math tests by working with in a tutoring capacity.
-Consistently received positive teacher evaluations from students.
-Met with parents to resolve conflicting educational priorities and issues
Jr. High Math & Math Lab teacher 08/1996 to 08/2002
C.E. King Middle School---Sheldon ISD – Houston, TX
-Worked with lower grade students to increase their excitement and involvement in improving their grade
point average as well as interest in furthering their education beyond high school.
-Improved student test scores on state math tests by working with in a tutoring capacity.
-Consistently received positive teacher evaluations from students.
-Met with parents to resolve conflicting educational priorities and issues.
-Ran Math Lab
Education
Bachelor of Science: Nursing 2007
University of Texas Medical Branch (UTMB) - Galveston, TX
Was offered accelerated nursing program.
Bachelor of Science: Mathematics 1995
Missouri State University - Springfield, MO
Accomplishments
<Documentation
<Ensured charting accuracy through precise documentation.
<Patient Care on a neurological surgery floor
<Training
<Trained team of staff nurses in medical office procedures to ensure consistent quality of care. IT support of team on various projects.
<Clinical Skills
<Monitored patients' respiration activity, blood pressure and blood glucose levels in response to medical administration. IV therapy, RN Scope of Practice Acute IP Care
<Patient Advocacy
<Explained treatment procedures, medication risks, special diets and physician instructions to patients.
<Quality Assurance
<Ensured and enforced medical office compliance with HIPAA, OSHA and CLIA regulations for maximum quality and control.
Certifications
>Registered Nurse in Texas, License number 746231, 2007.
>Permanent Certification in Texas for secondary Education.
Additional Information
Graduated Cum Laude
Full Home office set up/Broadband to work at home efficiently and effectively
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