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Manager Case

Location:
Dickinson, Texas, 77539, United States
Posted:
October 17, 2016

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Resume:

• REGISTERED NURSE

• COMPLEX CASE MANAGER

• TRANSITIONAL CARE / MANAGED CARE NURSE

QUALIFICATIONS Summary

TEXAS RN LICENSE 530557

Current BCLS

Certified Hospice and Palliative Nurse

Advanced Cardiac Life Support Nurse (not current cert)

Specialty Areas of Expertise

Managed Care

Medicare

Medicaid

Hospice

Home Health

Psychiatric

ICU

Palliative Care

Geriatrics

Documentation and Computer Skills

Proficiency with computer skills which includes navigating multiple systems simultaneously

Proven ability to multitask, and prioritize tasks in a fast paced environment still ensuring high productivity and quality of computer generated documentation

Expert level of “bedside manner” developed during 30 years experience in Acute Care, Home Health and Hospice Care, which encompasses the critical areas of effective communication skills, both verbal and written

Proven abilities to utilize computer, and communication systems in a field and home office environment

Cross Facilities Coordination

Expertise in Coordination in various Medical Environments including and not limited to:

• Hospitals, Nursing Homes, Skilled Nursing Facilities, Long Term Care Facilities, Rehabilitation Facilities, Client Residences

Expertise in Coordination of various Medical Services including and not limited to:

• DME Companies, Physician Offices, Home Health Companies, Insurance Companies

Skill Base

Utilizes interviewing skills to ensure maximum member engagement in case management

Expert presentation of cases in multidisciplinary conferences for review/suggestions and peer training

Utilizes clinical tools and information/data review to evaluate member's needs and benefit plan eligibility

Address’ information from all sources to indentify conditions including co-morbid and multiple diagnoses that impact functionality during assessments

Reviews all available documentation for multiple possible impacts on current case management

Expert experience in assessing the need for clinical referrals

Proven facilitation of determining eligibility of appropriate benefits and/or healthcare information for members

Proven ability to utilize Health Strategies promoting activities that help ensure overall member wellness

Utilizes Services and strategies, policies and programs to successfully and timely return members to work

Proven skills to develop, implement, and support strategies, tactics, policies, and programs designated for the timely delivery of benefits to members

Provide utilization review, assessment of patient needs/family abilities, transitional care/discharge planning and continuity of care arrangements for patients Complex Health Care Issues

Proven skills to in network management, and clinical coverage

Professionalism and Integrity

Deep Core belief in Nursing code of ethics

Advocate for members utilizing a holistic approach for guidance navigating the healthcare system,

Result oriented, highest level of care for client, and delivery of necessary documentation on time

Utilizes case management processes in compliance with regulatory and company policies and procedures

Utilizes supervisors and others for mentoring in meeting goals and objectives for highest care KELLY A. HARRIS, RN

PO BOX 1028, DICKINSON, TEXAS 832-***-**** acw3mz@r.postjobfree.com Page 2 of 3

EMPLOYMENT HISTORY Summary – Companies and Titles only Aetna Houston, Texas

August 2014 – September 2016 (current)

TRS CASE MANAGER

Univita Health Care Houston, Texas

January 2013 – June 2014

TRANSITION COACH

HOUSTON TEAM LEAD

HOUSTON TRAINING COORDINATOR

DEVELOPMENT ADVISOR FOR INITIAL PILOT PROGRAM

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United Health Group Houston, Texas

2007 – 2011 (4 years)

CASE MANAGER - LEVELS 3/4

CASE MANAGER - HOSPICE

Hospice Care Team Texas City, Texas

1999 –2004 (5 years)

CASE MANAGER - HOSPICE

CASE MANAGER - ON CALL POSITION (FULL CASE LOAD) First American Home Health League City, Texas

1994 -1997 (4 years) concurrent with Continue Care

CASE MANAGER – MEDICARE HOME HEALTH

Continue Care Health Services Houston, Texas

1992 -1995 (4 years) concurrent with First American

MEDICARE PER DIEM NURSE

Baywood 1986-1992 (Psychiatric 6 years) Institute Webster, Texas

STAFF NURSE

GENERAL PSYCHIATRIC NURSE

SUBSTANCE ABUSE NURSE

ACUTE PSYCHIATRIC NURSE

Clear 1986-1992 Lake (6 Hospital years) Webster, Texas

ICU CORONARY CARE

ICU GENERAL CARE

ICU SURGICAL CARE

St. Luke’s Episcopal Hospital Houston, Texas

Texas Heart Institute Houston, Texas

Texas 1984-1985 Children’s (2 years) Hospital Houston, Texas

STUDENT NURSE

Training in all specialties assisting with patient care KELLY A. HARRIS, RN

PO BOX 1028, DICKINSON, TEXAS 832-***-**** acw3mz@r.postjobfree.com Page 3 of 3

EDUCATION AND TRAINING

San Jacinto College Pasadena, Texas

Associates Degree, Nursing Major

The University of Houston Clear Lake Campus - Houston, Texas 50+ hours achieved towards a Bachelor of Science Degree Texas Nursing Board

Completion of required Continuing Education courses since 1985 as required by the Texas Board of Nurse Examiners

All Employers

Completion of all required training by various employers during course of career KELLY A. HARRIS, RN

PO BOX 1028, DICKINSON, TEXAS 832-***-**** acw3mz@r.postjobfree.com



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