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Case Manager Practical Nurse

Location:
Stockbridge, GA
Posted:
October 11, 2023

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Resume:

RW

Ryeisha Woodard

Professional Summary

Dependable, Professionally trained, highly skilled, organized and enthusiastic LPN, who takes initiative and embrace challenge and opportunity. As well as having experience in ensuring high standards of culturally competent care for a wide variety of patients with diverse needs. Work History

Kaiser Permanente - LPN(PRN)

Atlanta, GA

08/2022 - Current

HealthSnap - Case Manager (Full Time, 36Hrs.)

Lakeland, FL

08/2021 - 08/2022

Monitors electronic messaging related to patient and provider requests and inquires within scope of practice

Determines patient and family health education needs, provides health teaching and counseling and evaluates effectiveness of the education process.

Obtained case history and gathered triage information to determine appropriate avenue for care.

Educated patients, families and caregivers about conditions and treatments.

Delegated patient care responsibilities to nursing assistants and student nurses.

● Observed and assessed patients to identify concerning symptoms. Clearly and thoroughly explained diagnoses, treatment options and procedures to patients and loved ones, checking in to verify understanding.

Administered testing with electrocardiogram for patients experiencing events and as screening tool.

Administered medications via oral, IV, and intramuscular injections and monitored responses.

● Participate in quality improvement activities

Analyzed patient assessments and laboratory data to bring any issues to attention of physicians.

ad0bhy@r.postjobfree.com

678-***-****

McDonough, GA 30253

Skills

● Case management

● Performance Monitoring

● Epic Systems

● Team Building

● Recordkeeping and Maintenance

● Planning and Coordination

● Google Workspace

Education

12/2017

GA Piedmont Technical College

Newton, GA

Practical Nursing Diploma

Certifications

● Licensed Practical Nurse of Georgia

BLS CPR – Adult, Infant & Child w/

AED & First Aid(American Heart

Association)

Health Information Technology

Certificate

Conduent Business Solutions - Medical Review Auditing Nurse (Part- time, 20Hrs.)

11/2021 - 04/2022

Georgia Behavioral Health(Full-time, 40 Hrs.) - Licensed Practical Nurse Stockbridge, Georgia (GA)

06/2019 - 11/2021

Kaiser Permanente (Full-time, 40 Hrs.) - Licensed Practical Nurse

● Remote patient monitoring for Hypertension and Diabetes Assisted members with social determinants of health and linked to appropriate community resources.

Worked with patients to ascertain issues and make referrals to appropriate specialists.

Provided information about health system navigation, patient rights and health information privacy.

Partnered with physicians, social workers, activity therapists, nutritionists, and case managers to develop and implement individualized care plans and documented patient interactions and interventions in electronic charting systems.

Evaluated treatment plans against individual goals and healthcare standards.

Provided education on health and nutrition for patients to maintain healthy habits and wellbeing.

Coordinated with community stakeholders for successful implementation of social and community service initiatives.

Reviewed medical bills unrelated charges, non compensable charges, coding, and billing errors

● Process ER claims(ie. down code or approve)

Reported findings to quality departments after conducting routine restraint audits and worked with team to devise corrective actions for deficiencies.

Compiled, abstracted and coded patient data using classification manuals and standard systems.

Used correct diagnosis-related groups based on patient encounter details.

Evaluated medical guidelines and benefit coverage to determine appropriateness of services.

● Answered between 100-150 calls from patients

Performed prescription tracking and process refills and co-payments electronically

● Schedule appointment for medication management/therapy Contact pharmacies to inform of prior authorization approval or denial for medication

Performed routine evaluations of each patient's status, needs and preferences.

Collaborated with interdisciplinary team of healthcare and social service providers to address patients' needs through effective intervention and care planning

● Completed referrals and provided referral status to callers 12/2017 - 06/2019

Premier Primary Care Center(Full-time, 36 Hrs.) - Medical Assistant College Park, Georgia

01/2011 - 12/2015

● Triage patients of both adult and pediatric patients

● Completed school forms and patient charts, using EPIC and GRITS. Explained course of care and medication side effects to patients and caregivers in easy-to-understand terms.

Continually evaluated patient care needs, prioritizing treatment and maintaining patient flow.

Performed several medical procedures, including temperature, pulse and blood pressure readings, TB testing and EKG's.

Made outreach calls for preventive care which include reviewing patient care gap reports presented in the EPIC EMR system and scheduling members to have those care gaps addressed and completed during office visit.

Proactively scheduled patients for appointments particularly for blood pressure check, A1C screenings, mammograms, BMI, immunizations and colorectal cancer screenings.

Educated members on conditions such as diabetes and A1c levels, on what preventive measures can be taken to keep levels within normal limits

Assisted with routine checks and diagnostic testing by collecting and processing specimens for adults and pediatrics

● Obtain immunization from GRITS

● Assisted with well exams and sports physicals

● Administered Vaccines to pediatric patients

Directed patients to exam rooms, fielded questions and prepared for physician examinations.

Communicated clearly and effectively with patients to verify information, determine purpose of visit and record medical history.

Followed guidelines, procedures, practices, rules, regulations, public law and/or policies related to prescription benefits and perform research utilizing a suite of automated systems.



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