Christa Blue-Alston, RN

West Allenhurst, NJ ***** ■ 732-***-**** ■ ad0ehv@r.postjobfree.com

Registered Nurse

Background encompasses 20+ years of nursing experience in the areas of direct patient care, assessments, care plan development, patient teaching, patient relations, clinical supervision, and case management. Dedicated, detail-oriented healthcare professional with strong clinical, interpersonal, communication, and organizational abilities. Education

• Brookdale Community College, Lincroft, NJ – Associate of Applied Science in Nursing, 2003

• Monmouth County School of Practical Nursing, Long Branch, NJ – Awarded Certificate of Completion, 1991

• Union Technical Institute, Neptune, NJ – Completed Medical Assisting Course, 1987

• Licenses – State of New Jersey Registered Nurse

Professional Experience

HORIZON BLUE CROSS BLUE SHIELD, Wall, NJ June 2020 – Present Case Manager

• Maintain a high rate of member satisfaction by providing timely and relevant resources and information regarding healthcare options, benefits, and solutions. Coordinate care among providers, DME companies, and other vendors.

• Review members’ cases, medical histories, and diagnoses to provide education to reach healthcare objectives. Work collaboratively with internal Medical Directors regarding challenging cases to develop care strategies and approaches. HACKENSACK-MERIDIAN HEALTH, Red Bank & Neptune, NJ Aug. 2016 – May 2020 Utilization Review Case Manager

Riverview Medical Center (Apr. 2017 – May 2020); Jersey Shore University Medical Center (Aug. 2016 – Apr. 2017)

• Performed daily utilization reviews of ER admissions to ensure medical necessity for admission and continued stay.

• Completed 25-30 utilization reviews each day with an exceptionally low rate of insurance denials.

• Worked closely with a multidisciplinary team, which included physicians, social workers, and other case managers.

• Reduced the hospital’s risk and liability by ensuring appropriateness of ER admissions.

• Maintained written, email, and phone correspondence with various insurance payers to coordinate case reviews.

• Minimized patients’ lengths of stay while ensuring proper care through comprehensive case reviews and progression of care reviews. Ensured compliance with all regulatory standards, including CMS guidelines.

• Played a key role in reducing healthcare costs through detailed and comprehensive case reviews. RIVERVIEW MEDICAL CENTER, Red Bank, NJ Apr. 2006 – Aug. 2016 Registered Nurse – Medical-Surgical Floor (per diem), 2006-2016

• Performed all aspects of patient care on a 29-bed medical-surgical floor. Performed patient assessments and created nursing care plans. Member of a multidisciplinary healthcare team; interfaced with physicians, RNs, therapists, and other health care professionals to coordinate and implement treatment plans. Supervised PCAs.

• Educated patients in disease processes, medical treatments, medications, and home care procedures.

• Initiated & maintained IV infusion lines. Performed wound care. Aided physicians in performing invasive procedures.

• Performed all aspects of new patient admissions. Obtained medical histories.

• Served as Charge Nurse. Monitored work performed by nursing staff to ensure compliance with quality standards and hospital regulations. Coordinated assignments. Responded to emergency situations on the unit. Registered Nurse – Psychiatric Floor, 2007-2010

• Assessed incoming patients and coordinated admittance. Prepared documentation to process commitments.

• Facilitated groups in medication, stress management, coping, and interpersonal skills. HORIZON NJ HEALTH, West Trenton, NJ 2012 – 2015

Registered Nurse/Case Manager

• Performed all aspects of case management for a portfolio of 70 to 100 members. Provided local resources for a wide range of basic services and needs including healthcare coordination, food, transportation, and housing.

• Educated members in disease states, medication, diabetes management, and healthcare options and services. Prior Experience

• Monmouth Medical Group, Colts Neck, NJ – Registered Nurse/Back-Office Manager, 2005-2007

• Riverview Medical Center, Red Bank, NJ – Registered Nurse, 2003-2004; LPN, 2001-2003

• Licensed Practical Nurse, 1992-1999