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Case Manager Management

Location:
Urbana, OH
Salary:
100,000
Posted:
December 12, 2023

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Resume:

Denise Martin

*** ******* ******, ******, **** 43078, 937-***-****, ad1wvg@r.postjobfree.com

I have been an RN for many years. I have strong clinical experience in Critical Care, and worked as a Travel RN as a Critical Care RN. With experience as a travel RN, I had to jump in, and start working without orientation. I have worked in Homecare and Managed care/other Insurance companies as a Case Manager. I have audited charts regarding records and recouping money.

I have also worked in various types of Clinics which included Wellness, Flu, Pediatric Neuromuscular Dystrophy clinic/office, and clinics for conferences. At these clinics I worked along with Paramedics regarding various types of medical situations that occurred. I am working in the Neuromuscular clinic working the children and families as a clinic and case manager. Also, I have worked in Long Term Care, and have had family in the Long Term Care center. I have worked alone with others managing the supplies and the paperwork that was needed. I have worked with electronics and medical software, Milliman Care Guide, and ICD10. I have ICU and telemetry experience

Experience

6/5/2023- Present Neuromuscular Clinic-Office and triage Nurse

555 S 18th Street, OC1A Clinic; Columbus, Ohio 43205

Nationwide Children’s Hospital

I work in the clinic two-three days a week. I help the patients be roomed, do an assessment regarding medications, changes in mobility/assessment by asking patient/parents. Work with patients who have wheelchairs. I have also worked with gene-therapy patients during and post gene therapy. In the Neuromuscular clinic I work with multidisciplinary physicians and therapy to assist what is best for the patients and children.

As an office nurse, I work with the admins, other nurses, and physicians to assist the patients and parents regarding Medical Equipment, medications, Home care, Letters for schools and Certification of Medical Necessary, and Prior Auths and appeals for the various medications that these patients/children need so their lives can improve. I am considered a triage nurse that helps facilitate the calls to help with the needs of the patients. I compose a lot of letters regarding Medical Necessity, medication and Medical equipment denials and appeals, school letters, etc…

10/29/2018-5/31/2023 OSU as a Clinical Case Manager

410 West 10th Ave Columbus, Ohio 43210

OSU Wexner Medical Center

Worked as a Case Manager (Pulmonary services), ICU and Neuro critical care. I worked as a team member with other RN's, Social Workers, Residents, Certified Nurse, Practitioners/Physician Assistances, Physical and Occupational therapy, and Attending Physicians. The team is responsible in assisting the patients in medical care and needs which are needed for post discharge from the hospital to home with home care skilled nursing facilities, LTACH and IPR. I also have floated to other teams, and worked with medical, surgical, trauma, orthopedic, and burn patients. I also worked with EPIC charting system. Worked with infusion, DME, respiratory equipment, Prior Auths, and enteral therapy companies.

Denise Martin

118 Madison Avenue, Urbana, Ohio 43078, 937-***-****, ad1wvg@r.postjobfree.com

3/30/18-10/26/2018 For OSU as a Clinical Case Manager

410 West 10th Ave Columbus, Ohio 43210

Medical Staffing Options Main address:

Worked as a Case Manager as a contract nurse as team member, while being a traveler, with other RN's, Social Workers, Residents, Certified Nurse Practitioners/Physician Assistances, Physical and Occupational therapy, and Attending Physicians. The team is responsible in assisting the patients in medical care and needs that are needed for post discharge from the hospital. I also have floated to other teams, and worked with medical, surgical, trauma, orthopedic, and burn patients. I worked with EPIC charting system. I worked with Neurology, surgical, orthopedic, and respiratory services.

5/31/2017-2/28/18 For Premier Health Partners

110 N Main St Dayton, Ohio 45401

Evolent Health Healthcare Main address:

800 N Glebe Road, Suite 500, Arlington, VA 22203 571-***-****

Registered Nurse Care Advisor

I worked for Evolent Health Care which was a contract company for Premier Health as a telephonic RN. I was a temp employed by Evolent then hired on fulltime. I work as a Telephonic Care advisor assisting patients in obtaining the education and medical equipment needed to help them manage their health care, and feel that they can obtain what they need regarding health care needs. I also worked with the physician offices making them aware of what the patient may need. I also worked as a Team Member. I worked with Medicare and Medicaid patients, along with DSNP patients, Discharge planning, Disease Management, and worked with Passport case managers regarding assistance related to patients' individual needs.

3/1/2017-5/26/17 For Premier Health Partners through Evolent Health Care

110 N Main St Dayton, Ohio 45401

Judge Staffing for Evolent Health care

Registered Nurse Care Advisor

Worked as a temp telephonic nurse for Evolent Health as a Care Advisor for Premier Health. I worked as a Telephonic Care advisor assisting patients in obtaining the education and medical equipment needed to help them manage their health care, and feel that they can obtain what they need regarding health care needs. I also worked with the physician offices making them aware of what the patient may need. I also worked as a Team Member. I worked with Medicare and Medicaid patients, along with DSNP patients, Discharge planning, Disease Management, and worked with Passport case managers regarding assistance related to patients' individual needs.

Denise Martin

118 Madison Avenue, Urbana, Ohio 43078, 937-***-****, ad1wvg@r.postjobfree.com

6/2016-12/2016 1257 N Fairfield Rd 1A Beavercreek, Ohio 45432 937-***-****

Choice Health Care

Registered Nurse Home Care Chart Review

Worked as an RN as a QA nurse for HHC cases. I educate the nurses on what is needed to improve

charting. Also Put ICD10 codes regarding the patient's diagnosis and the needed

info to complete the charting.

6/2015-6/2016 (Fulltime) 1111 N Plum St #4 Springfield, Ohio 45504 937-***-****

Community Mercy Home Care

Registered Nurse Home Care Case Manager

Worked as an RN as team member in assisting patients at home. Work with Wound care, IV's, PICC

lines, Education for chronic medical conditions, and post surgeries. Worked with wound vacs, IV

antibiotics per ports and PICC lines, draw blood from lines and sticks, monitor BS- O2 sats, assess

to see if conditions are worse, coags for PT-INR, and worked with different types of stockings and

dressings. Worked with various Doctors regarding the care of their patients. I worked with Disease

Management, discharge planning, and Medicaid and Medicare patients. Did LPN and Home Health Aid reviews.

4/2012-6/2015 (Fulltime) 230 N Main St Dayton, Ohio 45401 937-***-**** CareSource Ins

Registered Nurse Case Manager

Most of my work was as a Telephonic nurse working with a team to help High Risk Members in obtaining optimal health. Setting up resources that might be available to the member, internally and in the community. Managing a team, reviewing the Members' notes and following if they are doing their part in assisting with the Members. I also went out into the community and met the Members at their homes, their Doctor appointments, in the hospital along with the discharge planner, in the home with the Home Care Agency, and also with Behavioral Health Providers for the Members. I worked with Medical and Behavioral Health members. I reviewed my own charts to make sure all is in order. I work with Medicaid and Medicare Patients. Help facilitate members obtaining Durable Equipment, pre-authorizations, and working out pharmacy concerns. Also helped them in getting Home Health Care and Private Duty nursing in their home, along with nutritional supplements, meds or other necessities for optimal health. I educated the members on their health and guiding them in how to take over and control their medical concerns. Helping them become their own advocate in dealing with health concerns. I worked with Disease Management and Discharge planning.

Denise Martin

118 Madison Avenue, Urbana, Ohio 43078, 937-***-****, ad1wvg@r.postjobfree.com

7/2007-1/2014 (Per diem) 1800 Watermark Dr, suite 430 Columbus, Ohio 43215

Academy Medical Services / Acloche 614-***-****

Registered Nurse/Staffing Perdiem positions

Most of my assignments involved working at first aide and wellness clinics. I have also done Insurance evaluations, along with flu clinics. I am responsible for assisting patients dealing with blisters, falls, low Blood Sugar, insulin shock, assisting squad when necessary, and directing patients to get more advance care when necessary. I worked as a Wellness RN who is responsible in teaching health, doing BMI’s, Cholesterol checks, bone density, and Blood Pressures. Teaching clients on how to become and stay healthy.

I did insurance assessments concerning original applications and also for long term insurance, mainly for senior citizens.

7/2011-03/2011 2200 East Main St. suite B Springfield, Ohio 45503 Cambridge Home Health 937-***-****

Registered Nurse

Home Care Nurse.(Case Manager) I opened cases, managed, and followed the care of the clients. I worked with Newborn clients to Senior Citizens. The clients dealt with various medical problems. I also do supervise visits of the client and home staff. I also reviewed and organized charts. I educated the Patients, followed Blood Sugar and BP's. I advocated for the patients related to their needs. I also did wounds, IV's and blood draws when needed. Did LPN and Home Health Aid reviews.

8/2008-8/2011 3055 Kettering Blvd. Ste319 Moraine, Ohio 45439 937-***-****

Maxim Health Care

Registered Nurse

Audit charts/utilization review. Assess the charting and explain how to improve the documentation. Also helped setting up how to improve charting and decrease errors. Compared the orders to the documentation. Educated the employees on correcting errors.

I assisted and ran Wellness and flu clinics, and administered vaccinations. I instructed patients

on how to improve their health and what the lab results meant. Also responsible in teaching how

to become and stay healthy, doing BMI’s, Cholesterol checks, bone density, and Blood Pressure.

Involved in orientation of new employees.

10/2005-Perdiem - December 2013 Private Duty Urbana, Ohio 43078

Caregiver, Nurse-Patient Advocate/Self Employed

Assisted Clients with everyday living. Assisted with patients medical and non-medical needs

Advocated for patients with Physicians, Hospitals, and Insurance Companies. Gave patients more independence by being able to stay in their homes. Assisted with the patient’s family understanding when a patient needed to be moved to a 24 hour care facility. Sold wound care devices/distributor and demonstrator. I worked with an Oxygen company and educated and assessed the patient/and oxygen equipment. I was contracted to run IV's and TPN. I also did Hospice care.

Denise Martin

118 Madison Avenue, Urbana, Ohio 43078, 937-***-****, ad1wvg@r.postjobfree.com

Other Work Experience Continued:

Clinical Experience 07/1980-4/2005

Worked at various Home Health Care agencies as a Part-time RN Case Manger to assist

patients in their home regarding medical needs and education. Managed wound care, IVs, and

managed medications, and assessed the patient's needs regarding other medical needs.

Traveling Registered Nurse

Completed work on ICU units, Neuron-ICU units, CCU, Step down units, and Transplant Units

throughout the United States. Went in without orientation, and learned the policies and techniques that

were favored at that facility by asking questions.

Continuation of Other Work Experience

Memorial Medical Center- Registered Nurse Critical Care

Worked in ICU, CCU, ER, OB departments, and Telemetry Unit

Assisted with post surgery, cardiac, post open heart, trauma, and pediatric patients, also floated

to other units in the hospital. Worked with Central Lines, Swan Ganz ports, ventilators, Chest Tubes,

Balloon Pump, ICP Monitor, Heart Monitor, Pulse Ox, and all equipment used in Critical Care.

Was PALS, and ACLS certified at that time. Assisted in the transporting of critical patients to other

Hospitals and Care Facilities

One Day Surgical Center

Worked as OR, Admitting, and Recovery Room Nurse

Sterilized equipment, admitted patients, assisted in OR

Completed patient education; pre and post-op; and ran labs when necessary. Also called and

check on patients to see how they were doing post-op.

Skills:

Microsoft Office, email, Power Point, Excel, Computer,

Wound Care, IVs, vents, traches, art lines, swans ganz, feeding tubes, PICC lines, Central Lines,

Balloon pumps, Chest tubes, JP drains, drains, ortho equipment, ICP monitors

Epic, other company medical software, Disease Management, DSNP, Managed Care, Insurance

Case, Manager, HHC RN Case Manager, discharge planner, clinic nursing, triage nurse, appeal

nurse.

Denise Martin

118 Madison Avenue, Urbana, Ohio 43078, 937-***-****, ad1wvg@r.postjobfree.com

Education

Alternative Medicine Training

Involved with Alternative treatment and Medicine and Health and Wellness since 2001

Milliman Care Guidelines/study guides/tutorial

2009 On job training

Registered Nurse Refresher Course

2005 Upper Valley Medical Center Troy, Ohio

Legal Nurse Consulting

2003 College for Professional Studies Boca Raton, Florida

Legal Nurse Consulting Certification

Registered Nurse

1980 Community Hospital School of Nursing/Clark State Community College

570 East Leffel's Lane Springfield, Ohio 45505

Registered Nurse Diploma Degree

(May be part of Clark State School of Nursing in Springfield, Ohio)

1976-77 Ohio Wesleyan Delaware, Ohio

1 yr of pre-nursing

General Education

1976 Urbana High School Urbana, Ohio

College Prep Classes High School Diploma

Continuing Education

CPR May 2023-July 2025

Ohio Nursing License renewed 10/2021to 10/2023

Multi License/Nursing Jan 2023 initiated for Ohio

Denise Martin

118 Madison Avenue, Urbana, Ohio 43078, 937-***-****, ad1wvg@r.postjobfree.com

Community Service

05/2006-2012 Medical Reserves Corps

Volunteer for community emergency organizations

2003-2012 Parish Nurse

Assist the church set up a Parish Nurse committee for the congregation

1994-2003 Cancer Association of Champaign County

Volunteered as a member of the board, assisted with fundraisers to provide financial

assistance to patients dealing with Cancer in Champaign County

1996-1998 Special Needs Children Boa rd

Volunteered as a member of the board, assisted families with children with special needs, such

as: Autism, cognitive deficiencies, and behavioral issues, by offering education on how to

advocate for their child.

License Number/certification/ References

Upon request

I have been a nurse for over 40 years with vast experiences.



Contact this candidate