Registered Nurse Case Management
Resume:
Pranav Patel
Registered Nurse
Dedicated and compassionate Registered Nurse with extensive experience in direct patient care and case management in fast paced environment. Proven ability to remain calm under pressure and skillfully handle difficult patients and high-stress situations.
ad20f2@r.postjobfree.com 630-***-****
EDUCATION
01/2014 – 04/2016
Associate of Science in Nursing ADN (RN)
Ambria College of Nursing
01/2008 – 02/2009
Diploma in Nursing LPN
Ambria college of Nursing
SKILLS
Case management Utilization Review
Quality Improvement Geriatric Nursing
Advance computer skills Excellent communication skills Intravenous therapy Leadership Management
Clinical documentation Improvement
Excellent phone presence
LANGUAGES
English
Native or Bilingual Proficiency
Hindi
Full Professional Proficiency
Gujarati
Native or Bilingual Proficiency
WORK EXPERIENCE
11/2019 – Present
Case Manager Emergency Department
AMITA Health (St. Alexius Medical Center)
Assuming primary case responsibility for documentation of appropriate medical necessity and level of care assignment for inpatient, observation, or outpatient status.
Communicating with physician, ancillary staff, and payers, and assisting in arranging transfers or alternate placement when indicated.
Assisting with complex, specialized billing and follow-up workflows including billing procedures requiring extensive communication with other departments.
Serving as content specialist for staff in the areas of utilization criteria, review process, and system documentation. Promoting appropriate Post hospital utilization of resources, including transitional care, adequate education of patient and caregivers, to decreased incidence of readmissions and improve patient outcomes.
06/2019 – 11/2019
Utilization Review Specialist
AMITA Health (North-West Region)
Analyzed patient records to determine legitimacy of admission, level of care, treatment and length of stay of patients.
Reviewed application for patient’s admission and approved admission or referred case to facility utilization review committee for review and course of action when case failed to meet admission or observation standards
Communicated with physicians to ascertain their plans for a timely discharge
Consistently related utilization assessment to payers that are needed to justify continued stay review
Collaborated with social work and case management to arrange discharge planning referrals per physician orders Identified denial patterns address payer disputes
Coached and mentored new team members when assigned. Achievements/Tasks
Achievements/Tasks
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WORK EXPERIENCE
11/2017 – 06/2018
Medical Surgical Registered Nurse
AMITA Health Bolingbrook Adventist Hospital,
Prepared, administered (orally, subcutaneously, through an IV) and recorded prescribed medications. Reported adverse reactions to medications or treatments in accordance with the policy regarding the administration of medications by a licensed registered nurse.
Initiated corrective action whenever the patient displayed adverse symptomatology.
Changes dressings, inserts catheters, starts IVs.
Prepares equipment and aids physician during examination and treatment of patient.
Responds to life-saving situations based upon nursing standards and protocol.
02/2009 – 05/2018
RN, Unit Nurse
Pathway Senior Living, IL
Assessed resident’s physical status upon admission, during severe changes in health, and annually
Established a care plan using the information that was gathered during assessment process.
Assured quality of care by adhering therapeutic standards; measuring health outcome against patient care goals and standards.
Managed residents’ medications, making sure to test a resident’s ability to manage their own medication
administration and storage
Resolved patient problems and needs by utilizing
multidisciplinary team strategies.
02/2009 – 04/2013
LPN, Unit nurse
Belmont Village
Assessed resident’s physical status upon admission, during severe changes in health, and annually
Assured quality of care by adhering therapeutic standards; measuring health outcome against patient care goals and standards.
Managed residents’ medications, making sure to test a resident’s ability to manage their own medication
administration and storage
Achievements/Tasks
Achievements/Tasks
Achievements/Tasks
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