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Case Management Manager

Location:
Las Vegas, NV
Salary:
$55-$60 per hour
Posted:
January 06, 2024

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Resume:

Verna Pitman

**** ***** ****** ** ***** Las Vegas, NV 89086 708-***-**** ad2imf@r.postjobfree.com

Professional Summary

Effective and compassionate Case Manager with over 15 years of experience and exemplary coordination ability. Solid clinical, utilization review, and case management experience. Highly competent with a passion for coordinating quality care for patients and offering exemplary interpersonal skills and commitment to helping patients receive care in line with preferences and standards of evidence-based practice.

Education

RN/BSN 2015 LEWIS UNIVERSITY

· Bachelor of Science Nursing

ASSOCIATE DEGREE 1986 TRITON COLLEGE

· Nursing Program

LPN 1980 TRITON COLLEGE

· Licensed Practical Nurse

Skills & Abilities

· Skilled in Conducting physical assessment

· Cardiac care nurse

· Committed to compliance reporting

· Advance Cardiac Life Support (ACLS) Certification

· Enthusiastic caregiver

· IV drug therapy management

· Medical clinical procedures comprehension

· Trained in- and out- patient care.

· Strong medical ethic

· Culturally sensitive

· Certification Case Management (CCM)

· Knowledgeable of Milliman

· Knowledgeable of InterQual

Experience

CASE MANAGER MACNEAL HOSPITAL 2008-2023

· Developed and maintained quality care systems and standards, including but not limited to creating and improving medical protocols/guidelines.

· Sound, ethical, and independent decision-making ability consistent with medical protocols.

· Performed all tasks with patient-centered focus while seeking opportunities to improve processes and treatments.

· Perform utilization and concurrent review of inpatient cases using Milliman and InterQual criteria.

· Conduct clinical chart assessments.

· Collaborate cases with treating physicians and other healthcare teams to understand the plan of care

· Determining needs, if any, for intervention and discussing with case managers and physicians.

· Identify and evaluate delays in care.

· Initiate a discharge plan and a readmission prevention plan.

· Arrange alternative care services; contact and maintain communication with long-term care, acute rehabilitation, or skilled facilities to move patients through the care continuum.

· Gather clinical information to assess and expedite care needs.

· Facilitate timely and appropriate care and effective discharge planning.

· Participate in team meetings, education discussions, and related activities.

· Maintain appropriate documentation.

· Consult with PA (Director) as needed to troubleshoot difficult or complex cases

· Identify opportunities for improved communication or processes.

· Participate in rounds with the medical teams regarding barriers

SCHOOL NURSE PROVISO EAST HIGH SCHOOL 2001-2022

· Provide medical care to the students, members of staff, and visitors while on site.

· Promote health education throughout the school community and take effective preventative health measures.

· Work with staff, students, and governors to develop health-related policies (physical activity, healthy lifestyle) and develop new initiatives in response to new research findings, examples of good practice, or new policy initiatives.

· Work with other designated members of staff, particularly the school counselor, to help to identify and act to safeguard children at risk of or suffering from physical (including self-harm), sexual, emotional abuse, or neglect as outlined in Every Child Matters agenda (2004).

· Work with the school counselor in terms of offering support and advice to young people concerned with issues of sexual identity and sexual health and help to develop peer health education schemes.

· Maintain medical and nursing records accurately, confidentially, and safely, comply with the school health and safety policies, and, while on duty, take specific responsibility for all health and safety matters relating to the surgery.

· Work closely and cooperatively with (Medical) and others terms of medical matters to ensure that seamless and continuous care is provide throughout the school week.

· Attended the meeting of the medical team maintain an appropriate level of training in all areas of practice.

STAFF NURSE ICU/CCU MACNEAL HOSPITAL 1990-2002

· Increased professional skills associated with numerous doctors and nurses at all levels.

· Responsible for promoting quality care.

· Post-op care for open heart patients.

· Post-op cardiac catheter and IABP patients.

· Charge nurse for the unit as needed.

TELEPHONE TRIAGE NURSE MACNEAL HOSPITAL 1997-1999

· Answer telephone inquiries regarding caller needs.

· Conducts sound nursing assessments, offering alternatives following established clinical guidelines.

· Refers inquiries to appropriate resources.

· Documents all inquiries for medico-legal/ statistical purposes.

· Maintains accurate records and reports and reports pertinent information regarding patient’s condition to the appropriate person.

· Utilizes the nursing process by assessing the needs and conditions of the caller.

· Maintain confidentially of all interactions. Interpret and document cardiac rhythm strips.

ASSISTANT NURSE MANAGER MACNEAL HOSPITAL 1990-1997

· Responsible for promoting quality care through role modeling.

· Consultation, Education, and Resource person for the nursing and responsible for professional staffing in the care of critically ill patients.

· Responsible for management staffing, payroll, and budgeting, 14-bed critical care unit.

OCCUPATIONAL HEALTH NURSE ZENITH ELECTRONICS/RAULANDS CORP 1983-1990

· Provide first aid for 300 employees in an industrial setting,

· Counseled and treated employees for occupational and non-occupational related problems.

· Assisted with health and dental insurance queries.

· Developed and maintained departmental records and reports.

· Maintained computer software data for OSHA 200.

NURSE AIDE/ STAFF NURSE WEST SUBURBAN HOSPITAL 1974-1983

· Responsible for promoting quality care.

· Medical/Surgical Units.



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