Case Manager Telephonic
Resume:
Kathie Matthews
Glen Allen, VA *****
ad2qel@r.postjobfree.com
Work Experience
Case Manager
Strive Health - Richmond, VA
August 2023 to Present
Telephonic case manager for telephonic case load of 70-100 patients. Employs quality metrics while providing care focusing on disease management, logistics and resource management. Home Health Nurse
Accent Care Home & Health Services - Mechanicsville, VA January 2023 to August 2023
Piloted new Medicare program for late stage depression, anxiety and dementia/caregiver stress. Program cancelled by corporate office August 2023.
Director of Nursing (DON)
Senior Helpers - Glen Allen, VA
March 2022 to January 2023
Assess potential clients needs to suggest resources and potential entry into private homecare services. Covid nurse
RHINO Medical - Arlington, TX
December 2021 to February 2022
Perform covid testing for adult and pediatric populations in a variety of community settings. UAI Nurse
Crater Health Dept - Hopewell, VA
October 2020 to November 2021
Perform Uniform Assessment Screenings for nursing home and community based treatment. Filled in as needed covering for public health peers pulled into Covid clinics . Excellent critical thinking skills and problem solving skills; experienced at performing assessments and patient education. Instructor- Medical Terminology
South University - Glen Allen, VA
January 2013 to April 2020
MAPD Case Manager
VA Premier - Glen Allen, VA
December 2017 to January 2019
Case manager for MAPD program. Accountable for high quality, cost effective care gorcMedicare members. Provided education on Medicare to peers.
Education
Master of Science & Bachelor of Science in Nursing Medical College of Virginia - Richmond, VA
Associate of Science in Nursing
Lincoln Memorial College - Harrogate, TN
Nursing Licenses
RN
Expires: June 2020
State: VA
Skills
• Case Management
• Strong organizational skills with proven success identifying and implementing workflow optimizations, increasing productivity and efficiency.
• Commitment to highest ethical standards relating to patient care, confidentiality, and regulatory compliance.
• Engaged and provided care management to identified patient populations. Managed case load of 100-200 telephonic/field members.
• Provided care management telephonically or face to face in the clinical practice setting.
• Created a personalized care plan for each patient involved in care management to resolve barriers to care, build additional education or contingency planning and engage with social support systems as appropriate.
• Coordinated with health plan clinical programs as appropriate.
• Complete all necessary care coordination and or assessment activities as outlined in the care plan.
• Mentored peers, providing guidance regarding best practices. Created/provided educational opportunities for fellow staff members.
• Developed, implemented, and evaluated individualized patient care plans, managing a case load of 75-80 waiver members.
• Advocated patient welfare, and served as a liaison between patients, their families, and healthcare providers.
• Responsible for the assessment, reassessment, care planning and coordination of care and services.
• Performed ongoing monitoring of an appropriate and effective person centered care plan, member education and care management. Managed a caseload of 225 -400 members
• Regularly communicated with the member's PCP and other providers, and integrated the member, caregiver and other provider feedback into the assessment and planning. Process and Personnel Management
• Managed 9 person staff, responsible for overseeing and directing the delivery of professional nursing care and services.
• Assisted and collaborated with care team such as, participation in interdisciplinary care team meetings to evaluate members care needs and direction for field visits to validate member needs; providing education and tools for care coordination intensive case management.
• Coached and mentored less experienced Care Managers. Developed schedules and supervised students during clinical training rotations.
• Conduct compliance audits of behavioral health service agencies by analyzing and comparing clinical documentation, claims and established state requirements for service delivery.
• Provide verbal and written training and education to behavioral health service agencies to resolve identified errors
• Create and implement training programs twice yearly on State requirements and statistical data regarding delivery and coding of behavioral health services
• Create summary reports for government agencies, create and make presentations of finding to medical professionals and internal customers. Training/Instruction
• Emphasize critical thinking and learning as a life-long process utilizing principles of adult learning theory and learning styles.
• Excellent interpersonal and communication skills with keen ability to present technical medical information in appropriate layperson terms.
• Skilled in instruction and facilitating student learning; committed to student, retention and success.
• Able to provide assessment of learning, development of curriculum and use of instructional delivery modes utilizing both traditional and non-traditional methodology.
• Knowledge of teaching, counseling and evaluation principles and techniques.
• Design and implement effective learning strategies and environments for Nursing/Health Sciences.
• Establish and promote an effective learning environment that maximize documented student learning.
• Prepare, submit and maintain reports related to student learning.
• Grade assignments in a meaningful way to promote continued student growth, return graded assignments to students in a timely manner, and assign final grades for all students.
• Prepared lessons and taught classes for 1st and 2nd year students. Acted as an advisor to 2nd year students.
• Communicated and delivered the course curriculum based on skill sets necessary for LPN licensing.
• Maintained accurate records on all students. Evaluated and documented students' progress through testing, observation and assessment of skills.
• Microsoft Office
• Teaching
• Microsoft Word
• Public Health
• Documentation review
• HEDIS
• Nursing
• Communication skills
• Intake
Certifications and Licenses
BLS Certification
CPR Certification
Certified Case Manager
Compact State Nurse License
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