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Utilization Review, Case Manager, OH compact Registered Nurse

Location:
Crooksville, OH
Salary:
90,000
Posted:
February 14, 2024

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Resume:

SARAH CRAIG

**** ******** **** *** ** Crooksville, Ohio 43731 · 740-***-****

ad3mr2@r.postjobfree.com

RN with Ohio Compact License

EXPERIENCE

NOVEMBER 2020-PRESENT

TEAM LEAD CASE MANAGER, AETNA

Telephonic case manager for acute cases to focus on admission avoidance. I am a team lead and preceptor for my team, helping with workflow questions, case assignments and staffing issues. I attend provider collaboration meetings and various care team collaboration meetings.

JULY 2019- NOVEMBER 2020

SOCIAL SERVICE DIRECTOR/ CM DISCHARGE PLANNER, ALTERCARE LANFAIR

Responsible for transition of care and discharge planning in a busy skilled nursing facility. Facilitated care conferences and addressed concerns. Assisted with MDS.

AUGUST 2017- JULY 2019

CARE COORDINATOR/UTILIZATION REVIEW NURSE, Quality Care Partners

Care Coordinator for the Accountable Care Organization in our region. As the first care coordinator in the facility, I helped build the program and develop protocols. I have been involved in an analytics program pilot in different offices for a population health portal. Implemented care coordination in several physician offices in our region. This includes organizing meetings with providers and staff, as well as other key players, and training them to perform care coordination, case management and disease management. I also had several patients of my own enrolled in case management and disease management. After contract changes, I pivoted to utilization review. As a utilization review nurse I reviewed service authorization requests including preservice requests and acute inpatient authorization requests for determination of medical necessity

JUNE 2017-AUGUST 2017

NURSE SUPERVISOR, Genesis-New Lexington Care and rehabilitation

Nurse supervisor for a Skilled Nursing Facility. I was also responsible for wounds and dressing changes for all residents in the building. I covered call offs for each unit throughout the week.

JULY 2011- JUNE 2017

REGISTERED NURSE, Genesis Hospital

My first year at Genesis I was a cardiovascular intermediate unit (CVIU) nurse. I was charge nurse and would also float to the critical care unit as needed for staffing issues. I then transferred to Labor and Delivery and eventually transitioned to Maternal/ Child administration, which is where I spent the last 2 years of my time at Genesis.

NOVEMBER 2010- JULY 2011

Responsible for patient care on two units in the skilled nursing facility. Was Charge nurse for facility which including completing staffing for each unit for the following day.

EDUCATION

2013-2015

BACHELOR OF SCIENCE IN NURSING, Muskingum University

Completed the RN to BSN program with a 3.9 GPA.

2007-2010

REGISTERED NURSE - ADN, Ohio University

Secretary/treasurer of my class. Graduated with honors.



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