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Case Management Manager

Location:
Syracuse, NY
Salary:
90,000 annually
Posted:
April 04, 2024

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Resume:

ANGELA LURCOCK

*** ****** ****, *****, ** *****

E-MAIL: ad4r02@r.postjobfree.com

607-***-****

EXPERIENCE

*/****-*******

Binghamton NY, Good Shepherd- HR Wellness RN/Infection Preventionist

Maintains employee health program for all employees to ensure all health code requirements and all local, state and federal regulations are met.

Performs all employee physicals including tuberculin testing, vaccinations, health assessments and performing respiratory fit testing.

Provide general orientation, mandatory in-service, continuing education, and other training to meet all department and facility needs and regulatory requirements.

Perform competency skill to assess safety in the work place and annually.

Observation of employee med pass/job duties

Work closely with the HR director and managers to coordinate an employee’s return to work assignment to include case management and set reasonable accommodations as needed for return to work.

Maintain all Employee Health Files and purge as required

Maintain confidentiality of all records and data.

Coordinate Infection Control including tracking statistics and communicating policies and procedure in conjunction with the Director of Human Resources. Work closely with the Health Care Administration on facility infection control manual.

Perform competencies to keep skills up to date.

Leader of infection control

Contribute to management team in such forums as leadership meetings and special meetings and committees; QAPI, Safety/safe Patient handling and corporate compliance.

11/2022-9/2023

Endwell NY, UHS Endwell Internal Medicine- Registered Nurse (Triage Nurse)

Coordinates Clinical training, orientation and ongoing evaluation of new existing clinical staff

Complete and submit all clinical competencies at a time of hire and annually

In collaboration with the unit coordinator, coordinates clinical schedules, ensuring appropriate clinical support

The RN provides clinical leadership while overseeing the scope of practice of LPN’s and Medical Assistants in the office

Triages and assesses patients for early identification of signs and symptoms to prevent complications and ensure timely intervention

Educates patient and family in health promotion and disease management using available resources

Utilizes a working knowledge of pharmacology and safely administers medications

Maintains and performs Lab testing and oversees proficiency validation and lab credentialing

Collaborates and leads patients’, families and all members of the health care team in coordinating patient care

In collaboration with the Unit Coordinator, participates in and facilitates Performance Improvement activities

Collaborates with the Unit Coordinator to promote and facilitate the compliance and understanding of all regulatory standards

Participates in educational opportunities and in collaboration with the unit coordinator

Acts as a resource for all clinical staff

Demonstrate commitment to organizational Values of Compassion, Trust, Respect, Teamwork, and Innovation

4/2022- 11/2023

Ithaca, NY Franziska Racker Agency- Residential RN

•Complete nursing evaluations

•Provide medical care to individuals and staff as needed

•Maintain and review medical and health information

•Provide initial training of nursing tasks or activities and periodic inspection of the actual act of accomplishing such tasks or activities to unlicensed direct care staff

•Provide assistance to Licensed Practical Nurses

•Confer with medical professionals with developing and implementing an individual health care program/nursing care plan

•Participate in individual life plan conferences for medical and/or health related concerns

•Complete self-medication assessments on assigned individuals and supervise staff in the implementation of self-medication goal plans

•Train staff in medication administration and other health and medical skills or techniques (ex. CPR, First Aid, Fire Safety, etc.)

•Perform or review medication inspections at designated sites

•Investigate incidents/accidents related to medication errors and/or health concerns

•Conform to program changes and regulations and keep abreast of developments in the field

•Perform required duties in a productive and safe manner

•Act as role model to individuals receiving services and staff

3/2021-4/2022

Harford, CT Carecentrix- Nurse Liaison

•Determine the optimal site of care post hospital discharge and develop a discharge plan

•Manage and influence the transition of assigned Post-Acute Care patients from acute care setting to the SNF, IRF, LTACH or home setting

•Facilitate home health physician orders for home care upon a patient’s discharge to home

•Contact referral sources to advise and relay updates to the appropriate individuals

•Partner closely with the PAC Medical Director in reviewing discharge plans and length of stay status to ensure optimal outcomes

•Communicate customer service/provider issues to supervisor

•Engage and coach the patients/caregivers for performing standard assessments, patient care plans, and document progress

•Work closely with the home health agency nurse to facilitate education and adherence to establish health care goals and care plan

•Act as a clinical resource for unlicensed staff, to provide clinical expertise and help with referral source directives

•Participate and contribute to ongoing quality assessment/improvement activities, performance, data collection, analysis, operational processes

•Assist team in implementing and maintain standardized operational processes to ensure compliance to company policies, legal requirements and regulatory mandates

•Establish and maintain professional working relationships with hospital staff and physicians

10/2019-3/2021

Endicott, NY Ideal Senior Living Center- Reimbursement Coordinator/MDS Coordinator

•Provides direct supervision to the Minimum Data Set (MDS) nurse completing all data collection and data entry to the MDS

•Make determination of Medicare coverage; notifies responsible party and provides requested documentation to support Medicare decision

•Coordinates all MDS to assure completion within the time frame mandated by the Department of Health

•Maintains the Care Conference schedules

•Conducts MDS meeting and trains/updates all staff on any new developments and instructions regarding the MDS

•Conducts continuing education for staff to provide clear guidelines for documentation requirements for reimbursement

•Works closely with other departments to assure reimbursement issues are addressed

•Represent interdisciplinary record keeping and ensures that compliance issues are communicated to the appropriate staff

•Works closely with finance department, providing updates on changes in payer sources, submission information and demand bills

•Attends all mandatory and required number of optional in-service training sessions

•Medical Appeals

9/2007-10/2019

Binghamton, NY Corporate Care Management-Nurse Case Manager

•Pre certify services requested by providers

•Medical appeals and completion of medical review for Physician determination of coverage

•Experimental/Investigational reviews

•Cosmetic procedure reviews

•Billing and coding dispute resolution

•Plan interpretation

•Case management

•Concurrent reviews

•Medical necessity reviews

•Negotiate and secure transplant rates

10/2006-9/2007

Owego, NY Riverview Manor Nursing Facility –Inservice Educator

•Responsible for scheduling and conducting state mandated in-services

•Provide re-education to all disciplined staff

•Monitor all CPR and CNA certification expirations and complete all necessary paperwork for recertification

•Provide immunizations to staff and volunteers

•Complete and maintain all employee health records

•Complete and revise policies and procedures, as necessary

7/2006-10/2006

Owego, NY Riverview Manor Nursing Facility –Nurse Manager

•Responsible for all admission and discharge information

•Complete daily treatments as ordered by physicians

Administer mediations when necessary

•Act as part of the interdisciplinary care conference team

•Provided direct supervision to the LPN’s and nurse aides

•Conduct weekly physician rounding and complete orders as written

•Provide support to the residents and their families

•Patient advocate

8/2005-7/2006

Owego, NY Riverview Manor Nursing Facility – Assistant Director of Nursing

•Patient advocate

•Provide help to the director of nursing and complete duties as assigned

•Monitor scheduling issues and provide coverage as needed

•Monitor weekly skin program and conduct weekly interdisciplinary skin meeting

•Infection control nurse

•Collect data and create monthly reports

•Act as primary supervisor during the absence of the Director of Nursing

•Maintain daily census

•Act as part of the quality assurance team

•Coordinate preadmission screen with the Social Worker

•Complete Patient Review Instrument when assigned

EDUCATION

•1998-2002 Tompkins Cortland Community College- Associates Degree in Nursing

•1987-1989 TST Boces- Early Childhood Education

•1976-1989 Candor Central School- Local Diploma

LICENSURE & CERTIFICATION

•NYS Registered Nurse Licensure received 2002.

•Case Management Education 2010

•Case Management Certification received 2011

•Advance Achievement in Transplant Management 2011

•CPR Certification 2023

REFERENCES

Laura Williams, BSN, RN Laurie Crowell Jennifer Zepkowski RN

Director of LHCSA/ALP Intake Coordinator RN/MDS Coordinator

607-***-**** 607-***-**** 607-***-****

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