Case Manager Physical Medicine

LORRAINE ROSADO

**** ******** ****** ****, ****** Valley, CA 91977 916-***-****

WORK EXPERIENCE

Kaiser Permanente-Roseville (2013-May 2023) Retired Roseville, CA Pediatric Physical Medicine & Rehabilitation and Nephrology Case Manager and Neuromuscular Clinic RN

● Established position as the first Pediatric Subspecialty Case Manager for Physical Medicine and Rehabilitation in Kaiser Roseville Pediatric Specialties Department.

● Work closely with Physical Medicine and Rehabilitation doctors with over 2,000 children who receive CCS services and are also Kaiser members and manage all cares warranted from DME to outside referrals as needed.

● Check insurance coverage patients scheduled into CCS MTU clinic and notify CCS supervising therapists if the insurance is terminated.

● Coordinate monthly MTU visits for Sacramento County at Rancho Cordova clinic Coordinate several visits to Placer, Solano, Sonoma, El Dorado, Yolo and Stanislaus counties for our KP CCS population.

● Check DME coverage for patients scheduled into CCS MTU clinics Maintain current CCS, Regional Center and Shriner ROI’s for all MTU patients in Health Connect.

● Provide CCS MTU staff with pertinent office visits and x-ray reports for CCS MTU patients.

● Attend off site CCS MTU clinic visits with PMR MD and document visit in Health Connect Submit any eDME orders for CCS patients in eDME, provide a paper script to CCS MTU site. Upon denial of DME fax to appropriate MTU so that CCS can fund for family Coordinate care of CCS patients with other sub-specialty appointments as needed

● Provided resources for families like Regional Center, Medtronic ITB therapy, ISIS adaptive driving, conservatorship information.

● Initiated ABPM program in Pediatric Specialties in August 2021 in our department (24 hour BP monitoring)

● Identify potential CCS clients and send appropriate e-consults for MTU services Place e-consults for CCS eligible procedures for clients for authorization

● Fill role of CCS RN for monthly Neuromuscular Clinic in conjunction with CCS.

● Fax reports of NMC visits to MTU’s once completed Provide PT/OT MTU plans in effect for NMC clients attending the NMC.

● Assist PMR MD with Botox procedures with or without Versed Assist and perform Baclofen refills on pediatric population in our area Assist families with any DME issues Provide MTU’s with necessary documentation needed to provide families with the equipment and supplies needed.

● RN Case Manager for Pediatric Dept of Nephrology. Follow our pediatric members that have had renal transplants outside of Kaiser.

Kaiser Permanente-Roseville (2010-2013) Roseville, CA Patient Care Coordinator NICU/PEDIATRICS/PICU/MOTHER/BABY

● Coordinate discharge with Multidisciplinary Team of NICU graduates during weekly CCS rounds

● Assess needs for discharges to home and arrange necessary equipment and or outside services Assess for breast pump needs of mothers upon baby admission and order as needed

● Collaborates with families and patients to ensure safe appropriate discharges

● Identifies possible CCS candidates and collaborates with Kaiser CCS manager regarding new referrals per state guidelines

● Maintains CCS checklists of babies meeting criteria for CCS

● Evaluates infants eligible for High Risk Infant Follow-up Program through Kaiser per policy and discusses with HRIF program pediatrician

● Utilization reviews done daily via Midas system

● Enroll parents in NICU classes as appropriate and teach discharge class on Fridays’

● Set up in family conferences and interpreters as needed

● Order DME of maternal child patients needing equipment for home

● Make daily rounds in NICU pods in am and pm’s to meet with bedside RN’s to discuss any concerns or issues with families and infants

● Follow the utilization of the NICU parent stay rooms and keep sign up sheet updated.

● Discuss with parents and provide the parent stay letter. Kaiser Permanente-Santa Clara (2008- 2010) Santa Clara, CA Pediatric Subspecialty Case Manager

● Established position as the first Pediatric Subspecialty Case Manager for Physical Medicine and Rehabilitation and Pediatrics Pulmonology

● Initiated G-Tube lists for pediatric patients in our region to keep track of bi-yearly appointments to appropriately maintain DME supplies

● Work closely with Physical Medicine and Rehabilitation doctor with over 350 children who receive CCS services and are also Kaiser members and managed all cares warranted from DME to outside referrals as needed

● Work closely with Pulmonology Pediatrician and assist with DME issues and other referrals that may be needed.

● Set up parent teaching in sleep lab for CPAP use and referred to pediatric asthma RN for outpatient teaching as needed Maintained HEDIS list for Asthma kids of immediate region which included 5 Kaiser Permanente facilities.

● Called families to check in and evaluated compliance of using appropriate medications so as to limit Emergency room and urgent clinic visits and admissions.

● Facilitated DME ordering process from CCS clinics by entering all orders electronically and corresponded with vendors to allow for timely processing and delivery of services.

● Follow up with families involved to troubleshoot with repairs and delays

● Identifies possible CCS candidates and collaborates with Kaiser CCS manager regarding new referrals per state guidelines

● Assist PM&R physician with Spina Bifida Clinic in Oakland, Ca

● Travel with PM&R physician to off campus CCS clinics weekly for bi-annual or annual evaluation

● Perform High Risk Infant Program testing in outpatient pediatric clinic when needed Identify possible San Andreas Regional Services candidates and assist with referral and application process

● Assist Kaiser members who are scheduled for Kaiser services outside of Santa Clara with travel and lodging information

● Assist Kaiser families with any DME or insurance or medication issues

● Assist families with schools needing medical information including special education.

● Facilitated release of information forms and medical info to be scanned into patient records.

Kaiser Permanente- Santa Clara (2006-2008) Santa Clara, CA Patient Care Coordinator NICU/Pediatrics/PICU/Adults

● Coordinate discharge with Multidisciplinary Team Assess needs for discharges to home and arrange necessary equipment

● Assess for transportation needs and arrange as necessary

● Collaborates with families and patients to ensure safe appropriate discharges

● Identifies possible CCS candidates and collaborates with Kaiser CCS manager regarding new referrals per state guidelines

● Identifies patients that may qualify for Santa Clara County Early Start Program and initiates referrals per Early Start criteria Evaluates infants eligible for High Risk Infant

● Follow-up Program through Kaiser per policy and procedure guidelines and e-consults referrals prior to discharge

Riverside Community Hospital (2005-2006) Riverside, CA Case Manager

● Perform discharge-planning hospital wide. Order durable medical equipment for patients.

● Arrange for transfer of patients to acute or sub acute facilities Provide resources for patients who need assistance from the community.

● Call in clinical reviews to private insurance companies case managers Mediator between physicians and patients’ families.

Riverside Community Hospital (2004-2005) Riverside, CA Obstetrical Registered Nurse

● Perform Labor and Delivery duties

● Provide High risk ante-partum care

● Provide Level 2 NICU care to neonates Able to float to postpartum and well baby nursery as needed.

● Provide breastfeeding teaching Translator for Spanish speaking patients Kaiser Permanente Hospital (2005-2006) Riverside, CA Per-diem Obstetrical Registered Nurse

● Perform Labor and Delivery duties

● Provide high risk ante-partum care Circulate cesarean sections

● Spanish certified translator for entire hospital. Riverside Community Hospital (2004) Riverside, CA

In House Registry Obstetrical Registered Nurse

● Perform Labor and Delivery duties

● Provide high risk ante-partum care Floated to well-baby nursery and postpartum units as needed

Travel Nursing Throughout USA (2001-2004) Multiple Locations Travel RN – American Mobile & RN Network

● 13-week assignments at various medical centers and hospitals throughout the United States. Three years at Riverside Community Hospital obstetrics.

● Labor and Delivery – care of the obstetrical patients throughout the stages of labor, delivery and recovery.

● Additional duties include circulating in the operating room for cesarean section and care of ante-partum and high-risk patients and all 3 levels of NICU. Rancho Springs Medical Center (2000-2005) Murrieta, CA Obstetrical Registered Nurse

● Perform Labor and delivery duties Care for high risk ante-partum patients.

● Circulate for cesarean sections

● Care of wellborn infants and stabilization of sick neonates. Fallbrook Hospital (1999-2001) Fallbrook, CA

Per Diem Obstetrical Registered Nurse

● Perform Labor and Delivery duties Care for high risk ante-partum patients

● Circulate for cesarean sections

Pro-care One (1998-2000) Santa Ana, CA

Agency Nurse

● Functioned as a per diem in the nursing pool for all obstetrical areas. Travel Nursing (1996-1999) Multiple Locations

United States Travel Registered Nurse

● 13-week assignments at various medical centers and hospitals throughout the United States.

Mercy General Hospital (1993-1995) Sacramento, CA

Staff Nurse RN – II

● Performed Labor and Delivery duties and functioned as charge nurse.

● Circulated for cesarean sections Delivered care to high risk ante-partum patients and to NICU infants

Nurses Services Inc. (1992-1993) Sacramento, CA

Float Pool Registered Nurse

● Functioned as per diem in the nursing float pool in all obstetrical areas. Military Registered Nurse (1989-1992) Multiple Locations US Air Force Captain RN

● 1989-1990 – Successfully completed Obstetrics Internship at Andrews Air Force Base, MD. 1990-1992 – Functioned as Charge RN on the obstetrics unit at Mather Air Force Base, Sacramento, CA.

● Worked on Labor and Delivery, Nursery, NICU and Postpartum.

● Circulated on cesarean sections and functioned as night charge nurse over three units.

● Developed childbirth and breastfeeding classes for Spanish speaking patients.

● USAF Reserves duty till 2005 with an Honorable Discharge. EDUCATION

University of California Riverside Riverside, CA

● Legal Nurse Consultant

College of New Rochelle: School of Nursing New Rochelle, NY

● Bachelor of Science in Nursing, June 15, 1989

● Honors: Dean’s List 1985-1989

LICENSES AND LANGUAGES

● License: Registered Professional Nurse, New York, 1990, California 1991

● License: Public Health Nurse, California 2013 Certifications: BLS, PALS

● Languages: Fluent in verbal and written Spanish

Contact this candidate