Practical Nurse Care Manager
Resume:
Alexandra Toussaint
https://my.indeed.com/p/alexandrat-upxrv50
Brandon, FL 33511
*****************@*****.***
Competent Hedis chart review, care manager,documentation review, pre-authorization nurse. Competent in caregiver to patients on ventilators, tracheostomy, and tube feeding. Energetic geriatric License practical nurse with over 19 years In Florida, Experienced working in long term care facilities, hospice, case management, primary care, obstetric and gynecology clinic while also volunteering at church food banks centers in my free time. Has provided compassionate care to patients and family members thru out my career. Experienced Life, Property And Casualty insurance agent. Proficient in Microsoft and excel. Infection control nurse.
• SPEAK English, French and Creole
• Read English, French and Creole
• Write English,French and Creole
Authorized to work in the US for any employer
Work Experience
Nurse Case Manager
Optum
November 2022 to Present
Prioritizes patient care needs upon initial visit and addresses emerging issues. Meets with patients, patients' family and caregivers as needed to discuss care and treatment plan as delineated in Transitions of Care program.
Identifies and assists with the follow-up of high-risk patients in acute care settings, skilled nursing facilities, custodial and ambulatory settings.
Uses protocols and pathways in line with established disease management and care management programs and approved by medical management in order to optimize clinical outcomes. Oversees provisions for discharge from facilities including follow-up appointments, home health, social services, transportation, etc., in order to maintain continuity of care. Maintains effective communication with the physicians, disease management, hospitalists, extended care facilities, patients and families.
Demonstrates a thorough understanding of the cost consequences resulting from Care Management decisions through utilization of reports and systems such as Health Plan Benefits, utilization of metrics and CM. Approve or deny referrals based in patient’s needs. Licensed Practical Nurse
Baycare client services - Brandon, FL
September 2022 to Present
Manage care for patients on ventilator, g-tube, tracheostomy care. Clinical Care Manager Assistant
Gulfside Hospice - Zephyrhills, FL
October 2022 to November 2022
Monitor medication refills, monitor census, visits to facilities, communication with providers for patients status, new orders and refills.
Clinical Supervisor
TAMPA FAMILY HEALTH CENTERS - Tampa, FL
March 2022 to September 2022
Supervisions of medical assistants in the primarily care and OB GYN clinic, assist providers with their task buckets, communicating with insurance companies on approving medications, administer medications and injection, monitoring refrigerators and freezers temperatures for vaccine for children and private insurances. Floor inventory of all medications in the center. Wound care for patients and administering Depo-Provera injections and educating patients on the schedule. Keeping a log of all equipments in the center. Experience in Epic and Athena. OB GYN experienced, Hedis chart review for Gyn, depression assessment. Disney and jog blood pressure education. Medication pre-authorization. Review of medical records. Experienced in Medicaid and other insurance pre-authorization. Education for diabetic patients, chronic disease, high blood pressure. Teaching patients and employees about infection control. Covid-19 nurse
Medex - Bradenton, FL
March 2020 to March 2022
Read rapid test results, swab patients, perform par, register patients for covid-19 testing, medical interpreter French, creole. Teaching patients about infection control. LPN Case Manager
Omega Healthcare Management Services Pvt. Ltd.. - Orlando, FL March 2018 to February 2020
Managing patient care after discharge from the hospital. Review their chart to manage their chronic disease. Often contacting their provider to give patient’s updates and sometimes requesting medication change or dosing. Providing resource to patients for food pantry, transportation for their doctor’s appointment. Provider communication for new medication orders. Medication pre-authorization. Manage care of patients with chronic kidney disease, high blood pressure, and diabetic patients. Meet deadlines after discharge, attend financial meetings with the medical director and the treatment team. Crisis Care Nurse
TideWell HOSPICE AND PALLIATIVE CARE
May 2013 to October 2018
Provide end of life care to patients, assess patient conditions, medications administration, communicating with physicians to get medications orders. Emotional support to family members. Contacting funeral homes. Wound care per hospice protocol. Home Health Nurse
NurseCore Management Services, LLC - Port Charlotte, FL September 2017 to May 2018
Home visits
Medication management box
Wound care
Blood sugar check
Ventilator
Tube feeding
Tracheotomy
IV certification
Administer insulin
Monitor patients with for pacemaker check when the company calls. Teaching patients about infection control.
Charge Nurse LPN
Solaris Health Care - Port Charlotte, FL
October 2008 to May 2013
Collaborated well with team members to carry out daily assignments . Filed records to keep system efficient and information organized. Maintained and updated files and records to support efficient nursing operations. Medication administration, wound care, computer charting, tracheotomy care, colon ostomy care. Taking orders from the physicians, medical interpreter French, creole. Medical Records audit charts. Administer injections. Residents admissions care plans and discharge for residents in the rehab. Paper work for specimen to be picked up by laboratory. Interview and recruit certified assistants to be on my floor. Supervise certified nursing assistants. Review nursing staff documentations. Discharge planning. Documentation trainer for the nurses, chart review. Teaching certified nursing assistants about infection control. CNA - Certified Nursing Assistant
Deep creek rehab - Punta Gorda, FL
October 2003 to June 2006
Provide activity of daily living to elderlies, take vital signs, feed the residents.
(Inbound Call Center Representativtative)
Sprint Telephone company - Fort Myers, FL
May 2001 to September 2003
Customer service and billing, sell sprint products.French, creole I interpreter. Getting 150 calls per day . Inbound sales call center.
(Travel Consultant)
American Express Platinum Travel - Miami Lakes, FL February 1999 to May 2001
Was among the first 10 co-workers who were hired to open the call center to service American Express platinum card members. Handled 250 calls everyday selling airline tickets, making car and hotel reservations, cruise reservations. Handling members complaints. Award for best travel consultant of the month for sales and no issues with platinum members. Customer satisfactions.
(Inbound Call Center Representative)
Worldex travel
April 1995 to February 1999
Make resort reservations, sell airlines tickets, car and hotel reservations, customer service and complaints. Inbound sales call center. Handled 80 calls per day, reward for best seller of the month. Ticket Agent
ALM Antillean Airlines - Miami, FL
January 1987 to February 1993
Sell airlines tickets to passages, gate agent boarding and un boarding flights, follow immigration guidelines, list and found, suitcase recovery .
Education
Certificate in Medical Billing And Coding
Ashworth College - United States
January 2022 to Present
Certificate-completed in Electronic Medical Records Ashworth College - United States
January 2022 to February 2022
Diploma in Nursing
Sarasota County Technical Institute - Sarasota, FL April 2007 to June 2008
High School Diploma
COLLEGE MARIE ANNE Bourdon
July 1986
Certificate in Scribe
Scibeamerica
Nursing Licenses
PN
Expires: July 2023
State: FL
Skills
• Medication Administration
• Vital Signs
• EMR Systems
• Triage
• Home Care
• Experience Administering Injections
• Hospice Care
• Nursing
• Patient Care
• Medical Records
• Case Management
• Documentation review
• Microsoft Word
• French
• Translation
• Tube Feeding
• Interpretation
• Infection Control Training
• Phlebotomy
• Insurance Sales
• Quality Assurance
• Laboratory Experience
• HEDIS
• Supervising Experience
• Medical Coding
• Computer Networking
• Medical Billing
• Epic
• Medical office experience
• Filing
• Clerical experience
• Motivational interviewing
• Negotiation
• Communication skills
Languages
• French - Expert
• Haitian Creole - Expert
Certifications and Licenses
BLS Certification
February 2021 to Present
LPN
July 2021 to July 2023
CPR Certification
February 2021 to October 2023
Property & Casualty License
Scribe
March 2022 to Present
Documentation for providers
LVN
Additional Information
License life insurance agent with Primerica since 2019
Contact this candidate