Case Manager Health Care
Resume:
Cherie Wolff, RN, CCM
Mountain Center, CA 92561
Objective:
Seeking advananced position with the opportunity to advance and enhance my knowledge while utilizing past and concurrent skills.
Employment History
6/2006-Current: Molina Healthcare, Inc. Perform concurrent review. Utilizing Interqual criteria for appropriateness of LOC, continued stay. Coordinate discharge needs with in house UR/CM/RNs to facilitate a timely and appropriate discharge. Specialize in utilization of MHC NICU population.
1/2008-1/2009: MHC Clinical Liaison for Carenex Health Care
6/2008-2018 Emergency Room UR/CM Tri City Hospital. Perform Interqual reviews for ER admission to ensure clients meet hospital accepted guidelines, review medical necessity, appropriate level of care and assist with alternate discharge plans as needed coordinating with physicians, family, and patients, skilled nursing and or alternative level of care facilities, including any needs ensuring appropriate vendors are utilized per Insurance specifications.
9/2005-6/2006: Quality Manager. Vantage Medical Group.
Responsible for implementing the QM process: Utilize auditing standards and practices to ensure medical services provided by health care agencies and documentation of services rendered accurately and completed per DHS requirements.
10/2001-8/2004: Medical Field Case Manager. Concentra Managed Care, Inc.
As a field case manager I worked independently and collaboratively with a multi-faceted medical teams, including but not limited to: Physicians, PT/OT/ST/SW and multiple insurance adjustors, third party administrators, defense as well as applicant attorneys, HR personnel and directly with injured parties and their employer throughout the U.S.
8/1999-12/2001: Quality Manager Analyst. Parkview Community Hospital
Per Diem NICU RN
1984-87: NICU Bedside nursing at Riverside County Hospital
1992-2001: NICU Bedside RN at Parview Community Hospital
Education:
1998, ASN, University of New York
1984, LVN ASN, Riverside City College
Accreditation
Certified Case Manager
References furnished upon request.
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