Manager Case

Ethel West R.N., CCM

Phone: 407-***-****(c)

E-mail adhj2l@r.postjobfree.com

EDUCATION

Central Texas College

*/** – 12/83 U.S. Highway 190 West

Killeen, Texas 76542

Credentials Associate Degree Applied Science (RN)

Certified Case Manager (CCM)

Work Experience

10/18 to present Amerisys

240 E. Central Parkway

Altamonte Springs, FL. 32701

Sr. Case Manager

Telephonic Medical management of worker compensation patient, to include coordination of medical care including providers, ancillary services, and DME while controlling cost; performing bill and utilization review; reviewing of medical records for appropriateness of treatment; facilitating the injured workers safe return to work

03/17 - 10/18 Ambetter Sunshine Health

70 S. Keller Rd.

Orlando, Florida

Transitional Care Case Manager(TCU)

Coordinate post hospitalization care to assure they obtain the authorized services for their recovery, including medications, DME, home health, rehab, and in doing so preventing unnecessary readmissions to the hospital

10/16 -03/17 Department of Health -Children’s Medical Services

321 S. Keech St

Daytona Beach, Florida 32114

Nurse Care Coordinator of pediatric Medicaid client with special health care needs-performing full assessments on client’s physical, social, and mental status; completing care plan, providing client and family education on home and overall health care; document the progress of individual therapeutic programs; completing eligibility screening for the health plan

7/06 –9/16 Orlando Health

1414 Kuhl Ave

Orlando, Florida 32806

Nurse Case Manager for group health plan: case management of high risk patient with orthopedic, renal, urological, and auto immune diseases;

Utilization review inpatient rehabilitation and adult rehabilitation;

utilization review of durable medical equipment and medical procedures for the above clinical conditions using Interqual criteria

-and-

Worker Comp Case Manager for 3 of the Orlando Health Hospitals:

responsibilities include coordinating care for injured workers; evaluating treatment for medical appropriateness; assisting the injured worker’s safe return to work; monitoring employer’s compliance to physician’s ordered work restrictions; obtaining completion of the state – required worker’s compensation forms.

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