Elaine Annelle Celander, RN, B.S.N.

Risk Management Utilization Review Case Management

Quality Coordination

Odessa, TX 79762 432-***-**** adjd8h@r.postjobfree.com

Summary

Passionate and dedicated Registered Nurse with extensive healthcare experience comprising of both supervisory and management responsibilities within Risk Management, Care Coordination, Case Management, Direct Patient Care, and Healthcare Administration Policies. Extraordinary communication skills promoting collaboration and successfully managing time, prioritizing tasks, and organizing projects to improve outcomes. Reputed as a problem solver that enjoys being challenged while focused on maintaining quality, integrity, and excellence in service.

Highlighted Qualifications

Risk Management Performance Improvement Registered Nurse Policies and Procedures Direct Care

Case Management Utilization Review Hospital Organization

Medical Legal Insurance Risk Patient Satisfaction Terminology Concepts

Methodologies Standards and Regulations InterQual ICD-10 Coding Collaborative Self-Initiating

Time and Task Management Written and Verbal Communication Worked with Millman

Professional Experience

Case Manager II, RN, BSN 2017 - Oct 2019

Encompass Health Rehab Hospital Midland, TX

Effectively applying risk management knowledge and skills within current caseloads

Actively participating in IDT meetings with a focus on navigating healthcare challenges and coordinating care through all settings with the dual objective of improving outcomes for patients while reducing costs

Ensuring accurate and timely case management while actively managing and directing use of resources to achieve the highest quality outcomes and patient experiences

Successfully communicating and collaborating with patient, family, team members, physicians, and other health care professionals

Evaluating the effectiveness of nursing interventions by performing ongoing assessments and reassessments of patient problems, conditions, and treatments

Performing clinical and technical aspects of care in accordance with established policies, procedures, standards of practice and within limits of the Nurse Practice Act

Providing clinical insight and focusing on clinical competency including participation in ongoing education, evaluation and development

Successfully managing information and communications to effectively oversee healthcare delivery and facilitate interdisciplinary plan-of-care decisions

Monitoring discharge plan implementation while identifying and addressing each patient’s psychosocial and support-systems concerns

Overseeing the coordination of services and managing issues in the areas of admission and discharge, team conference and interdisciplinary plan-of-care communication, patient/family education, payor relations and total fiscal management

Ensuring cost-effective treatment is provided and patient rights regulations are adhered to

Utilization Review

Review patient requests for medical treatment and confirmed that the plan provided coverage for the medical service which helped the company minimize cost and determined if the treatment is appropriate

Ensure quality and cost efficiency for healthcare services

Help patients to make informed decisions about their healthcare by educating them on the benefits and limitations of their coverage

Floor Registered Nurse Telemetry and Medical/Surgical RN, BSN 2007 - 2014

Odessa Regional Medical Center Odessa, TX

Delivering skilled patient care through the nursing process in accordance with established policies and procedures

Coordinating care among patient/family, medicine, nursing, ancillary and other team personnel while acting as patient advocate

Consistently directing precept staff members in all aspects of patient care and management

Director of Case Management/RN Case Manager/Quality Care Coordinator RN, BSN 2000 - 2006

Regency Hospital Company Odessa, TX

Conducting IDT meetings with a focus on navigating healthcare challenges and coordinating care while simultaneously improving patient outcomes at reduced costs

Examining patient procedures for appropriateness, screening admissions according to InterQual criteria for LTACH, and monitoring patient progress and appropriate length of stay

Coordinating discharge planning in in accordance with next appropriate level of care and collaboration with family and physicians

Managing per patient day revenue per budget as well as census

Supervising two full-time employees, supervising their caseloads and tracking DRG's for accuracy

Develop, implement, and evaluate quality care program

Track trends and recommend improvements

Peer review

Worked with NCQA guidelines and HEDIS measures

Allegiance Behavioral Hospital 1998 - 2000

Staff Nurse/Case Manager/Risk Management Midland, TX

Performed integrated case management functions with high risk members

Help health plan members achieve their goals, empowering and improving quality of life for their behavioral and physical health issues

Technology

Document Software: Microsoft Office (Word, Excel, PowerPoint, Outlook)

Additional: EHR/EMR systems, Zoom, Dropbox

Education, Licenses, and Certifications

Registered Nurse License

Bachelor of Science (BSN): Nursing, UTEP, El Paso, Texas

BCLS ProCPR

Associate of Applied Science (AAS): Nursing, Odessa College, Odessa, Texas

RN, 27 Years

References

Dr. Paul Best 432-***-****

Dr. Varsha Gillala 248-***-****

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