Nurse Medical
Resume:
RN Case Manager Experience
UPMC Children’s Hospital — Pittsburgh, PA
Professional Care Manager
Covered all units of the hospital as necessary, primarily covered ED and Observation units; Determined which ED patients will need ongoing care, whether outpatient or assisting/alerting care managers on the floors of their needs; Responsible for all culture follow up calls to ensure that families were aware and able to acquire necessary medications and ongoing care; Fielded general questions coming through the ED regarding guidance for ongoing care; Follow up with parents and liaise with necessary parties to make sure patient’s needs were met; Provided guidance to parents to help prevent return visits as part of a hospital readmissions study; Close contact with physicians, PAs, and NPs to consult/determine medications and/or therapies needed; Coordinated with pharmacies, nursing, and medical equipment providers.
UPMC Health Plan — Pittsburgh, PA
2010-2015
Medical Review Specialist
Gathered and reviewed medical records for inpatient population for all products; Applied Interqual criteria and critical thinking to ensure timely, adequate, and appropriate medical attention for the best possible outcomes for patients; Worked closely with Medical Directors, Discharge Planning, Case Management Staff, and hospital reviewers to provide quality care for members and prevent readmissions.
United Health Group — Pittsburgh, PA
2008-2010
NICU/Pediatric/Complex Infant Care Manager
Position required Utilization Management and Case Management responsibilities. UM duties included: Provided authorizations and assigned levels of care for NICU infants; Worked closely with Medical Directors on cases that did not meet standard criteria; Worked closely with hospital staff to assist with safe yet timely discharge needs. CM duties included: Called parents to provide support and education regarding the NICU environment while infants were inpatient; Assisted with application to SSID if appropriate; Ongoing CM after discharge to prevent infant readmissions and ER visits by continuing education regarding s/s illness; Encouraged follow up with pediatricians and specialists; Provided support with community resources, transportation, skilled nursing, equipment, supplies, etc.
Clinical RN Experience
RN Demand — Irving, TX
2007-2008
Travel RN, NICU
West Penn Hospital — Pittsburgh, PA
2004-2007
Staff Nurse, NICU Level III
Allegheny General Hospital — Pittsburgh,
PA
2000-2004
Staff Nurse, NICU Level III
The Children’s Home of Transitional Infant
Care — Pittsburgh, PA
1997-2000
Staff Nurse, Level II
Forbes Regional Hospital — Monroeville,
PA
1994-2000
Staff Nurse, Special Care Nursery Level II
Magee Women’s Hospital — Pittsburgh,
PA
1991-1993
Staff Nurse, NICU Level III
Education
Mercy Hospital School of Nursing —
Pittsburgh, PA
1989-1991
Nursing Diploma
Avalon Junior/Senior High School —
Pittsburgh, PA
1970-1976
High School Diploma
Kathleen Weinroth
PA Licensed RN
29 years experience across clinical practice and case management Contact Info
5621 Marlborough Rd,
Pittsburgh, PA 15217-1404
adk5l4@r.postjobfree.com
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