Manager Air Force

EDCUATION

****-******* **** ********* ** to BSN (Online program)

****-**** ********* ******* *** Registered Nursing

****-**** ******* ****** ********* College AAS Liberal Arts

**** ****** ***** **r Force Technical Training

1991-1995 Medina Senior High School

EXPERIENCE

Icircle – 11/1/2021 – Present, RN Utilization Review Nurse: Responsible for performing case reviews related to medical necessity and cost efficiency in regards to services, supplies, or equipment requested by members and other health care providers. Communication with team members, Icircle members, and other health care providers regarding requests. While following and maintaining NYS DOH guidelines and deadlines. UM makes recommendations to Care Managers and Supervisors for more cost effective and medically appropriate ways to meet members needs when services requested are denied. In addition, performing High Utilization Review for members exceeding heath care dollars received by the plan.

Icircle – 8/2018 – 10/31/2020, RN Case Manager: Responsible for managing and monitoring health needs and medically necessary services for assigned case load. As the Case Manager provide education to assigned members to help decrease hospital admissions as well as assist with general overall health and wellbeing. Care managers are responsible for reviewing UAS assessments and implementing a safe Plan of Care for all assigned members. CM is responsible for making referrals to community resources to keep all members as safe as possible and to thrive in their communities. Communicate with all assigned members at least monthly.

Home Care of Rochester: 1/2015-8/2018, RN Case Manager: Responsible for creating interdisciplinary care plans for home health patients from admission to discharge. Acting as the liaison between patient and family and homecare personnel (Nursing, Physical and Occupational Therapy, and Home Health Aides, as well as Community Physicians) to ensure necessary care is provided promptly and effectively. Responsible for direct supervision of Home Health Aides. As well as obtaining all lab work, providing wound care, educating patients and family members on health maintenance and avoiding hospitalizations.

Independent Health: 1/2014-3/2015, RN Utilization Review Nurse: review medical records and prepare clinical appeals (if appropriate) on medical necessity, level of care, length of stay, and authorization denials for hospitalized patients

Healogics: 11/2013 -1/2014, RN Case Manager: Responsible for creating and updating charts and care plans for each patient in the wound and hyperbaric program to include ensuring each patient has a complete list of current medications, allergies and procedures. Assessing patients education and learning level for health literacy. Conducting fall/risk assessment, an abuse assessment, and physician orders. Reviewing and documenting healing rates at each visit and recommending changes to care plan when necessary. Communication with facility and other staff members to ensure continuity of care.

Absolute Care of Gasport: 12/2010 -11/2013, Rehabilitation Unit Nurse Manager: Acted as liaison between Nursing, other disciplines, and administration. Allocate available resources for the safe, efficient delivery of care. Responsible for scheduling, staff development, coaching, Department of Health follow through, care plans, family meetings, and discharge planning. Also responsible for rounding with MD, order transcription, prompt initiation of care, and follow through.

United States Air Force: 1995 – 1999, Communications and Administration: Publications and forms design and management. 375 Communication Squadron responsible for design and maintenance of For Official Use Only Web sites on the Intranet.

Volunteer

Forrestel Farm Riding and Sports Camp: 2015-Pres, Health Director for Summer Horseback Riding Camp. Manage all Nursing Staff, development of care plans, review of all health forms and educating staff. Assessing camper injuries and issues with initiation of appropriate care.