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Case manager, utilization review, clinical manager

Location:
Rochester, NY, 14604
Posted:
March 05, 2022

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Resume:

Christy Furman RN-BC,BSN

****

I, Christy Furman, would like to take this opportunity to introduce myself and thank you for viewing my resume. I have been a nurse for 22 years and 14 of those years I have worked in case management as well as maintaining a per diem position as the Clinical House Supervisor/Manager at Lourdes hospital. Currently, I am employed as the interim Manager -PAC Nurse Liaison. From 11/21/20, I supervised 13 PAC nurses for the Florida region and prior to that I was a PAC Nurse Liaison for the NY market since 4/19/19, reviewing medical necessity and extension of stay for Skilled Nursing Facilities and Inpatient Rehab Facilities, insurance verification, second-level physician advisor collaboration, readmission reviews and analysis, concurrent and proactive denial management. I have supervised Adult Health Careers in the BOCES school systems, including but not limited to supervising 38 instructors and school nurses, as well as coordinating the LPN program, sterile processing, phlebotomy and nursing assistants. I have been an instructor in the LPN at BOCES prior to advancing into the Supervisor role. I have worked as a registered nurse on a busy step-down unit managing surgical and chronic care patients for 8 years. My strengths are in critical thinking, quality patient care and advocacy, utilization/case management, administration with leading staff by prioritizing tasks, enhancing quality, problem solving, controlling expenses and navigating through the healthcare system. Thank you for the consideration, Christy Furman RN-BC, BSN.

Christy L Furman RN-BC, BSN

589 Abell Rd

Little Meadows, PA 18830

607-***-****

adqeho@r.postjobfree.com

Innovative Professional Nurse Leader

Clinical leader, Case/Utilization/Access/Disease Manager, Multidisciplinary and multilevel staff management, Clinical educator, Nurse Liaison, Supervisor of Adult Health Careers

Professional Experience

April 2019- present- CareCentrix

Interim Manager PAC Nurse Liaison (2/14/21)- Providing leadership and Guidance regarding patient centered interventions in acute and post-acute facilities. This role leads the team of liaisons in driving the desired clinical outcomes across hospitals, inpatient rehab facilities and skilled nursing facilities. The clinical manager collaborates with case management leadership and physicians to achieve the patient centered goals while of clinical complex patients.

Clinical Supervisor PAC Nurse Liaison (11/21/20)- Supervise the Post-Acute Care team members (clinical/non-clinical), provide team leadership and guidance regarding patient centered interventions, oversee daily workload, assign and ensure timely completion of tasks. Monitor performance and productivity of the team and take appropriate action to ensure guidelines and goals of the department are met. Complete performance reviews and mentor the Post-Acute Care team members. Work collaboratively with Provider Relations and provider network department to achieve desired goals. Work with Clinical Management to implement best practices for care transitions, utilization and authorization management of selected home care services and support clinical and utilization management goals and objectives.

PAC Nurse Liaison (4/19/19)- utilization management, physician advisor collaboration, customer service, facility and pt advocacy to the insurance co

Aug 2015-June 2019 Our Lady of Lourdes Hospital-Binghamton, NY

(per diem Aug 2018-March 2019)

Case Manager/Nurse Navigator- Responsible for effective and efficient discharge planning and utilization review. Orthopedic educator and guidance through the continuum of care

Aug 2018-March 2019- BOCES

Supervisor of Adult Health Careers- Supervised 38 employees School nurses/healthcare instructors-professional adult learning construction of courses following federal and state guidelines-reimbursement contracts

Feb 2014-August 2015 Bioscrip Infusion Co-Dunmore, PA

Clinical Liaison- Clinical expert coordinating infusion services for hospitalized patients transitioning into the home.

Mar 2007-Feb 2014 Our Lady of Lourdes Hospital-Binghamton, NY

Cardiovascular Disease Manager- Nurse clinical expert on CHF, AMI, Stroke. Integrating current evidence-based clinical management into practice.

Case Manager- Responsible for safe, effective and efficient discharge planning and utilization review.

Utilization/Access Manager- Responsible for facilitating and coordinating the utilization management to ensure timely and appropriate level of setting of care for patients in the acute care setting. Concurrent and retrospective clinical updates provided to insurance providers. Denial reviews and assistance in appeal processes. Identification of readmissions and strategies identified to avoid reoccurrence.

Clinical Manager- Representative for the hospital and nursing administration for a 167 bed facility overseeing and directing the clinical activities of all patient care areas.

Mar 2007-2000 Our Lady of Lourdes Hospital-Binghamton, NY

Medical/Surgical- staff nurse on a step-down cardio-surgical unit.

Professional Certifications

Registered Nurse/BSN- NY State licensed

Medical-Surgical certification

ACLS certification

PRI certification

Sigma Theta Tau International Honor Society of Nursing 2013

Education

Broome Community College, Binghamton, NY-Associates Degree in Applied Science- May, 2000

Keuka College, Keuka, NY- Bachelors Degree in Science- May, 2013



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