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Tallahassee Fl Management Specialist

Location:
Niceville, FL
Salary:
85000
Posted:
May 03, 2022

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Resume:

Dawn Barnes

**** ********* *****

Niceville Florida 32578

adqyii@r.postjobfree.com 850-***-****

Authorized to work in the US for any employer

Work Experience

Case Management Specialist RN, CCM

Sedgwick, Tallahassee FL, June 3, 2019-Present

I currently carry a caseload of 60-75 injured workers; assist with coordinating RTW LD, FD and MMI through organization of Primary Treating Providers office visits, diagnostics, therapy visits, etc. Communicate with IW, Providers, Therapist, Vendors, Claims Adjusters, and Employers throughout the injured workers recovery period. I complete utilization review process to determine authorization for recommendations per providers. Submit peer reviews when outside of guidelines. I carry licenses in compact state and multiple non -compact states.

HCMRN

Humana - Saint Petersburg, FL August 2014 to May 28, 2019

I currently carry a caseload of 585 SNP members. I communicate telephonically with members who have chronic conditions and or duel eligible. Complete assessment, complete care plans and ICT per CMS requirements. We educate members and connect them with resources to help them manage chronic conditions. I review medications, make appropriate referrals. Follow up with member’s pre-post discharge from inpatient acute care, SNF, behavioral health. Communication with PCP, specialist, DME, pharmacy etc. I am point person when coach away, mentor new associates and participate in special pilot programs.

Case Manager

Hospice of The Bluegrass - Cynthiana, KY November 2008 to August 2014

Responsibilities

Case manage terminally ill patients. Work collaboratively with interdisciplinary team to ensure quality of life. Oversee meds, complete comprehensive assessments. Complete computerized charting to comply with Medicare requirements.

Accomplishments

CHPN certification. CPR instructor.

Skills Used

Assessment, vital signs, lab work obtained. IV fluids, pain management, pain pumps. Excellent phone skills, educator

Owner/Operator

A Step Ahead - Cynthiana, KY February 2004 to November 2008

Responsibilities

Case manage a group of 40 children and 10 employees. Complied with state regulations to operate daycare center. Participated in national food program. Completed all required paperwork and computer charting required.

Skills Used

Organizational skills, managerial skills

Staff Nurse

Harrison Memorial Hospital - Cynthiana, KY May 2001 to May 2002

Responsibilities

Staff nurse med surg and of. Assessment of patient, medication administration. Attended c- sections, newborn care. Float nurse. Completed computer charting.

Skills Used

Basic nursing skills

Case Manager

Wedco Home Health - Cynthiana, KY March 1997 to May 2001

Responsibilities

Case manage about 30 patients. Worked collaboratively with physicians, community resources to assist patient back to a healthy lifestyle. Provided education on disease specific.

Skills Used

Assessment, communication, v/s, IVs lab work etc.

Staff Nurse

Dover Manor - Georgetown, KY May 1995 to March 1997

Responsibilities

Manage geriatric patients daily needs. Administered meds, completed assessments, communicated with physicians families. Completed MDS paperwork, conducted family meetings, completed care plans.

Skills Used

Basic nursing skills

Education

Associates in early childhood ed in Early childhood

Ashworth College - Norcross, GA

2002 to 2004

Associates in applied Science in Nursing

Maysville Community College - Maysville, KY

1992 to 1995



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