R.N Case Manager
Resume:
Kathleen Ludlow
RN CARE MANAGER
San Antonio, TX 78209
adr7fi@r.postjobfree.com
R.N. with almost 4 years experience as a telephonic RN with Optum, 5 years experience in Case Management in a Managed Care setting and over 20 years experience in the home health industry in San Antonio.
Most recently worked as a remote telephonic RN with Optum taking inbound member calls answering questions and performing assessments and education when appropriate as well as telephone triage. After Optum took some personal time to travel and rejuvenate. Due to physical limitations, no longer able to perform some types of patient care as unable to lift more than 15 lbs, squat, kneel and unable to stand or walk more than 5 to 10 minutes at a time. Available anytime and willing to work nights and every other weekend. Not bilingual but with the right tools can complete a basic assessment and follow-up if a Spanish- speaking RN is not available.
In the past have done assessments for Primary Care, chart reviews and Utilization review and supervised non-skilled caregivers when worked for Home Nursing and Therapy services, Have also worked as a dialysis Nurse as well as in Renal Transplants from 1983 to 1993. Willing to learn. Great on-line research skills.
Authorized to work in the US for any employer
Work Experience
Registered Nurse (RN) Telephonic
Optum Health/United Healthcare - San Antonio, TX
November 2017 to August 2021
1. Took member calls and answered questions regarding care, disease processes, and diagnoses. 2. Performed telephone triage as needed.
3. Directed members to appropriate resources.
4. Provided patient-specific education when appropriate. RN Case Manager II
Molina Healthcare of Texas - San Antonio, TX
November 2013 to October 2017
Performed face-to-face clinical nursing assessments. Created and executed basic care plans on Nursing facility members for the Medicaid nursing facility carve in.
From 6/2015 to 4/ 2017 performed assessments for the STAR + PLUS waiver program known as the Money Follows the Person Demonstration Project.
RN CASE MANAGER
Pinnacle Senior Care - San Antonio, TX
June 2012 to October 2013
Performed Skilled assessments (Start of Care, Re-certification, Resumption of Care and SCIC) of adult Medicare Home Health clients and completed required Medicare Documentation. Provided direct Patient care as needed for adult Medicare and Private Insurance clients working primarily with the Geriatric/ Senior population Obtained labs via veni-puncture or via Central venous access. Assessed, performed instructed on simple to complex wound care including Wound Vac (Certified). Instructed Patients and family on disease processes, medications and S/S to report to Physician or SN.. Coordinated care with the Physician and other members of the multidisciplinary team in order to provide the best possible care for my patients and their families in the home setting. RN CASE MANAGER
Interim HealthCare - San Antonio, TX
June 2011 to June 2012
Performed Skilled assessments (Start of Care, Re-certification, Resumption of Care and SCIC) of adult Medicare/Medicaid Home Health clients and completed required Medicare Documentation. Provided direct Patient care as needed for adult Medicare, Medicaid and Private Insurance clients.(approved provider for Humana HMO). Administered and instructed Pts. and families on IV Antibiotics via PICC line, Medi-port or Central Catheters. Obtained labs via veni-puncture or via Central venous access. Assessed, performed instructed on simple to complex wound care including Wound Vac (Certified). Instructed Patients and family on disease processes, medications and S/S to report to Physician or SN. Coordinated care with the Physician and other members of the multidisciplinary team in order to provide the best possible care for patients and their families in the home setting. RN FIELD CASE MANAGER
A Plus Family Care LLC - San Antonio, TX
December 2003 to May 2011
Performed skilled assessments (Start of Care, Re-certification, Resumption of Care and SCIC) of adult Medicare/Medicaid Home Health clients and completed required Medicare Documentation as well as Utilization review and chart reviews.
Provided direct Patient care as needed for adult Medicare, Medicaid and Private Insurance clients. Administered and instructed Pts. and families on IV Antibiotics, T.P.N. via PICC line, Medi-port or Central Catheters and obtained labs via
veni-puncture or via Central venous access. Assessed, performed instructed on simple to complex wound care including the KCI Wound Vac. Instructed Patients and family on disease processes, medications and S/S to report to Physician or SN. .
Proficient with KINNSER documentation software.
Temporary contractor
SUPERIOR HEALTH PLANS - San Antonio, TX
February 2011 to April 2011
Relocation Nurse:
Worked contract through Health Care Support Staffing out of Florida. Performed Medicaid comprehensive assessments to assist plan members in transition from the long- term care or Rehab setting back into the community with the support of the Texas Star +Plus Medicaid program. Assessed client's eligibility for the Star +Plus program. Coordinated care with the multidisciplinary team to facilitate the client's transition into a community setting. Performed home assessments to determine eligibility for home modifications. Met clients at their residence in the community to make sure all necessary services and supplies were in place upon their transition from the long-term care facility.
RN Patient Care Coordinator; Interim DON
Home Nursing and Therapy - San Antonio, TX
January 1999 to November 2003
Performed skilled assessments (Start of Care, Re certification, Resumption of Care and SCIC) of adult Medicare/Medicaid Home Health clients and completed required Medicare Documentation. Provided direct Patient care as needed for adult Medicare and Medicaid clients. Assessed, performed instructed on simple to complex wound care including Wound Vac. Instructed Patients and family on disease processes, medications and S/S to
report to Physician or SN.
Acted as Interim DON which included:
overseeing RN's, LVN's, HH Aides and Therapy Modalities. Monitored and performed Quality Assurance review of Patient Charts for Billing Purposes, Supervised and assisted with creation and implementation of Staff schedules using the Lewis Software program, and made sure Medicare regulations regarding Home Health Aide supervision were met.
Field RN
Various home health agencies - San Antonio, TX
July 1997 to November 1999
Worked per visit for several home health agencies learning the industry. Including Santa Rosa Home Health, Optima care and Girling.
Dialysis RN
Metropolitan Methodist Hospital - San Antonio, TX
December 1996 to July 1997
2nd shift
Assess patients and perform Hemodialysis treatment in a Hospital setting. Both in the Dialysis unit as well with a portable machine in an ICU setting.
Set up and performed CCPD on inpatients in the acute care setting. Unemployed
N/A
August 2021
1. Took time off for personal reasons.
Education
Diploma Nursing Program in Nursing - R.N
Misericordia Hospital School of Nursing - Winnipeg, MB August 1979 to June 1981
High school diploma or GED
Nursing Licenses
RN
Expires: August 2023
State: TX
Skills
• Computer Skills: Word, Outlook Express, Internet Explorer, Firefox, Chrome, Epocrates, Kinnser home health software. Wound Vac certified, Care of Central line, Medi-port and PICC line; IV and TPN administration. Venipuncture, IN Ratio PT+INR machine, blood glucose monitors (10+ years)
• ICD-10 (Less than 1 year)
• Managed Care (4 years)
• Dialysis Experience (3 years)
• Triage
• Primary Care Experience
• EMR Systems
• Nursing (10+ years)
• Medication Administration (10+ years)
• Employee Orientation
• Patient Care (10+ years)
• Anatomy Knowledge
• Case Management (3 years)
• Discharge planning
• Vital Signs (10+ years)
• Experience Administering Injections (10+ years)
• Supervising Experience (2 years)
• Medical Coding (Less than 1 year)
• Customer service (10+ years)
• Management (Less than 1 year)
• Documentation review (5 years)
• English (10+ years)
• Medical Records
• Laboratory Experience
• Care plans (10+ years)
• Communication skills
• Phone triage (5 years)
• Infusion (10+ years)
• Patient monitoring (10+ years)
• Patient observation (10+ years)
• Microsoft Office
• Microsoft Outlook
• Utilization management (Less than 1 year)
• Microsoft Excel
• Organizational skills (10+ years)
• Microsoft Word
• Home Health (10+ years)
• RN (10+ years)
• Care Management
• Home Care (10+ years)
• Leadership
Certifications and Licenses
RN
August 1990 to Present
Nursing license for the State of Texas.
Compact State Nurse License
August 2023
CPR Certification
Assessments
Clinical judgment — Proficient
December 2021
Assessing a patient's condition and implementing the appropriate medical intervention Full results: Proficient
Case management & social work — Proficient
December 2021
Determining client needs, providing support resources, and collaborating with clients and multidisciplinary teams
Full results: Proficient
Protecting patient privacy — Expert
April 2022
Understanding privacy rules and regulations associated with patient records Full results: Expert
Medical terminology — Highly Proficient
April 2022
Understanding and using medical terminology
Full results: Highly Proficient
Customer focus & orientation — Proficient
April 2022
Responding to customer situations with sensitivity Full results: Proficient
Indeed Assessments provides skills tests that are not indicative of a license or certification, or continued development in any professional field.
Additional Information
Over 20 years experience as a Registered Nurse with a primary focus on Home Health services prior to working in managed care. I am certified through KCI in wound vac wound management, proficient in the administration of IV antibiotics and TPN via PICC, Central Line, and Mediport. Proficient in the use of OASIS C assessment tools and familiar with ICD-10 coding in the Home Health setting. I also have a background in Renal Transplantation, Hemo and Peritoneal Dialysis and try to keep current with regards to immunosuppressive therapy and post-transplant care.
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