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Case Manager Registered Nurse

Location:
Paseh, West Java, 40383, Indonesia
Posted:
September 10, 2022

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Resume:

Barclay Stepp

Care Consultant Sr

Versailles, KY

adsit4@r.postjobfree.com

+1-859-***-****

Registered nurse with diverse background. 5 years case management experience in acute hospital setting with

admission assessment and precertification as well as discharge planning. 1.5 yrs case management in skilled rehab unit.

Experience with assisting

providers with popultion health management and patient centered medical home concept. Prior clinical roles include pre-op, PACU, Med-surg ICU, open heart recovery, home health and orthopedics.

Work Experience

Case Manager

Cardinal Hill Rehabilitation Hospital - Lexington, KY October 2017 to July 2018

Case manager responsible for 15 to 20 patients in a short term skilled rehab unit. Responsibilities included leading the interdisciplinary team for bi-weekly meetings, including family as a key role in decision making regarding the discharge process.

Care Consultant Sr

Anthem - Louisville, KY

April 2014 to August 2017

Assisted providers with care coordination of higher risk patients as provider clinical liaison Completed transformation action plan for prover group every six months and recommended goals for practice improvement.

Organized, set agenda and tracked goal progress in monthly meetings for multiple practices Worked collaboratively with physicians, nurses, practice managers and office staff to improve work flows and processes for increased quality of care.

Promoted early annual wellness visits, care gap closure, and persistent condition validation for Medicare patients

Rn-Case Manager

Long Term Acute Care Hospital - Lexington, KY

February 2009 to March 2014

Assessed patient referrals for admission to LTACH from outside facilities Collaborated with on call physician and support staff on admission process Performed precertification for admission for commercial, Medicaid and Medicare LOB's. Coordinated discharge planning for patients to go home, to acute rehab or to a SNF Reviewed patient's medical record for continuation of hospital stay for Medicaid, Commercial and Medicare

LOB's.

Coordinated meetings between physicians and family for progress reports and discharge planning Coordinated weekly interdisciplinary team meetings for review of all facets of patient care Helped coordinate patient and family advisory council to help increase quality of care and patient and family satisfaction

Provided emotional support for patients and family members with drastic lifestyle changes due to illness. Education

diploma in Nursing

Saint Mary's School of Nursing

University of Tennessee

Skills

• MEDICARE (8 years)

• DATA ANALYTICS (2 years)

• DISCHARGE PLANNING (5 years)

• HEDIS

• Case Management

• ICU Experience

• Six Sigma

• Nursing

Certifications and Licenses

Registered Nurse (RN)

June 1988 to October 2019

Active registered nurse license.

Yellow Belt Lean Six Sigma

2017

Additional Information

Skills

Familar with HEDIS process and care gap Experience with pre-cert, assessment and closure discharge planning for patients in acute hospital Yellow belt in Lean Six Sigma setting

Familiar with principles of Patient Centered Familiar with Medicare and commercial LOB's Medical Home Proficient in Excel, PP, Word and Outlook Worked with practices to develop disease Ability to use data analytics to prioritize areas of management programs for chronic conditions focus for goal setting for population health such as COPD, asthma, HTN, DM, CHF, CAD, management obesity and migraine



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