Case Manager Registered Nurse
Resume:
Barclay Stepp
Care Consultant Sr
Versailles, KY
************@*****.***
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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