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Team Member Case Manager

Location:
Clarkston, MI
Posted:
December 14, 2022

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Resume:

Gina Mirjah

248-***-**** cell

Clarkston, Michigan, United States

adt10u@r.postjobfree.com

Summary

Experienced Nurse with a demonstrated history of working in the consumer services industry. Strong healthcare services professional skilled in Nursing Education, Health Promotion, Infection Control NCQA/HEDIS standards for BCBSM. Empathetic, supportive and a good listener. Supportive team member that can work independently. Proficient in Microsoft programs

(Excel, OneNote, Outlook, Teams, Word)

Experience

Case Manager SHS (remote)

Arrow Strategies/BCBSM

October 2021-October 2022

Achieved quarter goals, maintaining NCQA/HEDIS/STARS ratings and standards

Communicate with member, caregivers and providers via phone calls, emails, and text messages using the BCBSM messaging platform.

Uses Care Management process to assess, develop, implement, monitor, and evaluate care plans of members and work with member to reach set goals within NCQA standards

Provide holistic care to member with the coordination of multidisciplinary team that consist of Behavior and Medical Health Social Worker, Registered Dietician, Pharmacists, Clinical Support staff and Medical Director.

Engages members and/or caregiver to develop an individualized plan of care and identify GIC and promote overall health.

Educated member and/or caregiver on health promotion, via approved educational resources.

Monitor and evaluate member progress to goal and document progression accordingly, reevaluating and adjusting as necessary to reach established goal.

Secure DME and transportation for member to promote continued health safety and follow up appointment.

Home care Nurse

William Beaumont Home Care

Aug 2013 – September 2021 (8 years 1 month)

Arranged primary care, hospice care, DME, for home care patients.

Developed patient care plans, including assessments, nursing diagnosis and evaluations.

Collaborated with attending physician, patients and their families and other members of the patient care team in the development and execution of POC and achievement of goals.

Complete updated POC according to state regulations and communicate changes to attending physicians, and others providing care.

Provided patient/family education on disease processes

Planned for successful discharge of patients with chronic illnesses such as, HTN/CAD, CHF, DM, COPD, Alzheimer’s,dementia.

Provided supervision and evaluation of LPN and aides.

Collected necessary labs for optimal care

Proficient in venipuncture, chest tubes, wound vacs, compression wraps, PICC dressings, infusions, Foley catheter, suprapubic Foley, wound care. Nurse

William Beaumont Hospital

Aug 2005 - May 2018 (13 years 10 months)

Med-Surg RN 5N and 5CN

Registered Nurse/Charge Nurse

Beaumont Health Systems

Aug 2005 - Aug 2018 (13 years 1 month)

Provided pre- and post-op care to patients while developing and implementing a plan of care for patients and family members. Identified life threatening cases and reassigned asappropriate.

Accessed medical records and interviewed patients and family members to gain medical histories and medication regimes.

Maintained crash carts and emergency equipment and responded to codes on the floor.

Identified and prioritized new admissions and assigned tasks to 10-14 Staff Nurses.

Continually monitored cases and prioritized as appropriate.

Accessed and updated patient records via EPIC.

Ensured staff adherence to industry and hospital best practices, HIPPA and JCAHO regulations.

Completed RN and nurse assistant assignment for oncoming shift, worked with nursing resource team as needed to fill staffing needs.

Proficient for insertion of peripheral IV's, especially in poor access conditions throughout the floor.

Administered blood products, insulin drips, hydration products and medication through peripheral IV's, PICC lines, IJ's and Medi-ports per physician orders.

Assisted physicians with treatment procedures.

Performed discharge duties and instructions to patients and family members

Implemented and evaluated patient teaching and discharge plans for areas of diabetes mellitus, CHF,

hypertension, valve replacements and CABG's.

Prepared patients for transport to surgery, procedures, and tests.

Communicate with members of multidisciplinary health team.

Trained new hires on hospital policies and procedures; supported and mentored through orientation

period.

Oakland Community College

Associates of Applied Science



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