Case Manager Utilization Review

Linda M. Augustine, BSN, RN

Three Oaks Hospice August 9, 2021 to Present

Nurse Case Manager

Oversee the care of patients nearing end of life

Manage case load of 10-12 patients ranging from private homes to care facilities

Admit patients by reviewing records and coordinating with families

Communicates patient’s progress to family and other medical professionals

Provide comfort and support to the patient and their family

Facilitate interdisciplinary cooperation to provide optimal care for patient and family

Heartland Hospice May 31, 2018 to April 3, 2019

Admission Nurse

Traveled to facilities and homes of patients to assess for eligibility for hospice care, physical assessment, review of chart, communication with family and facilities

Reviewed medications with primary physician and hospice physician

Added comfort medications as ordered

Communicated with all hospice team members to provide comfort and support for patient and family

Routine case manager visits as needed

Christ Medical Center April 24, 2017- October 30, 2017

Staff Nurse- Medical/Surgical floor

Provided safe, quality care to medical -surgical patients including hospice patients

Provided compassionate support to families of hospice families

Holy Cross Hospital March, 1998 – January 2017

Staff RN – Medical/Surgical Unit/Pediatrics/ Family Birth Center 1998-2007, 2011-2017

Provided safe and quality patient care

Assessment of new admission for wounds and skin breakdown

Provided wound care per hospital policy

Participated in wound prevention

Completed patient assessments timely with sound clinical judgment

Strong critical thinking skills

Preceptor to new nurses

Patient Advocate

Participated in quality improvement initiatives

Cared for Season’s Hospice patients on Medical-surgical floor at Holy Cross Hospital

Unit Based Council Chairperson which duties included holding monthly meetings for staff and recording and logging minutes

Wound Care Champion duties which include participating in wound care audits

Provided education to staff for clinical ladder

Case Manager 2007 to 2011

Utilization review

Managed patient’s length of stay and medical necessity

Coding 24 hour admissions and long term patients

Communicated with insurance companies about patient symptoms and medical delays on daily basis

Refer patients to nursing homes

Reviewed patient charts

Liaison between nurses and doctors to assure quality and correct treatment

Christ Medical Center/Hope Children Hospital 1999-2007

Staff RN – Registry Part time

Provided safe quality patient care for pediatric population

Completed patient assessments timely and with sound clinical judgment

Strong critical thinking skills

Education:

Trinity Christian College

Bachelor of Science in Nursing

Credentials:

Illinois Registered Nurse – since 02/1998. License No. 041.308984

CPR Certified – American Heart Association – Expires 2023

Software:

Meditech, EPIC, Cerner

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