MR Marion Robinson

West Palm Beach, FL ***** 614-***-****

adtx2r@r.postjobfree.com Online Digital Resume

PROFESSIONAL

SUMMARY

Compassionate Nurse Case Manager offering over 40 years of experience working with patients and families to facilitate smooth transitions following discharge from medical facilities. Committed to working collaboratively with health plan, leadership and department coordinators to achieve highest quality of patient satisfaction. Well-versed in developing individualized care plans and advocating patient welfare.

Skilled in creating and implementing processes to improve patient care and cultivate support teams.

Seasoned nursing professional offering proven clinical knowledge, natural interpersonal strengths and technical abilities. Knowledgeable about EMR charting, medication administration and interdisciplinary collaboration focused on optimizing patient care and support. Quality-focused and efficiency-driven leader. Excellent reputation for resolving problems and improving customer satisfaction. ACCOMPLISHMENTS Supervised team of staff members.

Achieved many awards by completing work considered above and beyond with accuracy and efficiency.

Documented and resolved customer issues which led to happy customers. Collaborated with team of Doctors, Nurses, Social Workers, Medical Supply Staff, Pharmacy to create Quality Control and Utilization for members.

Achieved very high reviews by completing reviews, patient care, documentation with accuracy and efficiency.

SKILLS Patient Health Information Access

Operational Standards

Diet and Nutrition

Medical Supply Management

Patient and Caregiver Education

WORK HISTORY NURSE CASE MANAGER 12/2016 to 10/2020 Humana Louisville, KY

Educated patients and caregivers on healthcare protocols and processes. Developed and modified patient care plans and assisted interdisciplinary team in identifying client needs and goals to determine priorities of care. Managed support services and fostered communication among social workers, therapists, hospital staff and patients.

Collaborated with healthcare leaders and physicians to support and offer resources in performance of duties to maintain high-quality and efficient patient care.

UTILIZATION 12/2011 to 12/2016

Humana Louisville, KY

Evaluated medical guidelines and benefit coverage to determine appropriateness of services.

Performed prior authorization review of services requiring notification. Performed admission reviews based for medical necessity based upon Millimen specification.

Provided authorizations for various levels of care. ADMISSION RN 12/2003 to 12/2011

Blue Ridge Home Health Care Morganton, NC

Assessed new patients' care plans and administered prescribed medications and treatments.

Displayed functional familiarity with Medicare, Medicaid and private insurance coverage protocols.

Provided physicians and other medical personnel with patient assessment details and answered patient care-related questions. Coordinated patients' tests and treatments with other hospital departments. DIRECTOR OF CASE MANAGEMENT 08/1992 to 12/2003

Holy Cross Columbus, OH

Created care plans that addressed clinical and financial challenges, family requirements and facilitated patient quality of life. Leveraged case management tools and conflict management techniques to help interdisciplinary teams achieve optimal outcomes. Streamlined, standardized and implemented case management processes and techniques to maximize revenue cycle.

Guided and supervised inpatient SNF programs through chart review for appropriate level of care to promote social work and case management principles.

EDUCATION BSN Nursing 08/1977

Pace University, New York, NY

Professional development completed in Subject

Associate Degree In Nursing Nursing 07/1973

Felician University, Lodi, NJ

Professional development completed in Subject

CERTIFICATIONS BLS

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