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Case Manager Utilization Review

Location:
Greenville, SC
Salary:
85,000
Posted:
January 16, 2023

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Resume:

Lillian Stevens

Montgomery, AL *****

adupdk@r.postjobfree.com

334-***-****

Experienced Registered Nurse with over 28 years of experience with the last 10 years being in rehabilitation. Excellent reputation or resolving problems and improving customer satisfaction. Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals. Authorized to work in the US for any employer

Work Experience

Rehab Liaison/Admission Liaison

Encompass Health Rehabilitation Hospital - Montgomery, AL March 2012 to Present

• My role as a rehab/admission liaison is to find potential patients for the Inpatient Rehabilitation Facility

(IRF) and then screening those patients to make sure they are a good match.

• Established collaborative relationships with patients and families through consistent and effective communication.

• Communicated back to PMR and therapists regarding patient performance and condition.

• Established collaborative relationships with patients through consistent and meaningful communication.

• Identified concerns and reported issues to management for decision making regarding appropriate, and high-quality care with reasonable results.

• Submitted EMR to insurance providers requesting approval for admission. RN Case Manager

EnCompass Rehabilitation Hospital - Montgomery, AL March 2012 to September 2013

• Utilization Review.

• Discharge planning.

• Resource Management.

• Coordination of care.

• Transition to post-acute care.

• Monitor for compliance with treatment plan.

• Ensure appropriate level of care and care setting.

• Educate on Healthcare benefits.

• Helped patients receive appropriate, high- quality care with reasonable results.

• Partnered with physicians, social workers, physical occupational, and speech therapist nutritionists and respiratory therapist to develop and implement individualized care plans and documented patient interactions and interventions in electronic chart systems

• identified care needs of individual patients and coordinated responses based of physician advice, insurance limitations and procedural costs.

• evaluated treatment plans against individual goals and healthcare standards.

• Direct communication with insurance case managers providing necessary documentation requested regards discharge planning or for continued stay reviews. Education

Associate Degree in Nursing in Nursing

Wallace Community College - Selma - Selma, AL

May 2001 to May 2003

Skills

• Rehabilitation Services

• Proformance Inprovement

• Orthopedic Rehabilitation

• Patient Interviews

• Acute and Rehabilitation Care

• Patient Admission

• Marketing

Certifications and Licenses

BLS Certification - PENDING MSL APPORVAL



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