Pharmacy Delivery Case Manager

Leah Culley, RN

************@*****.***

Foxridge, Maryland 240-***-****

Skills

●LTC supervision and management

●Case management, UR

●Delegating nurse, CNA instructor

●Healthcare sales and marketing

● Records review

● Covid-19 testing, screening, vaccines, triage

●Flu vaccine clinics

●Computer literacy

●Workers' Compensation Case Management

●Employee Health

Experience

Johns Hopkins Hospital Systems

Occupational Health RN

February 2021 - to date

PRN Covid triage for students and employees

Maxim Healthcare

Covid Tester, Vaccinator

December 2020 - to date

Covid Testing with DC Department of Health

Rapha Life Services, LLC

Independent nurse case manager/contractor, CEO

January 2015 – Current

Independent Nurse Case Manager/Independent Nurse Contractor, Covid-19 testing and triage, flu vaccine clinics, delegating nurse services

The SRS Group, Mechanicsburgh, PA, June 2018 - June 2019

Workers Compensation Field Nurse Case Manager

Duties: Negotiation with providers for cost savings, determination of appropriate care based on national and best practice guidelines and cost savings,care coordination for injured workers, return-to-work coordination for early return to work, records review, patient advocate.

State Auto Insurance, June 2017 to June 2018

Telephonic Nurse Case Manager

Duties: Workers' Compensation Telephonic case management for injured workers, treatment authorizations, price negotiations, return to work coordination, records/treatment review, cost contained treatment for injured worker through collaborative process of identifying potential high-cost/risk claims, through early assessment of claim; expedited cost-effective claim resolution via, planning, facilitation, care coordination, evaluation and advocacy for options and services to meet injured workers' and family's comprehensive health needs.

GENEX - Elkridge, MD - February 2015 to November 2016

Duties: Workers' Compensation Field Case management for injured workers, treatment authorizations, price negotiations, return to work coordination, records/treatment review, cost contained treatment for injured worker through collaborative process of assessment, planning, facilitation, care coordination, evaluation and advocacy for options and services to meet injured workers' and family's comprehensive health needs through communication and available resources to promote quality cost-effective outcomes.

FutureCare - Pasadena, MD August 2013 to October 2014

Regional Care Manager/Liaison & Facility Utilization Review Case Manager

Duties: Assessment of potential admissions in regional acute care hospitals for sub-acute stay for rehabilitation, ventilator and/or hemodialysis programs. Performed UR for managed care stays to justify necessity of ongoing stay.

GENEX Services - Elkridge, MD - May 2012 to August 2013

Workers' Compensation Field Case Manager

Duties: Field case management for injured workers', treatment authorizations, price negotiations, return to work coordination, records/treatment review, cost contained treatment for injured worker through collaborative process of assessment, planning, facilitation, care coordination, evaluation and advocacy for options and services to meet injured workers' and family's comprehensive health needs through communication and available resources to promote quality cost-effective outcomes"

Community Hospices - Washington, DC - January 2011 to May 2012

Clinical Liaison

Duties: Relationship-building with area health care providers, review of clinical records to determine appropriateness for admission to inpatient or outpatient hospice program.

First Insurance Management - Washington, DC - February 2009 to January 2011

Workers' compensation case management consultant

Duties: Performed telephonic case management for injured workers employed with DC Government, care coordination, treatment authorizations, records review.

Beth Abraham PACE Program- Queens, NY - January 2008 to January 2009

Nurse Manager

Duties: Responsible for the day to day operations of Utilization Management within the Medical Management Department. Responsibilities include oversight of Medical Management Specialist staff and reviewing/providing authorization, for services requested by providers or members; monitored activities and outcomes against established regulatory and contractual requirements.

Holliswood Acute Psychiatric Hospital - Queens, NY - March 2004 to November 2006

Staff Nurse/Nurse lead

Charge or medication nurse for adult, adolescent or substance abuse units

Concentra - New York, NY - November 2002 to December 2007

Field Case Manager

DUTIES: Field case management, medical care coordination for injured workers, crisis response, home behavioral evaluations for long/short term disability claims, and PIP claims. Field case management for injured workers', treatment authorizations, price negotiations, return to work coordination, records/treatment review, cost contained treatment for injured worker through collaborative process of assessment, planning, facilitation, care coordination, evaluation and advocacy for options and services to meet injured workers' and family's comprehensive health needs through communication and available resources to promote quality cost-effective outcomes"

Jewish Home & Hospital, New York, New York – May 2002- January 2003

Clinical Care Unit Coordinator/manager

Duties: Unit Manager for 25 bed unit, supervision of unit staff, transcription of MD orders, family/patient conferences

DRS & Associates, Buffalo, NY - January 1999-October 2001

Workers' Compensation Field Case Manager

Duties: Field case management for injured workers', treatment authorizations, price negotiations, return to work coordination, records/treatment review, cost contained treatment for injured worker through collaborative process of assessment, planning, facilitation, care coordination, evaluation and advocacy for options and services to meet injured workers' and family's comprehensive health needs through communication and available resources to promote quality cost-effective outcomes

Grace Manor Nursing Home-Buffalo, NY – December 1998- April 2002

Nursing Supervisor

Duties: Supervision of staff and facility during after hours; pharmacy orders, receipt of pharmacy delivery; patient assessment, new admissions.

Geneva B Scruggs Community Health Care Center, May 1996-July 2002

HIV Clinical Coordinator

Duties: Clinical Coordination of services to HIV positive patient population, clinical triage, HIV counseling and testing in an ambulatory care setting.

Episcopal General Home Care – Buffalo, NY – May 1996- December 1998

Home Care Case Manager

Duties: Skilled Nursing Visits, certified home care, case management, supervision of CNAs.

Erie County Youth Detention – Buffalo, NY

February 1994-May 1996

Staff Nurse

Duties: Assessment and evaluation off detainees, medication administration, care coordination

Staff Nurse

Hamlin Terrace Nursing Home

Medication and treatment nurse

Buffalo, NY – April 1994’-April 1996

Education

Montgomery Community College, 2012, Train the Trainer Certificate for CNA instruction

Anne Arundel Community College, Glen Burnie, MD, 2011, Delegating Nurse Case Manager

Erie Community College/State University Of New York At Buffalo, Buffalo, NY, January 1989- December 1991, ADN

State University at Buffalo, Buffalo, NY, Liberal Arts studies 1983-1984

Bethune Cookman College, Daytona Beach, Florida, Pre-Medicine, 1982-1983

Awards

Erie County Foundation Award for Outstanding Scholastic Achievement

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