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Review Nurse Case Manager

Location:
Shrewsbury, MA
Posted:
January 23, 2023

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Resume:

DEBORAH BONNETTE

** ****** **, *********, ** ****4 · 508-***-****

aduvd4@r.postjobfree.com

Registered Nurse with 20+ years’ experience in a variety of clinical settings providing nursing care to diverse populations. Case management experience with both and outpatient populations.

EXPERIENCE

12/2021 – CURRENT

NURSE MANAGER, VETERAN’S INC. INDEPENDENCE HALL

Responsible for day-to-day running of the nursing staff.

Training and orientation of new nurses.

Scheduling and payroll.

Coordinating with Admissions/Screening intakes and streamlining workflows.

Strategizing with Case Managers and Counselors to ensure that patient needs are met.

09/2016 – 12/2021

UTILIZATION REVIEW NURSE, Harrington hospital CDU

Responsible for obtaining and maintaining and entering authorization for inpatients.

Concurrent reviews to justify lengths of stay per medical necessity.

Tracking and maintaining Medicare IMM letters.

Retro reviews and appeals.

Monthly UR meetings with management and other units to track lengths of stay and readmissions.

Daily team meetings to discuss unit, patients’ status, after care and projected discharge date with the other team disciplines.

Discharge notifications to insurance.

Back up SW and assist with discharge planning when needed.

01/2015 – 06/2015

DEPARTMENT COORDINATOR, Northstar anasthesia

Educate patients and their families on their anesthesia options.

Ensuring patients are safe to undergo anesthesia.

Ensuring appropriate testing and follow-up have been done.

Coordinating with surgeons, anesthesiologists, and other disciplines to ensure optimal patient outcomes.

Chart reviews for safety and appropriateness of patients not scheduled for face-to-face interview.

05/2013 – 01/2015

CASE MANAGER, FALLON TOTAL CARE

Part of the original upstart of a One care program from its inception.

Working with a dually eligible population to remove barriers and decrease hospitalizations.

Coordinating care with multiple disciplines to ensure optimal patient outcome and cost efficiency.

Patient education, advocacy, and empowerment meeting with them both in their homes and in the community.

09/2012 – 04/2013

CASE MANAGER, DAY KIMBALL HOSPITAL

Evaluating patients for appropriate level of care according to Interqual guidelines.

Consulting physician review when there is question of level or admitting.

Ensuring patients meet ongoing criteria.

Developing a safe and individualized discharge plan.

Working with various providers and insurances to provide appropriate cost-effective care, quality, individualized patient care.

11/2006 – 04/2012

ORTHOPEDIC RN – NURSE CASE MANAGER, RELIANT MEDICAL GROUP

Wrote, developed, and taught joint replacement program for chair of orthopedics.

Worked with pre and post replacement populations as well as other orthopedic issues Program was later taken over by St Vincent's Hospital due to its success.

Outpatient case management - Spencer Clinic, Webster Clinic and Medical Specialties Clinic-wide.

Arranged for Skilled Nursing Facility and Visiting Nurse Association where necessary.

Coordinated with primary care physicians, specialists, family, and community resources to ensure optimal patient outcomes.

Ran bi-monthly medical management meetings with medical director to review status of inpatient population to identify at-risk patients and assess for emergency room usage and out of network referrals as well as other factors affecting the financial efficacy of our site.

EDUCATION

MAY 1995

BACHELOR OF SCIENCE, worcester state university

Nursing

SKILLS

Team motivator and teacher

Patient Evaluation/Intervention

Inpatient and Outpatient Experience

Strong in both medical and psychiatric

areas of care and management

Well-Rounded Exposure to Many Patient Populations and their needs both on an inpatient and out in the community.

Excellent Communication, Interpersonal and organizational skills

Policy and Program Development



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