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R.N Case Manager

Location:
Allen, TX
Salary:
83000
Posted:
May 07, 2023

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Resume:

Shanna M. Allen B.S.N., R.N.

**** ********** *****

Allen, TX 75002

302-***-****

adwzah@r.postjobfree.com

Employment:

Aveanna Healthcare Dallas (Dallas, Texas) 03/2022-06/2022 Director of Nursing, Registered Nurse

● Director of Nursing for a large Dallas office. Four RN case managers reported to me. A Quality Assurance LVN (Licensed Vocational Nurse) reported to me. All RNs and LVNs for eighty-four patients who were seen 24 hours/day also reported to me. Ensured adherence to State, Federal, Local, and Aveanna policies and procedures.

● Responsible for QAPI. Developing Daily, Weekly, and Monthly Reports including hospitalizations, ER Visits, Infections, Procedures, Covid Exposures (client and staff), Supervisor Visits, Incidents.

● Fielded calls from nursing staff regarding concerns with patient care and family dynamics, medications, and order changes to be made in the system, spoke with family members daily regarding the care of their children, and supported both the nursing staff and the nursing case managers in their roles.

● Held weekly team meetings for the nursing case managers to go over any issues they may be experiencing. Discussed what my Regional Director of Operations talked about in her Clinical Director meeting the previous day that was relevant. Laid out the appropriate tasks and expectations for the next two weeks.

● Organized weekly 1:1’s with each of the nursing case managers. Talked about any problems they were facing in doing their jobs. Reviewed a care plan of theirs each week to determine if there were any mistakes or if anything needed to be changed prior to submission to the doctor and/or insurance provider.

● Promoted and enhanced the level of clinical expertise of staff to provide safe and quality nursing care for the patients.

● Reviewed physicians’ orders and updated the plans of care and documentation, as necessary.

● Assisted with interviewing, selecting, training, and validation of new clinical staff.

● Collaboration with the operations and business development teams.

● Visited new clients for admission to Aveanna Healthcare Dallas. Admission Assessment completed. Plan of Care generated and sent to the physician promptly as per Aveanna and insurance policies.

● Visited new clients for skilled nurse assessment visits to help clients with skills the family was not familiar with. Often taught family how to work the GT, JT, and Feeding pump. Also, taught families how to set up a feeding for overnight feeds, how to bolus a patient for a one-time feed, and how to set up the pump for a feed over one hour. Allowed families time to ask any questions and offered my support.

United Healthcare/Optum (Plano, Texas) 11/2021-03/2022 Case Manager, Registered Nurse (Remote)

● Case Manager for Optum Group handling medical/surgical, OB/GYN, pediatric, and psychiatric health needs.

● Assessed patients at high-risk for readmission, identified root cause for readmission, and developed a plan as well as collaborated with a multidisciplinary team regarding discharge planning to the next level of care.

● Participated with other members of the team regarding opportunities for improvement in standard of work.

● Also responsible for the utilization management process, acted as a case manager liaison with post-acute providers.

● Applied the existing body of evidence-based practice and scientific knowledge in health care to nursing practice, ensuring that nursing care is delivered based on the patient's age specific needs and clinical needs as described in the department’s Scope of Service.

● Addressed care opportunities and decreased future spending by helping those with chronic or complex health care conditions manage their health.

● Addressed gaps in care and minimized disease progression.

● Provided personalized care, with quality outcomes.

● Delivered timely and relevant communications with our members regarding their care and care coordination. Our technology and data worked together to quickly give feedback to the patients and their physicians. Additionally, our predictive modeling can identify those individuals who are at risk for a potential health event.

Bayada Home Health Care (Plano, Texas) 9/2020-11/2021 Clinical Nurse Manager/Case Manager, Registered Nurse (Hybrid)

• Demonstrated and communicated the core values of Bayada and The Bayada Way.

• Conducted client admissions, on-going assessments and completed the care planning process including development, implementation, and updates to the client’s individualized plan of care.

• Responsible for clinical and client case management with the interdisciplinary team.

• Provided clinical oversight to field staff including RNs, LVNs, and HHAs.

• Supervised nurses providing in-home, around the clock, private duty nursing care to infants, children, adolescents, and/or adults.

• Case Manager over the skilled nursing clients in the Dallas office. Monitored nursing care, in addition to managing the case including DME supplies, medication management, supporting the families and nursing staff, developing, and maintaining the care plan/485, and working one-on-one with the physicians, respiratory therapists, Speech/Occupational/Physical Therapy, and other team members involved in the care of private duty nursing clients.

* Received CHAP Certification within the first year of opening in Dallas.

*Volunteer at Ronald McDonald House for Children.

Blue Cross Blue Shield of Texas/Health Care Service Corporation (Richardson, Texas) 6/2018-9/2020

Utilization Management Coordinator, Registered Nurse (Remote)

• Utilization Management Coordinator of Neonatal Intensive Care (NICU), High Risk Obstetrics, Maternity, Labor & Delivery, Acute and Surgical Inpatient, Private Duty Nursing, and Skilled Nursing requests as well Physical, Occupational, and Speech Therapy requests and Referrals.

• Operated Smart UM and Aerial programs to review requests for ERS accounts.

• Prepared initial and concurrent reviews to maintain continuity of care.

• Accessed and employed MCG guidelines and HSCS’s Medical Policies.

• Effectively communicated with social workers, case managers, utilization review departments, providers, team members, management, and physicians regarding cases and team issues.

• Collaborated with the team and management to serve our members.

• Competent in the use of Word, Excel, PowerPoint, Outlook, Google Email, Jabber, and EMAR systems.

• Member of the Culture Club and Women Improving the Strength of the Enterprise Club (WISE).

• Volunteered with Girls Embracing Mothers (GEM).

Angels of Care Pediatric Home Health (Sherman, Texas) 2/2018-6/2018 Field Pediatric Nurse, Registered Nurse

• Primary case manager RN for a nine-month-old baby, born at 23-weeks' gestation.

• Assessed systems, documented, and communicated with appropriate members of the multidisciplinary team.

• Monitored oxygen and titrated, as needed.

• Gave pulmonary treatments via aerospace chamber and nebulizer.

• Administered gastrostomy feedings and medications via a new mickey button and maintained new button.

• Attended and participated in physician appointments, speech, physical, and occupational therapy visits to assist the family.

• Contacted DME Companies for equipment and coordinated deliveries of all supplies.

• Provided the families with support and daily, ongoing education on patients’ diagnoses, medications, treatments, procedures, equipment, and changes with care.

• Trained new employees in the field and in the care of my primary patient. Hope Pediatrics (Dallas, Texas) 1/2016-6/2018

Field Pediatric Nurse, Registered Nurse

• Primary case manager RN for a child who was ventilator dependent and born with an omphalocele

(not surgically closed). The child was also born with liver, gallbladder, and intestines posteriorly. The liver, gallbladder and intestines were dressed daily by me in a sterile environment to keep the child free of infection and to reduce the size of the omphalocele prior to impending surgery. Child also had a tracheostomy, GT, and JT.

• Monitored ventilator and would troubleshoot any problems that arose.

• Gave nasogastric (NGT) feedings and medications via NGT.

• Administered IPV and nebulizer treatments to maintain proper aeration of lungs.

• Maintained tracheostomy care and managed intact tracheostomy to keep free of infection and monitored status of tracheostomy.

• Coordinated care, demonstrated teamwork, and communicated effectively with the multidisciplinary team including home health care, physicians, specialists, respiratory therapists, physical therapists, and occupational therapists.

• Ordered supplies from DME Company and refilled medications.

• Offered family emotional support and education on patient’s diagnosis, care, needs and necessary medical treatments.

• Performed education with new and current employees to meet standards and protocols. Epic Home Health Services (El Paso, Texas) 11/2012-12/2015 Field Pediatric Nurse, Registered Nurse

• Provided case management and thorough care for babies with tracheostomies, dependent on ventilators.

• Gave supplemental oxygen as needed.

• Delivered feedings via gastrostomy, jejunostomy, and nasogastric tubes to maintain nutrition and hydration.

• Communicated with physicians and specialists to manage care.

• Supported families in decision making processes and stressful situations.

• Attended physician appointments with parents and patients. Altomar Home Health Care Inc. (El Paso, Texas) 7/2012-11/2012 Field Pediatric Nurse, Registered Nurse

• Provided case management and in-depth care to infants and children with medical, post-surgical, and end of life needs.

• Delivered care to infants with developmental delays due to such things as prematurity and brain injury.

• Executed tracheostomy, gastrostomy, and jejunostomy essentials.

• Proficient with use of oxygen, CPAP, BiPAP, and various modes of mechanical ventilation.

• Obtained and monitored significant laboratory values.

• Supported families by educating, mentoring, and offering appropriate resources.

• Communicated with all members of the multidisciplinary team including doctors, nurse practitioners, speech therapists, occupational therapists, and physical therapists to manage care. Bayada Home Health Care (New Castle, Delaware) 10/2011-7/2012 Field Pediatric Nurse, Registered Nurse

• Provided case management and intensive care for children and infants with medical and therapeutic needs in the home.

• Delivered Total Parenteral Nutrition via Central Venous Catheters.

• Gave feedings and performed stoma care via gastrostomy and jejunostomy tubes.

• Experienced with CPAP, BiPAP, Vapotherm, and numerous ventilation devices.

• Assisted families in decision making by providing vital resources. Christiana Care Health Services (Newark, Delaware) 01/2004-10/2011 Neonatal Intensive Care Unit Level III, Registered Nurse

• Administered care for premature and term critically ill newborns including those with either birth injuries or birth problems, low birth weight, prematurity, Respiratory Distress Syndrome, Neonatal Abstinence Syndrome, neurological conditions, pain ailments, jaundice, sepsis/infection, and a host of other issues.

• Monitored pertinent laboratory values and managed care accordingly.

• Proficient with numerous ventilation devices for respiratory needs as well as central venous lines and PICC Lines for hydration and nutrition.

• Preceptor for the Neonatal Nurse Internship Program, Stable Trained, and NRP Certified. Education:

Immaculata University Immaculata, Pennsylvania

Bachelor of Science in Nursing, Magna cum Laude, 2004-2007 Delaware Technical and Community College Stanton, Delaware Associate Degree in Nursing, 1997-2000

References:

Available upon request.



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