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Case Manager Intervention Specialist

Location:
Dublin, GA
Posted:
June 26, 2023

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Resume:

STACY MURRAY, RN, MS

*** ******** ***** • Dublin, GA 31021 • 478-***-****

adxw3r@r.postjobfree.com

CAREER OBJECTIVE:

To obtain a rewarding position in nursing where my vast experience and skills will be utilized in determining the psychosocial, biophysical, self-care and learning potential of the patient, family and other stakeholders to implement and evaluate an appropriate plan of care. PROFESSIONAL EXPERIENCE:

Carl Vinson VAMC November 2013 – February 2023

OEF/OIF/OND TCM Case Manager

Home Telehealth Care Coordinator

Dublin, GA

• Monitor veteran’s health data daily and contact via telephone to discuss needs for evaluation, education and/or referrals.

• Utilize broad-based consistent clinical knowledge and critical thinking skills to complete comprehensive initial and ongoing assessments of OEF/OIF/OND and Post 911 veterans and their support system to identify health issues and health care goals. Reassess goals to develop a care plan conducive to veteran’s ongoing healthcare and social needs.

• Conduct comprehensive assessment in veteran’s homes, face to face in facility and telephonic to meet the needs of the veteran.

• Implement, manage, and evaluate appropriate treatment and referrals for OEF/OIF/OND and Post 911veterans. Maintain ongoing communication with veteran between regular visits and advocate for veterans to ensure appropriate care needs are met.

• Collaborates with client and care providers when indicated to assess for needed changes in clients’ care. Adjust plan of care appropriately according to veteran’s needs and collaboration of interdisciplinary customer-focused patient care delivery system.

• Coordinate and identify cost-effective resources to aide with completion of care plans.

• Communicates and coordinate care with the PACT members, specialty care areas to aide in transition of veteran’s care to ensure “just in time” care is met.

• Collaborate with and provide appropriate information to PACT to ensure veterans receive appropriate durable medical equipment, medications, supplies, skilled and non-skilled services, and community resources needed to meet unique needs of each case managed veteran in a cost effective and clinically sound manner.

• Maintain appropriate documentation of case management, encounters, and veteran’s progress in achieving goals, objectives, and expected outcomes per care plan in CPRS.

• Responsible for outreach activities throughout the medical center’s service area to include rural areas and CBOC’s to communicate veteran’s needs.

• Educate and coach veterans and caregivers on management of chronic diagnosis to improve self-care and management of disease.

• Assist with education and set up of telehealth technology for self-care management of chronic diseases with Post 911 veterans to ensure case management needs are met.

• Participates in community meetings to discuss needs of veteran population.

• Facilitate TBI 2nd level evaluations via telehealth services in an effort to improve access to care for veteran’s in rural areas and to decrease delay of care.

• Participate in TBI telehealth disciplinary meetings to ensure TBI initiatives are being met.

• Facilitate training with new TCM staff and Social Work Students.

• Utilize ability to multitask to ensure all duties and performance measures are met related to my current position.

Carl Vinson VAMC June 2013 – November 2013

Care Coordination Case Manager

Dublin, GA

• Coordinate care and services for multiple populations of veterans in need of care management.

• Case manage veterans in need of care management addressing the medical, nursing, and personal care needs to aide them in obtaining an optimal level of functioning.

• Complete comprehensive assessments of veterans and their support system to identify problems, health care goals, and to reassess goals to develop a care plan.

• Coordinate and identify cost-effective resources to aide with completion of care plans.

• Communicates and coordinate care with the PACT members to aide in transition of veteran’s care.

• Collaborate with PACT to ensure veterans receive appropriate durable medical equipment, medications, supplies, skilled and non-skilled services, and community resources needed to meet unique needs of each case managed veteran.

• Maintain appropriate documentation of case management, encounters, and veteran’s progress in achieving goals, objectives, and expected outcomes per care plan in CPRS. Hospice Advantage May 2012 – February 2013

Per Diem RN Case Manager

Wrightsville, GA

• Conducted home visits, skilled nursing facility visits to conduct assessments to effectively implement treatment plans for palliative care of chronically ill and dying hospice patients.

• Completed accurate and timely documentation of patient services to reflect plan of care.

• Case managed and participated in day to day clinical care of terminally ill patients.

• Attended weekly interdisciplinary meetings to ensure patients holistic needs were met.

• Developed Hospice Health Aid care plans and performed Health Aids supervisory visits.

• Assessed criteria for Palliative Care and need for other services including social service, pharmacy support, spiritual care and voluntary involvement.

• Educate patients and family members in Advance Care Planning while ensuring accuracy of reference information and supportive documentation for hospice transition.

• Communicated information and strategies in a timely manner to after hour physicians to enhance care of new patients.

Lighthouse Nursing (formerly Psychiatric Nursing) Agency Feb 2004 – June 2013 Registered Nurse - Charge Nurse

Perry, GA

• Contracted to various agencies as Charge Nurse and supervised LPN’s and Health Service Techs. Agencies to include medical surgical, mental health, detoxification, and crisis stabilization units.

• Completed comprehensive assessments of admitted clients/patients and developed an appropriate plan of care for admissions, treatments, and discharge planning of patients/clients.

• Monitored and evaluated needs of patients/ clients requiring 24 hours skilled nursing care and/or rehabilitation treatment including short stays, long term stays, respite care and hospice care.

• Delegated appropriate assignments to LPN’s and Health Service Techs. Monitored the outcome of the assignments and offered constructive support to improve care as needed. Judge Group (United Healthcare/Medicaid) February 2008 – June 2013 RN Case Manager

Conshohocken, PA

• Contacted United Health Care members to initiate community assessment in home.

• Completed comprehensive assessments of members and developed an appropriate plan of care for treatments and self-care management of chronic disease.

• Educated member and family support system on chronic disease and disease process to ensure appropriate care is met.

• Entered and submitted member’s assessments, follow ups, treatment plans and discharge plans in technology system assigned by United Health Care in a timely manner.

• Provided continued follow up care monthly and as needed with members to ensure appropriate care and resource needs were met.

• Monitored Case Plan monthly to determine appropriate treatment and compliance with treatment goals.

Horizons Family Services June 2003 – December 2009 In-Home Case Manager/Crisis Intervention Specialist Dublin, GA

• Contracted through the agency to offer services to families in crisis to the Department of Family and Children Services.

• Provided assistance to families to aide them in completing the defined goals and steps of their court ordered case plans.

• Coordinated community resources to aide clients in completing case plans.

• Coordinated and supervised visitation between parents and children to prepare family for reunification.

• Monitored families’ home for safety and stabilization to care for their children.

• Completed drug screens on parents/relatives of children to insure safety of placement.

• Prepared and instruct parenting classes for parents to educate on proper care and behavioral aides needed to discipline and demonstrate emotional support for their children.

• Completed home evaluations for relatives identified as a possible placement for children who have been removed from their parents’ homes.

• Completed background checks on relatives who have been identified as possible placement for children who have been removed from their parents’ homes. Carl Vinson VAMC June 2007 – February 2008

Suicide Prevention Coordinator

Dublin, GA

• Responded to consults from the Veterans Crisis Line

• Maintained timely and accurate documentation, using appropriate notes and templates as defined within the facility Suicide Prevention Program as well as behavioral health.

• Created database, monitored and case managed veterans who were identified as high risk for suicide.

• Assisted with provision of on-going training program for community partners, new employees and non-clinical frontline staff, such as clerks, and as needed, to assure that all VA staff are aware of options for Veterans with whom they come in contact during crisis situations.

• Assured that all Veterans assigned to the facility high risk monitoring list are being followed for a time period not less than 90 days following hospitalization, or 90 days from the date of assignment to the high risk list. Collaborated with the provider/practitioner to oversee the transition of care to assure that appropriate behavioral health follow was in place, when it was clinically determined that a Veteran is no longer at high risk.

• Tracked any no-show appointments by these Veterans and followed up with the Veteran and provider/practitioner as soon as possible to assess safety and reschedule the appointment.

• Initiated emergency interventions appropriate to the situation, including but not limited to, contacting Veteran's identified emergency contact, and /or calling 911, if the safety of a high risk Veteran is unable to be established, or if it is determined that the Veteran is at imminent risk for self-harm.

• With Veteran's consent, contacted family members and/or other identified supports to provide education and involve in patient's treatment and safety planning.

• Completed Root Cause Analysis on veterans who commit suicide or attempt suicide to assess for innovative treatments to reduce the risk of suicidal behavior.

• Prepared daily, weekly, and monthly reports related to suicidal behavior.

• Conducted face-to-face and/or telephone contact with the Veteran to assess their safety and ongoing compliance with treatment.

Three Rivers Home Health July 2003 – July 2004

Registered Nurse - Case Manager

Dublin, GA

• Completed admissions on patients who were referred by medical doctors for home health services.

• Assessed the admission/patient to ensure that patient met the guidelines for admission set by private insurance companies, Medicaid, or Medicare.

• Compiled patients’ treatment plans and performed treatment according to treatment plans to work toward discharge planning/goals.

• Assessed the patients’ homes for safety, medication administration, and treatment compliance.

• Educated the patients and family members on skills related to medication administration, side effects, and proper care for patients. As well as, when to call or take patient to seek medical attention.

EDUCATION:

ASSOCIATE OF SCIENCE IN NURSING JULY 2003

ASSOCIATE OF SCIENCE IN PSYCHOLOGY MAR 1997

Middle Georgia College Dublin, GA 31021

BACHELORS OF SCIENCE IN SOCIOLOGY DEC 1998

Georgia College & State University Milledgeville, GA 31061 Master of Science in Human Services June 2011

Capella University Minneapolis, MN 55402

CERTIFICATIONS/TRAININGS

Patient-Centered Community Care (PC3)Training July 5, 2016 Carl Vinson VAMC Dublin, GA 31021

CVT: Core Competencies April 1, 2016

Carl Vinson VAMC Dublin, GA 31021

CVT: Operating Your Clinical Cart April 1, 2016

Carl Vinson VAMC Dublin, GA 31021

CVTCIMS Stethoscope: Access Training April 1, 2016 Carl Vinson VAMC Dublin, GA 31021

Managing Self Through Change January 21, 2016

Carl Vinson VAMC Dublin, GA 31021

2015 Heart Code BLS Certification July 8, 2016

Carl Vinson VAMC Dublin, GA 31021

Nonviolent Crisis Intervention Certification (CPI) September 23, 2011 Phoenix Center Behavioral Health Service Warner Robins, GA 31088



Contact this candidate