Case Manager Rn

************@*****.*** Ivy Loveland, Berry OH +1-513-***-****

WORK HISTORY

RN Case Manager at AETNA CVS

**/**** - **/**** (1 year)

* Responsible for evaluating and implementing healthcare plans for members, collaborating efficiently with medical personnel to provide comprehensive care, while ensuring compliance with regulatory standards and procedures.

* Utilizes advanced clinical judgment and critical thinking skills to facilitate appropriate physical and behavioral healthcare and social services for members.

* Coordinates assessment and member-centered care planning, direct provider collaboration, and psychosocial wraparound services to promote effective utilization of available resources, optimal member functioning, and cost-effective outcomes.

After-Hours Nurse Triage at OPTIMA HEALTH

01/2021 - 02/2022 (1 year)

* Managed triage after-hour calls utilizing Schmitt Thompson Protocols.

* Demonstrated and implemented expert listening skills to determine the triage acuity level - high acuity 911 ER level of care, Urgent Care, or low acuity which can be controlled at home with proper Medical Advice to the patient and follow-up with PCP.

* Streamlined operations to successfully save millions of dollars for insurance companies.

Home Health Director, RN at CARE ADVANTAGE

05/2017 - 04/2020 (3 years)

* Managed admission of new clients from various payor sources.

* Obtained authorizations from VAMC, Medicaid, LTC Insurance companies, SSSEVA, and Private Pay.

* Provided supervision and training to all PCA s CNA s. Performed a 90-day supervisory visits as required by state licensure.

* Utilized online charting for patient assessments and developing a personalized Plan of Care.

* Provided guidance and counsel to the patient and family in meeting ADL s IADL s.

* Communicated effectively, both verbally and written, with all levels of the organization.

* Performed Annual Reviews for all employees, as well attended Budget and Corporate Trainings as needed in Richmond, VA. Case Manager Registered Nurse at INTERIM HEALTHCARE 12/2016 - 05/2017 (5 months)

* Collaborated with interdisciplinary departmental group including other skilled RN s, MSW, Chaplains, Physicians and other staff to provide the best care to patients and families.

* Sustained effortless training as a result of previous experience, knowledge, tools, inspiration and support to impact the lives of the patients and families.

* Assisted families during initial start of care and continuing past their loved one s death.

* Maintained efficient communication with the hospice team to facilitate quality patient care.

Case Manager Registered Nurse at PERSONAL TOUCH HOME CARE HOSPICE 04/2016 - 08/2016 (5 months)

* Served as a Hospice RN Case Manager to establish a professional and caring relationship with patients and families, support staff, physicians, discharge planners, social workers, facilities and other health care professionals by providing hands-on care, on-going clinical management and education regarding hospice care.

* Facilitated and inspired a productive culture and work environment, with passionate individuals demonstrating the knowledge, tools, inspiration and support to make a positive difference in the lives of the patients and families.

* Coordinated professional management of patient and families during initial start of care and after their loved one s death.

* Communicated efficiently with medical professionals and hospice team to facilitate the best ad quality care.

* Maintained accurate and updated records, as well continuously providing training for volunteers and new staff.

Case Manager Registered Nurse at GENTIVA KINDRED HEALTHCARE AND HOSPICE

02/2015 - 10/2015 (1 year)

* Collaborated with interdisciplinary departmental group including other skilled RN s, MSW, Chaplains, Physicians and other staff to provide the best care to patients and families.

* Sustained effortless training and assisted families during initial start of care and continuing past their loved one s death.

* Maintained efficient communication with the hospice team to facilitate quality patient care.

Triage Nurse at POSITIVE REINFORCEMENT NURSING

10/2013 - 02/2014 (5 months)

* Managed clients issues by calmly and positively answering after-calls for physicians nationwide.

* Made crucial and critical decisions on emergency calls for escalations to Emergency Rooms.

* Demonstrated knowledge and expertise in utilizing Triage Logic system, Schmitt and Thompson protocols.

* Contacted pharmacies and relayed medication orders.

* Utilized online charting for patient assessments, and provided thorough documentation and nursing notes.

Triage Nurse, Drug Poison Information at CINCINNATI CHILDREN S HOSPITAL MEDICAL CENTER

01/2005 - 10/2010 (6 years)

RN Specialty Pharmaceutical Utilization Manager at MEDPRO STAFFING - ANTHEM

01/2009 - 10/2009 (1 year)

PRIVATE DUTY, LPN at

10/2006 - 05/2007 (1 year)

EDUCATION

Graduated 1970

Reiki 1 Certification

Great Oaks Institute of Technology

Graduated 2004

Licensed Practical Nurse

Excelsior College

Graduated 2009

ASSOCIATE OF SCIENCE (NURSING)

Commonwealth of Virginia

Graduated 2015

Multi State License as a Registered Nurse

SKILLS

customer service, 0 year

listening, 0 year

customer satisfaction, 0 year

LANGUAGES

French, Fluent

English, Fluent

Spanish, Fluent

SOCIAL NETWORKS

Facebook, https://Taras Art and Entertainment

Twitter, https://Yes

Linkedin, https://Linkedin

ABOUT ME

I served in the military

I have a drivers license

I have management experience

I have a security clearance

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