Registered Nurse ( Case Manager and Educator)
Resume:
LADONNA BARGE
Albany, GA *****
**************@*****.***
Committed Registered Nurse with 23+ years of experience Accomplished Case Manager that has mastered handling high intensity and high caseloads without sacrificing quality of care. Operates exceptionally well in high-pressure environments, problem solving, great at multitasking, and time management abilities. Recommends best resources and courses of action to benefit patient needs and return each to optimal quality of life. Work Experience
Registered Nurse Case Manager (5 Month Contract)
CenCal Health
May 2024 to October 2024
Performed Annual Medical Reviews on pediatrics and adults Worked with members that had Medi-cal, D-SNP, and various health insurance plans Worked with Essette, Oracle, and CMSNET systems
Reviewed CMSNET annual notes and wrote authorizations (RAFS and 50-1) as needed. Promoted continuity of care by advocating for patients within the healthcare system. Provided education and counseling on health promotion, risk reduction strategies, disease prevention and self-care techniques to patients and their families. Coordinated with healthcare team to establish, enact and evaluate patient care plans. Referred patients to specialized health resources or community agencies to furnish additional assistance. Managed caseloads involving multiple chronic illnesses across various settings such as hospitals, long- term care facilities or private homes.
Identified potential risks related to medication use or inadequate follow up care after discharge from the hospital.
Evaluated effectiveness of treatments provided by consulting specialists or other providers involved in a patient's care plan.
Collaborated with physicians on patient medications, medical needs and performance. Collaborated in consults, patient care plans development, patient monitoring and evaluations. Advocated for patients by identifying insurance coverage, communicating care preferences to practitioners and verifying interventions met patients' treatment goals. Secured insurance authorizations to rehabilitation facilities and long-term care placement. Helped patients and families feel comfortable during challenging and stressful situations, promoting recovery and reducing compliance issues.
Maintained strict patient data procedures to comply with HIPAA laws and prevent information breaches. Utilized computerized Resource and Patient Management System (RPMS) and Electronic Health Record
(EHR) system.
RN Case Manager ( 3 Month Contract)
Kaiser Permanente
December 2023 to March 2024
Communicated regularly with family members regarding patient care needs and progress toward goals. Assessed patient's physical, mental, and psychosocial health status to develop individualized care plans. Collaborated with physicians, nurses and other healthcare professionals to ensure optimal patient outcomes.
Coordinated medical services between primary care providers, specialists, hospitals and outpatient clinics.
Facilitated referrals to community resources for additional support services. Maintained accurate documentation of patient progress in the electronic health record. Participated in quality improvement initiatives related to case management processes. Coordinated with healthcare team to establish, enact and evaluate patient care plans. Developed discharge plans for patients transitioning from acute care settings to home or alternate facilities.
Case Manager And Ultilazation Review Nurse
Phoebe Putney Memorial Hospital-Albany, GA
October 2017 to August 2023
Reduce emergency services cost by 10-15% by curtailing medically unnecessary admissions, length of stays, and readmissions
Collaborate with physicians and providers to assign correct patient statuses, ensuring compliance to CMS guidelines for reimbursement
Review patient charts to determine correct status using Care Enhance Review Manager Criteria Identify insurance coverage
Home Hemodialysis and Peritoneal Registered Nurse
Dialysis Clinic Inc-Albany, GA
June 2009 to April 2017
Conducted home monitoring for patients performing a dialysis treatment, assessed supply area, treatment logs, and reenactment of various issues for resolution Instructed patients and family members on how to perform continuous ambulatory peritoneal dialysis and continuous cycles peritoneal dialysis activities Educated patients on participating in their dialysis care to prevent future illness, infections, and hospitalizations
Administered medications as prescribed by physician order; assessed patient responses to treatment therapy making appropriate adjustments to the treatment plan Conducted monthly, or as needed, medication reviews Reviewed hospital admission and discharge records and instructions with patients and family members Performed lab work and worked in triage as needed
Direct patient care, interaction with outpatient clinicians, and physicians Served on the infection and anemia control committees Attended annual Renal Conferences for additional educational advancements Attended monthly meetings with the interdisciplinary team which consisted of physicians, registered nurses, social workers, and dieticians
Implemented monthly education for patients and their care givers Registered Nurse Intensive Care Unit Weekends Only Phoebe Putney Health System-Albany, GA
June 2008 to December 2013
Worked as hospital intensive care unit nurse in the Cardiac Care Unit Served as a floater between Medical Intensive Care and Surgical Intensive Care Units Prioritized care and advocacy for each patient
Provided direct patient care, stabilized patients, and determined next course of action care plan Provided skilled, timely and levelheaded emergency response to critical ill patients Strengthened training and nursing knowledge by taking part in the continuing education programs and classes
Served as on-call nurse with the Rapid Assessment Team Evaluate the patients lab results and contacting the medical practitioner as needed Delivered optimum treatments to critical-care patients following prescribed rules, policies, protocol and procedures.
Monitored patients' respiration activity, blood pressure and blood glucose levels in response to medical administration.
Helped monitor, maintain and improve nursing-sensitive indicators, core measures and other identified outcome metrics.
Charge Nurse
Incenter Hemodialysis Clinic Dialysis Clinic Inc.-Albany, GA June 2001 to March 2008
Coordinated, tasked and supervised nurses and ancillary staff based on staffing requirements. Coordinated and performed patient admissions, transfers and discharges. Directed unit staff and promoted quality care for diverse patients. Collaborated with multidisciplinary healthcare specialists to devise, implement and modify plans of care defining patient outcome goals
Audited patient charts in real-time, verifying accuracy and completion of information. Distributed assignments to RNs, LPNs and resident advisors, guided work and delivered training to promote proper care standards for patients.
Advised, coached and mentored experienced and student nurses on medical issues, crisis management and appropriate nursing interventions.
Reviewed staffing patterns and census of nursing units, meeting staffing needs and budgetary controls. Assessed patient conditions, monitored behaviors and updated supervising physicians with observations and concerns.
Education
BSN in Nursing
Albany State University - Albany, GA
December 2000 to December 2000
Skills
• ESCO Nurse ( Case Manager For ESRD Patients) Interdisciplinary Collaboration
• Quality assurance controls Annual Case Reviews
• Well-trained in EMR And Careport Software Intervention Plans
• Excellent Critical Thinking And Problem Solving Skills Case Needs Assessment
• Ensuring Compliance to CMS guidelines Client Advocacy
• Using Care Enhance Review Manager Criteria Decision Making
• Hardworking And Proactive Case Planning
• Identifying Insurance Coverage Health History Documentation
• Reviewing Patient Charts Email and Telephone Etiquette
• Community Outreach Calm Under Pressure
• Family Education Programs Problem-Solving
• Home Visits and Inspections Patient Assessment
• Documentation
• Reporting Positive Attitude
Certifications and Licenses
RN License
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