Case Management Registered Nurse

Nicole Grimmer RN

*** * ********** **. ********, AZ 85286 480-***-**** – ******.*******@*****.***

SPECIALTY SPECIALTY SPECIALTY SPECIALTY

QUALIFICATION SUMMARY

Compassionate and results-driven Registered Nurse with over 3.5 years of clinical experience and 4.5 years in case management. Adept at coordinating comprehensive care plans, advocating for patient needs, and navigating complex healthcare systems. Strong communication skills with a focus on patient-centered care, cost efficiency, and interdisciplinary collaboration.

KEY SKILLS

Case Management

Care Coordination

Patient Advocacy

EMR Proficiency

Chronic Disease Management

Insurance & Benefits Navigation

Team Collaboration

Discharge Planning

ICD/CPT coding

RELEVANT PROFESSIONAL EXPERIENCE

Pre-op/PACU/PAT Oct 2023 - Present

USPI – Southwest Endoscopy Gilbert, AZ

A ambulatory surgery center that focuses on GI and colorectal procedures, including colonoscopies and endoscopies. Average 50-70 patients per day.

Collaborated with physicians and patients to ensure that medical conditions that could affect the safety of the procedure were reviewed.

Conducted utilization reviews and ensured adherence to insurance requirements and center policy.

Provided bedside care for patients with a wide range of medical and post-surgical conditions.

Developed strong patient education skills, contributing to improved patient satisfaction scores.

Obtained comprehensive health history for each patient, including, but not limited to, medications, previous surgeries, allergies and medical history that could affect the procedure.

Medical Staff Associate Nov 2022 – Oct 2023

CSL Plasma Gilbert, AZ

CSL Plasma is a global biotechnology company specializing in collecting human plasma to manufacture life-saving therapies.

Performed physicals to ensure that donors were suitable to donate plasma.

If a donor experienced a reportable reaction, provided critical care to ensure donor safety. Contacted EMS if care was beyond my scope.

Performed opening duties such as report reconciliation, equipment suitability and processing test results.

BI Claims Adjuster June 2008-May 2012

Sentry Insurance Phoenix, AZ

Offers property and casualty insurance, workers' compensation, life insurance, and other business insurance, as well as non-insurance products like annuities and retirement programs.

Receive, evaluate and determine claims that resulted in property damage, injury or loss of life due to a motor vehicle accident.

Roundtable with management to determine if my assessments were accurate and that the claimant or insured was being indemnified.

Issued timely payments and settlements to insured, claimants and attorneys.

Referrals/Scheduling Coordinator/Prior Auth Approx June 1997 - Oct 1999

Greater Waterbury Primary Care Waterbury, CT

Provides primary care services, including internal medicine, focusing on adult healthcare for patients of all ages, from teens through the end-of-life.

Received notification from MD to schedule patient for testing or specialist appointments.

Obtained ICD-9 and CPT codes to ensure prior authorization approval if required.

Followed up with specialists and testing facilities to obtain the results for patients.

LICENSES

RN Exp: June 2026

License #: 279016 State of Arizona

EDUCATION

Associates Degree in Nursing (ADN) May 7, 2021

Trident Technical College North Charleston, SC

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