Health Care Case Manager

Lenora “Lynne” A Young

P. O. Box *** Home Phone: 302-***-****

Frederica, DE 19946 Cell Phone: 302-***-****

RN, State of Delaware, L1-0037479, Expires 09/30/2025 EDUCATION

**/** - **/** ***-Wic Community College - full time, Nursing Program, completed PN program 8/2005, completed ADN program 05/2007

08/02 - 05/05 Wilmington College - Georgetown Campus, General Studies degree, with a minor in Nursing, Bachelor of Science General Studies/Nsg earned May 2004, Master of Science in Health Care Administration earned May 2005

06/12 – 06/14 Walden University, Bachelor of Science Nursing, completed May 2012, MSN – Nursing Informatics concentration, completed June 2014; currently pursuing doctoral degree in public policy and administration in healthcare

PROFESSIONAL EXPERIENCE

12/2019 – Present

06/2022 – Present

04/2012 – 06/2022

Option Care Health, Newark, DE – Part time

Infusion RN – provider of infusion services throughout the state of Delaware & parts of Maryland Responsible for performing admission assessments in the home, teaching patients administration of IV infusion medications; performing weekly home visits for dressing changes and lab collection; collecting lab samples from PICC line, port, or PIV insertion, accessing/deaccessing ports, completing physical assessments, and completion of electronic/paper documentation. Highmark Health Options, Wilmington, DE – Full time Case Manager, RN – manage up to 62 recipients receiving Delaware Medicaid; coordinate care with physician office, hospital, and/or other providers for continuity of care; facilitate necessary resources for members; perform necessary updates to ensure members are receiving appropriate services; submit requests for increased hours for care of members in their home; complete PASSR and PAE packet for transition into long term care; facilitate care setting change. Quality Health Strategies, Easton, MD – Full time

RN Claims Analyst – Government contractor for post review work of Medicare and Medicaid healthcare claims using Interqual

Responsible for supervising registered nurses for the purpose of reviewing medical claims for fraud, waste, and/or abuse; ensuring proper payment to CMS (Center for Medicare & Medicaid) for care given to patients receiving Medicare and Medicaid payments, write reports for submittal to medical director, proof and correct documentation for submittal to CMS Young, p. 2

05/09 – 06/2013 General Healthcare Resources, Newark, DE – Per diem RN - Long term care, school nurse, Director of Nursing (Assisted Living facility), Staff RN Participated in CPOE implementation, charter formation, project management team, risk assessment team, and staff training for new electronic processes, EHR training (Meditech) and retraining of staff with excessive errors, attended interdisciplinary meetings to trouble shoot EHR solutions (specifically, communication between the ED and receiving units), participated in Go Live day for upgrade for Allscripts upgrade, shadowed NI Director throughout Patient Portal implementation, as well as assisted with Go Live day for that implementation, assisted with MU2 requirements for outpatient stand alone centers, worked with LOINC mapping for interoperability with state agencies, created Powerpoint presentations for education during process changes, assisted with Patient Portal website, participated in Charter council for transitioning of all healthcare sites to same EHR; responsible for assignments of patients in acute & long term health care setting; supervising 22 CNAs, supervising nurses on an as needed basis, creating staffing schedule for upcoming month, counseling and completing evaluations for CNA staff 07/07 - 05/2009 Christiana Health Care System, Newark, DE - Part time RN - Med-Surg Unit / Admissions Unit

Responsible for the bedside care of five to six patients per day; monitoring patients’ overall status; collecting and reporting data; chart review at beginning and end of each shift, review of photocopied medical records leaving the facility to ensure proper order & correct documentation; monitoring of new orders & obtaining doctors’ signatures when necessary; contact physicians’ offices & other healthcare facilities on behalf of patient and their individual healthcare status; review of medications & assurance of pharmacy notification; ordering of previous admission records from within facility 12/08 – 06/2012 Favorite Healthcare Staffing - Full Time Staff RN, Charge Nurse - Medical Surgical unit

Responsible for care of up to 5 patients with conditions such as AIDS, COPD, CHF, Pneumonia, broken limbs, chest tubes, etc., responsible for coordinating care with techs and interdisciplinary team; responsible for communicating with physicians, families, and other facilities

Interim Assistant Director of Nursing - Full Time (long term care facility) Responsible for assisting with state survey, ensuring facility compliance with all state and federal regulations, resolving staffing issues, doing monthly reports for wounds; responsible for contacting local wound care clinic at an area hospital regarding effectiveness of treatment for pressure ulcers; assisted DON with monthly reports; responsible for Infection Control (ensuring that weekly reports were accurately completed, enforce compliance with good hand-washing techniques, monitoring of flu & pneumonia vaccinations for both skilled unit and independent living) completed staffing schedule for both nurses and CNAs (for 43 employees), attended morning meetings, corresponded with other department heads, facilitated safety for all residents & all employees in the workplace 08/98 – 02/2007 Bayhealth Medical Center @ Milford – Part Time LPN, Unit Secretary – Labor & Delivery

Responsible for assisting with delivery of new born babies; performed secretarial skills for the rehabilitation facility

REFERENCES UPON REQUEST

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