Case Manager Management

Terry J. Ries, RN

**** ***** ****** – Metairie, LA 70006 – Cell 504-***-**** – Email: ******@******.***

CLINICAL COORDINATOR/LIAISON/CASE MANAGER

TEAM MEMBER · AUTONOMOUS · CLINICIAN

Professional nurse with medical background in hospital/rehab/case management, home infusion nursing, home health and hospice nursing, and orthopedic joint replacement program management. Experienced educating disease management, outpatient discharge plans in home or medical setting, experience with all hospital/home med pumps, and broad spectrum of IV/PO medications. Ability to establish accurate plans of care for any patient disease process including involved caregivers with goal of achieving positive client outcome as end result. Confident with clinical knowledge needed for decision making. Act as confident liaison between medical interdisciplinary teams and patient/family/caregivers by providing effective communication to both groups with any medical treatment plan. Utilize strategic approach to achieve positive end result. Always eager to learn new skills and changes in dz process management.

NURSING CREDENTIALS

Associates Degree in Nursing, Delgado Charity School of Nursing

Summer of Qualifications

OVERVIEW Solid background in nursing with the knowledge effectively teach, develop, and perform treatment plans for all disease processes. Experienced in resolving existing internal/external conflict or client/physician concerns. Instruct a clear plan of care specific to client and family as well as ability to explain a decision for treatment. Ability to provide education on specific insurance guidelines (private/ME) as well as ability to educate/perform IV infusion treatments as well as many other interventions telephonically. Confident with ability to provide discharge plan for the transitioning client from inpatient hospital to hospital/outpatient/home setting by effective coordination with ordering medical staff as well as interdisciplinary health team participating in client tx plan of care. Well versed with computer skills Microsoft and knowledgeable of private/ME/ME adv guidelines/policy, positive understanding of Interqual/Millman URCM tools currently using Citrix. Developed positive relationships with other health care facility staff/physicians and external vendors with a primary goal: achieving company growth

CLINICAL Knowledge of multiple disease processes and treatment plans for specific disease with ability to recognize client/caregiver education level to establish most effective education plan with goal to achieve positive outcome. Experienced with various disease processes including psychiatric, acute/chronic IV therapies outpatient vs inpatient criteria - confident in multiple infectious disease with anticipated treatment plan. Confident with Medtronic device for continuous insulin subcutaneous administration as well sixteen years of DM disease management. Skilled with troubleshooting and operating multiple infusion pumps

PROFESIONAL EXPERIENCE

Clinical Case Manager: 2023 to present

At Home Healthcare

Metairie, Louisiana

• Provided accurate initial OASIS assessments/order of coding post hospital vs inpatient hospital

• Assessed/evaluated review of co-workers OASIS assessment

• Expert of ME guidelines for home care services

• Developed initial plan of care for each individual patient

• Advanced experience with home infusion pumps. Provided initial education for patient/caregiver on specific physician ordered plan of care including home IV pumps/central venous line maintenance – administration of IV infusion therapies

• Advanced experience with multiple wound care treatment plans including wound vac treatment plan

Bone/Joint Coordinator/Total Joint Center of Excellence Program Director: 2021 to 2023

Tulane HCA/Lakeside Campus

Metairie, Louisiana

• act as community liaison between orthopedic surgical patients and interdisciplinary team

• provide education to patient/caregiver/co workers specific to Total Joint Replacement program

• increased overall ortho surgery census by 50%

• coordinate patient operative plan of care

• JHACO program development

Case Management/Discharge Planning Case Manager: 2015 to 2021

Tulane HCA/Lakeside Campus

Metairie, Louisiana

Certified Case Manager per MIDAS InterQual/Millman guidelines/criteria – Microsoft/Citrix software

Provide accurate coding specific to disease process

Maintain organization of a 40 case load specific to Med Sx Acute/ICU/Inpatient Rehab, Provides education for Acute Med Sx post op ortho clients acting as a Team Lead within office setting

Delegate tasks as indicated/Act as independent decision maker

Knowledgeable of Federal ME/ME Advantage/Traditional State Medicaid LA/MS/Bayou MD/Private insurance plans/coding

Interact with medical team/IDT staff to achieve accurate tx poc

Act as patient advocate during interaction with client specific insurance provider

Recognize criteria for patient transition to IPR unit – coordinate transition with patient insurance provider using ME guidelines

Clinical Liasion/Account Manager: 2011 to 2015

Bioscrip/Infusion Partners

Metairie, Louisiana

Act as a community representative/liaison/sales for the central New Orleans territory by facilitating health care professionals/physicians with the discharge planning process for specific clients requiring home IV/Enteral therapies

Increased client census by 25% within assigned territory upon obtaining account territory within second year

Networked with multiple physicians – Infectious Disease specialist/Hem/Onc specialist/Orthopedic Sx, vendors within assigned territory to establish and maintain positive relationships with priority goal of achieving successful client post hospital discharge tx poc

Participate in Bioscrip CoE programs specific to nutrition/cardiac/infection treatment plans for certification to provide educational CEU classes to health care professionals within assigned territory

Performed administration of IV infusions in clinic and home setting

Knowledgeable on ME/MD/PI/PP requirements/rules/guidelines to achieve successful authorization for specific tx therapy/drug

Provide accurate education to client/caregiver on specific dz management reducing risk for hospital readmission with < 10%/quarter acute hospital re-admission rate

Interact with medical doctors within hospital/office setting specific to post discharge patient response to outpatient plan of care assisting with coordinating patient f/u office appointment if indicated

Oasis Review/Admission Nurse Case Manager: 2009 to 2011

LHC Group/Ochsner Home Health

Kenner, Louisiana

Director of Nursing/Administrator: 2007 to 2009

Canon Hospice Northshore

Mandeville, Louisiana

Multitasked Nurse/Preceptor/Educator: 2003 to 2007

Egan Home Healthcare

Metairie, Louisiana

Staff/Transplant Floor Nurse: 2001 to 2003

Ochsner Hospital Foundation

New Orleans, Louisiana

VOLUNTEER ACTIVITIES

Hurricane Katrina Evacuation Shelter Assist

Canon Hospice – Camp Swan

American Cancer Society Relay for Life

American Diabetes Association/Juvenile Diabetes education

EDUCATIONAL BACKGROUND

Associates Degree of Nursing (RN): 2001

DELGADO – CHARITY SCHOOL OF NURSING

New Orleans, Louisiana

Major: Nursing

Honors & Awards: GPA: 3.4/Clinical Excellence Award in Psychiatric Nursing

References Available Upon Request

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