Case Management Utilization Review
Resume:
Frances Casey RN, BSN
***********@*****.***
Summary
Advanced Registered Nurse with over 20 years of comprehensive experience within the Harvard University healthcare system, delivering high-quality care across diverse clinical settings. Detail-oriented and patient-focused, with a proven ability to adapt seamlessly to new environments and challenges. Skilled in training and mentoring new nurses in clinical best practices, safety protocols, and standards of care.
Expert in care coordination, including educating patients and families on treatment options and in-home care strategies. Proficient in developing long-term care plans that leverage community resources to support patient comfort and independence at home. Experienced in Case Management, Utilization Review, InterQual guidelines, and managing appeals to ensure optimal outcomes and regulatory compliance.
Skill Set
Telemetry & EKG Monitoring – Proficient in cardiac rhythm interpretation and continuous monitoring.
Phlebotomy & IV Placement – Skilled in venipuncture, IV starts, and vascular access techniques.
GI Admitting & Recovery – Experienced in pre/post-procedure care for gastrointestinal patients.
Case Management – Proficient with InterQual criteria, utilization review, appeals, and discharge planning.
Certifications – CPR, BLS, ACLS (current and active).
Leadership Roles – CN III, Resource Nurse, and Preceptor to new and transitioning nurses.
Time Management & Flexibility – Thrive in fast-paced, high-acuity environments with shifting priorities.
Microsoft Office Suite (Word, Excel, Outlook, PowerPoint)
Technical & Interpersonal Skills – Strong EMR proficiency and patient-centered communication.
oCerner
oMediTech
Relevant Experience
Observation Unit RN
BayCare Hospital, Florida
April 2024 – Present
Manage care and flow on a fast-paced 30-bed observation unit.
Provide direct nursing care with a focus on achieving positive patient outcomes within a 48-hour timeframe.
Care Coordinator / Case Manager RN
BayCare Hospital, Florida
January 2024 – March 2024
Collaborated with patients, physicians, and healthcare teams to ensure appropriate placement and continuity of care.
Identified high-risk patients, provided education, and facilitated timely discharge planning.
Seasonal RN
BayCare Hospital, Florida
June 2020 – December 2024
Supported various clinical units during peak periods.
Delivered direct patient care, medication administration, and care coordination.
Maintained high-quality standards in fast-paced, team-oriented environments.
Admitting/Recovery RN – Endoscopy Unit
Beth Israel, Boston, MA
October 2016 – Present
Provided post-anesthesia care and airway management for GI procedure patients.
Ensured safe recovery and discharge education.
Collaborated with proceduralists and anesthesia providers.
Float Pool RN
Largo Medical Center, Florida
May 2018 – October 2020
Delivered patient care across multiple units.
Administered medications and supported interdisciplinary team care delivery.
Case Management RN
Beth Israel, Boston, MA
January 2017 – April 2020
Managed social work cases for individuals and families.
Provided resource coordination, financial assistance, and program placement.
Conducted daily chart reviews using InterQual ISD criteria.
Participated in multidisciplinary rounds and developed discharge contingency plans.
Cardiovascular RN
Beth Israel, Boston, MA
June 2003 – December 2020
Cared for cardiovascular and diabetic patients, including pre-/post-op CEA and PCI patients.
Monitored procedures including angioplasties, ultrasounds, and stress testing.
Managed surgical cases involving PVD, amputations, aneurysms, and dialysis patients.
Utilized telemetry monitoring and sheath care.
Emergency Department Technician
Beth Israel, Boston, MA
May 1997 – May 2003
Facilitated patient flow and assisted physicians and nurses in emergency care delivery.
Labor and Delivery Technician
Beth Israel, Boston, MA
January 1992 – April 1997
Assisted as scrub tech for high-risk deliveries.
Managed clerical duties: registration, scheduling, and medical records coordination.
Operating Room Specialty Technician
Beth Israel, Boston, MA
May 1989 – December 1992
Oversaw surgical instrumentation, supply preparation, and sterilization processes.
Education and Awards
Beth Israel Deaconess Medical Center
Excellence in Nursing Award in Patient Education 2016
Nurse Preceptor and mentor for graduate nurses
Advanced clinical leader in April 2007
Invited delegate at the 2006 National Vascular Conference in Las Vegas
Achieved Clinical Nurse III status in May 2006
Contact this candidate