Case Manager Home Health
Resume:
GRIGORIANA SPENCIUC RN,MBA
Cypress, CA 90630
EDUCATION
USC University California BBA,MBA
USA RN Licence #464882
RN supervisor 2022 to present
Villa Del Sol post acute hospital
Admissions,transfer,discharge
Supervise patients,nurses
Send the lab and x-rays reports to MD for review
Assess patients complaints and inform MD
Fallow MD orders for IV hydrarion and antibiotics
Communicate with patient's family and MD
PROFESSIONAL EXPERIENCE
RN,MBA Case Manager 01/2005-8/2009
> Review new referrals and transfer roster for acceptance of claims that meet medical referral
> Make timely and effective three point contact as appropriate
> Direct injured worker to network provider
> Assess medical issue on original claims
> Develop,implement and document medical disability
> Negotiate medical services and medical equipment cost
> Communicate with claim case manager regarding medical issue
> Refer case for vendor management
> Arrange second opinion examen with the approval of claim case manager for QME
Clinical Staffing Registry 2000-2004
RN,MBA Discharge Planning
> Review files
> Contact medical insurance regarding patient status
> Discharge patients with appropriate medical services(home health,DME equipment)
Core Disability Company 1999-2000
RN,MBA Nurse reviewer
> Perform telephonic clinical review
> Assess and evaluate on going treatment to determine medical necessity of services
> Obtained clinical information from medical providers
> Participate in quality management
Saint Mary Medical Center 1995- 1999
RN,MBA Clinical Manager
> Communicate with physicians,patients,family members
> Develop and document cost saving analysis
> Hiring and orienting new staff members
> Utilization Review,case management and discharge planning for Medi-Cal,
Medicare,HMO and private insurance for Home Health
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