Nurse Case Manager with 20+ Years Experience
Resume:
Sherry Witt Perucca
Nurse Case Manager
Houston, TX 77069
**********@***.***
Over 20 years Case Management experience. Have worked in Outpatient Surgery, with Home Healthcare Quality, extensive UR experience, Inpatient Psychiatric Facilities, Insurance and UR companies as well.
Authorized to work in the US for any employer
Work Experience
Nurse Case Manager
North Cypress Medical Center - Cypress, TX
May 2010 to October 2017
Interviewing and assessing patients for inpatient vs outpatient criteria and discharge needs including placement, transfers to other medical facilities, DME, Initial Dialysis arrangements, Insurance contact and follow up care. contact with families, patients, Physicians and ancillary departments in order to coordinate appropriate discharge. Worked on the Telemetry Unit for the first three years at North Cypress and on the Oncology/Neurology Unit for the last four years.
Communications with Insurance HMOs and Commercial providers including UR and Denials. This facility uses McKesson/Interqual Criteria to review for In vs Obs patients. Assisted with new hire education regarding Case Management Purpose and Ethics basics. Admissions population is approximately 50%-60% Medicare population and 30% Medicaid. Nurse Case Manager/Denials Manager
Tomball Regional Medical Center - Tomball, TX
1999 to 2009
Case Management duties as previously mentioned for the first seven years and Denials Management for the last three.
This facility also utilized the Interqual Criteria and briefly Milliman. Created with one co-worker a Denials Lecture which I presented to the 2005 Case Management Conference in Las Vegas upon invitation.
Tomball Regional Hospital used a Physician assigned Case Management program in which each Case Manager was assigned several Physicians and would follow their patients as long as they were admitted within the facility. While working with Denials Management had success resulting in the majority of the denials being overturned in some Medicaid successes. This facility has a larger population of Geriatric patients than most area facilities due to the demographic location.
Education
Medical Massage Therapy
Lone Star College Aldine Westfield
2000
Associate of Arts in General Business and Extensive Nursing Lone Star College Kingwood
1989
Conroe Christian Massage School Conroe
Nursing Licenses
PN
Expires: January 2020
State: TX
Skills
• CASE MANAGEMENT (10+ years)
• NEUROLOGY (7 years)
• HEALTHCARE (Less than 1 year)
• PROBLEM RESOLUTION (Less than 1 year)
• TEACHING (Less than 1 year)
• LVN
• Utilization Review
• Home Health
• LPN
• Management
• Counseling
• Documentation
• problem solving
Additional Information
SKILLS
Case Management experience for over 20 Hospice philosophy understanding years Adept at prioritizing/managing deadlines
Denials Management for over 10 years Problem resolution capability Extensive Interqual experience and Professional bedside manner teaching, Home Healthcare Quality and Patient evaluation/intervention education Patient/family focused
Inpatient Psychiatric care Acute care expertise
Med/SX patient care Neurology awareness
Extensive UR Strong clinical judgment
Endoscopy at Houston NW Hospital
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