Case Manager Quality Assurance
Resume:
KATHLEEN
M. MEEHAN
***********@*****.***
Louisville, KY 40205
SKILLS
Health education
Clinical evaluation skills
Discharge planning coordination
Case management proficiency
HEDIS data analysis
Medical audit execution
Quality assurance
Utilization review
Electronic health records management
Proficient in Microsoft Office Suite
EDUCATION
Bellarmine University
Louisville, KY • 01/1984
Associate Degree: Nursing
CERTIFICATIONS
Certified Case Manager
PROFESSIONAL SUMMARY
Strong patient care skills, clinical assessments, and medical documentation in many work settings. Utilizes strong interpersonal skills to foster patient trust and enhance care delivery. Track record of maintaining accurate computer health records using different programs.
WORK HISTORY
OPTUM HEALTHCARE - Telephone Triage RN
Minneapolis, MN • 01/2023 - 12/2023
Took incoming calls for a hospital system in Pennsylvania to triage patients' symptoms
Guided patients to the appropriate level of care.
Handled call for both adult and pediatric patients.
Utilized Epic and Cerner medical record programs to access medical records, communicate with physicians and office staff, schedule appointments.
CHANGE HEALTHCARE - Covid Nurse
Nashville, TN • 06/2022 - 01/2023
Hired as temporary employee working for the New York City Department of Health, then hired fulltime by Change Healthcare in the same position.
Performed telephonic outreach program to deal with COVID 19 questions. and encourage testing and vaccinations.
Made 50-75 outreach calls daily in a 12-hour shift.
Took incoming phone inquiries about COVID and provided telephone triage and advice.
SIGNATURE STAFF RESOURCES - Covid Nurse
Rockwall, TX • 01/2021 - 06/2022
Hired as temporary employee working for the New York City Department of Health. See job description above.
CAREWISE HEALTH - Telephonic Case Manager
Louisville, KY • 01/2017 - 12/2019
Started as a temporary employee and hired full-time after 3 months.
Interacted with multiple clients to teach and support lifestyle changes.
Utilizing InterQual, reviewed and authorized transplants of all kinds, serving as department liaison with transplant centers.
WELLCARE - Hedis Review Nurse
Louisville, KY • 02/2016 - 05/2016
Performed chart review for HEDIS data collection in a temporary position.
PASSPORT HEALTH PLAN - Rapid Response Case Manager
Louisville, KY • 01/2011 - 05/2015
Responded to urgent/emergent needs of plan members ranging from medication problems to DME needs.
Skillfully navigated a path through the system to meet the member's needs.
NATIONAL GOVERNMENT SERVICES - Medical Review Nurse
Louisville, KY • 06/2002 - 10/2010
Performed pre-pay and retrospective medical record audits.
Educated healthcare providers and their staff, facilitating improved billing practices and timely payment.
Triggered fraud and abuse investigations.
VISITING NURSE ASSOCIATION - Clinical Manager
Louisville, KY • 05/1999 - 06/2002
HUMANA INC. - Case Manager
Louisville, KY • 09/1997 - 05/1999
FLOYD MEMORIAL HOME HEALTH CARE - Quality Compliance Assistant
New Albany, IN • 01/1993 - 01/1997
Floyd Memorial Hospital - Home Health Nurse
New Albany, IN • 05/1991 - 01/1993
JEWISH HOSPITAL - Staff Nurse
Louisville, KY • 1985 - 1991
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