Case Manager Rn
Resume:
Mary Olsen
Denver, CO *****
********@******.***
Authorized to work in the US for any employer
Work Experience
Community Service Volunteer
Elks Club-Denver, CO
Present
Volunteer support for community service projects
RN Case Manager
University of Colorado Hospital
January 2014 to April 2020
• Collaborated with interdisciplinary team members including physicians, social workers, and therapists to develop comprehensive care plans for patients
• Conducted thorough assessments of patient conditions and needs, identifying potential barriers to recovery and developing strategies for intervention
• Liaised between healthcare providers, insurance companies, and community resources to facilitate seamless transitions in care settings
• Closely monitored utilization of healthcare resources to ensure cost-effective delivery of services while maintaining quality standards
• Demonstrated proficiency in electronic health record systems (EHR), accurately documenting patient information and updating records as necessary
• Participated in multidisciplinary meetings to discuss complex cases, share knowledge, and collaborate on effective interventions
• Collaborated with insurance companies to obtain prior authorizations for necessary treatments or procedures ensuring timely access to care
Case Manager
Colorado Foundation for Medical Care-Greenwood Village, CO February 2010 to January 2013
1. Utilized Milliman Care Guidelines, Interqual Criteria, LEAN and QA methodology to to identify QA QI issues.
2. Investigated Medicare beneficiary complaints as QIO for Colorado, managed referrals OIG, federal and state resources.
3. Facilitated peer review, medical records, written notices within required timelines 100% rating 4. Utilized Facilitated Dispute Resolution, provided Immediate Advocacy for Medicare beneficiary issues, maintained computerized records, data collection and report 5. Reviewed medical records MD orders for dispute of Hospital Discharge complaints in acute hospital settings.
Registered Nurse Case Manager
HMC Wellpoint Blue Cross Blue Shirld-Denver, CO
May 2009 to November 2010
• Collaborated with interdisciplinary team members to develop comprehensive care plans for patients, ensuring continuity of care
• Managed a caseload of XX patients, coordinating and overseeing their healthcare needs
• Monitored patient progress and outcomes, adjusting care plans as necessary to optimize health outcomes
• Provided education and support to patients and their families regarding disease management, medication adherence, and lifestyle modifications
• Advocated for patients' rights and ensured they received appropriate resources and services
• Utilized electronic health records (EHR) systems to document patient information accurately and efficiently
• Coordinated referrals to specialists, ancillary services, and community resources based on individual patient needs
• Participated in case conferences with healthcare providers to discuss complex cases and develop collaborative solutions
• Implemented evidence-based practice guidelines in the delivery of nursing care, promoting quality improvement initiatives within the organization
• Collaborated with insurance companies to obtain pre-authorization for medical procedures or medications as needed
• Facilitated communication between healthcare providers involved in a patient's care plan
• Collaborated with social workers and other healthcare professionals to address patients' psychosocial needs
• Participated in interdisciplinary rounds to discuss patient progress and care plans RN Case Manager
Centura St Anthony North-Westminster, CO
February 2006 to April 2009
• Managed a caseload of XX patients, coordinating and overseeing their healthcare needs from admission to discharge
• Collaborated with interdisciplinary team members including physicians, social workers, and therapists to develop comprehensive care plans for patients
• Advocated for patients' rights and ensured that they received appropriate medical services in a timely manner
• Liaised between healthcare providers, insurance companies, and community resources to facilitate seamless transitions in care settings
• Closely monitored utilization of healthcare resources to ensure cost-effective delivery of services while maintaining quality standards
• Demonstrated proficiency in electronic health record systems (EHR), accurately documenting patient information and updating records as necessary
• Participated in multidisciplinary meetings to discuss complex cases, share knowledge, and collaborate on effective interventions
• Collaborated with insurance companies to obtain prior authorizations for necessary treatments or procedures ensuring timely access to care
• Demonstrated strong interpersonal skills when working with diverse populations including individuals with complex medical and social needs
• Implemented evidence-based practices in care coordination, resulting in improved patient outcomes and reduced hospital readmission rates
• Ensured compliance with regulatory standards and guidelines related to case management practices, maintaining accurate documentation of interventions
• Demonstrated proficiency in conducting psychosocial assessments, identifying mental health needs, and coordinating appropriate interventions
Education
Social Work (Master of science)
Colorado State University-Fort Collins, CO
Paralegal Studies (Certificate RN)
Denver Paralegal Institute-Denver, CO
Nursing (Bachelor of Science in Nursing)
University of Oregon-Portland, OR
CCM (Case Management)
Skills
• Emergency room experience
• Disease state management
• Managed care
• Durable medical equipment (DME) coordination
• Case management
• Patient referrals
• Neonatology
• Discharge planning
• Nursing
• Progress documentation
• Home health
• Care plans
• HIPAA
• ICU experience
• Community resource coordination
• Utilization review
• Rehabilitation center experience
• Epic
• Diagnostic evaluation
• Electronic health records (EHR) management
• Patient assessment
• Acute care
• Utilization management
• Insurance provider collaboration
Military Service
Branch: United States Navy
Service Country: United States
Rank: Lieutenant
ER, Ortho RN
Charge Nurse Outpt Peds Cinic Peds ER
Recruiter - Regional Medical Staff, RN staff
Commendations:
Letter of Commendation Recruiter
Athletic Performance
Awards
Kaiser
Certifications and Licenses
RN License
October 2025 to September 2027
RN License # 0174520 Compact Multi-state Colorado
RN License
December 1976 to August 2026
California RN License 273648
BLS Certification
May 2024 to May 2026
eCard Code 245********
American Heart Association
Certified Case Manager
Nurse Licensure Compact (NLC)
Contact this candidate