Resource Case Manager - RN, CCM with 21 Years Experience
Resume:
Danielle McSorley BSN, RN,CCM
Croydon, PA 19021
**************@*****.***
OBJECTIVE:
Organized Registered Nurse of 21 years. Seeking a position in Resource Case Management. Possessing a Bachelor of Science in Nursing (BSN),Case Management Certification(CCM), an aptitude in time efficient, safe, and successful patient discharges. Utilizing resources across the continuum to ensure client wellness and self-advocacy.
EXPERIENCE:
Trauma Clinical Resource Management 05/2022- Current
University of Pennsylvania Hospital
Presbyterian Medical Center Campus
Phila, PA 19104
●Discharge Planning - timely coordination of home care, DME,
●Placements, hospice, community resources,
●Risk management assessment and appropriate referral
●Develop and facilitate specific plan to address concerns identified.
●Identifies delays, communicates and ensures accountability with providers
●Facilitates daily Interdisciplinary meetings
PA Unemployment Case Manager 03/2021-11/2021
Genex Mitchell Resources
Wayne, PA 19087
●Direct contact with adjusters and direct physician care coordination
●Assessing clients’ needs
●Ongoing care of the client’s needs
●Evoking motivation to change
●Problem solving
●Referrals to community agencies and coordination of care providers to ensure safe and time efficient return to prior level of function and job capacity
Case Manager/Utilization Review 08/2016-09/2019
Temple University Hospital
Philadelphia, PA 19140
•Utilization Review and concurrent reviews proficiently using Interqual 2019, Epic, and Navinet
•Creating partnerships with medical payers to ensure proper payment
•Ensuring time efficient and safe discharges of medically complex clients
•Resourcing with multiple durable medical and pharmacy vendors
•Extensive collaboration within the multidisciplinary team for time effective discharges
•Procuring relationships with insurance companies
•Relentless advocacy and teaching for the client and family to enhance future Holistic Wellness
Emergency Room Case Manager/Utilization 07/2011-06/2015
Reviewer
Taylor Hospital
Ridley Park, PA 19078
•Utilization Management/Utilization Review/Discharge Planning
•Daily activities include reviewing all clinical information for Inpatient and ER admission reviews.
•The extensive use of Interqual - Care Enhance Review Management Guidelines.
•Use of State systems and MHS systems *McKesson Interqual Certification, Allscripts.
Proficient in: Utilization Review/Concurrent Review /SNF Rehab Prior Authorizations, Pre-Certifications of Elective Procedures, Transitional Care Discharge Planning, Responsible for Social Work duties for hospital during weekend position.
Initial Review/Case Manager 08/2015-07/2016
Mercy Fitzgerald Hospital
Upper Darby, PA 19023
•Review/Discharge Planning Daily activities include reviewing clinical information for acute admissions
•Utilization review with concurrent reviews and assist with retrospective appeals
Adult Case Manager/UR /Precertification Nurse Review 03/2007-07/2015
Health Partners
Philadelphia, PA 19107
•Utilization Management
•Utilization Review
•Discharge Planning utilizing
•Interqual Guidelines* CPHM Certification
Proficient in: Utilization Review/Concurrent Review /SNF Rehab Prior Authorizations, Pre-Certifications of Elective Procedures, Transitional Care Discharge Planning.
EDUCATION:
Holy Family University 02/2017-05/2020
Philadelphia, PA
Bachelor’s Degree-Science of Nursing
Roxborough Memorial School of Nursing 05/2001-05/2003
Roxborough, PA
Diploma-Registered Nurse
SKILLS:
• Utilization Review
Initiating Appeals process for approval of appropriate setting
• Transitional Care Discharge Planning
• Adult Case Management/Disease Management
• Obtaining approval and securing safe transitions to secondary facilities
• Accident and Emergency
• Registered Case Manager
• Mc Kesson InterQual Interrater reliability re certification 2019
• CPHM Certification
• Telemetry Care
• Obtaining and approving Pre-Certifications of Elective Procedures
• CCM Certification
• Acute Care Medicine
• High Risk Population Discharge Planner
Registered Nurse issued by PA State Board of Nursing in Pennsylvania
Issued-07/2003 Expieres-10/2022CE
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