RN Integrated Care Coordinator (24+ Years)

Angela Fravel,

Registered Nurse

Avon, IN *****

angiiirn3@gmail.c

om +1(317) 868-

4215

Professional Summary

Nursing professional bringing 24 plus years of experience. Passionate about delivering and educating a holistic approach towards health and wellness. Exceptional care delivery to a diverse patient population. Knowledgeable and skilled at maximizing patient comfort and safety while meeting strict cost control standards. Seeking full time day position. Authorized to work in the US for any employer. Authorized to work in the US for any employer

Work Experience

Integrated Care Coordinator RN

United Healthcare-Hybrid

March 2024 to January 2026

Worked as an Integrated Care Coordinator registered nurse for the Pathways (PWA) Program including members on the Medicaid Aged and Disabled waiver aged 60 years of age and above.

Facilitated comprehensive care for members by managing medical, behavioral, and social needs to improve health outcomes. Remote or field-based, involve developing care plans, removing barriers to care, and collaborating with interdisciplinary teams. Key Responsibilities

• Care Planning: Assess, develop, and implement individualized care strategies for members, often focusing on complex, older adult populations or specific conditions.

• Coordination & Navigation: Act as the primary point of contact for members, guiding them through the healthcare system, scheduling appointments, and ensuring access to appropriate services.

• Barriers Reduction: Address social determinants of health (e.g., housing, transportation, financial assistance).

• Monitoring: Track care for at-risk, fully insured, or Medicaid/Medicare members to prevent gaps in care.

• Documentation: Utilize EHR and proprietary systems to maintain records and track metrics.

• Organizational, and care management skills.

Integrated Case Manager RN/Delegated Care Coordinator Oak Street Health/Presbyterian Health Plan-Remote

November 2021 to 2024

Integrated case management, and care coordination for Zing health Insurance, Presbyterian Health plan, Medicare, Medicaid plans SNP and DSNP population. 100% remote position placing outreach calls to members. individualized Care plan creations, health risk assessments comprehensive risk evaluation interdisciplinary care team meetings, transitions of care, medication reconcile and subsequent follow ups. Clinical Trials Registered Nurse - RN

NOVASYTE/IQVIA/ELI LILLY-

Indianapolis, IN

September 2020 to 2024

• Travel to various care facilities throughout the United States.

• Input reporting and event notes post assignment and refer any pertinent information to supervisor program lead.

• Supporting the clinical trials and clinical research for patient infusions under physician orders either at a clinical site or in the patients home. Self Employed

SC Dev-Con-Indianapolis, IN

November 2013 to September 2020

· Administrative duties for opening a brewery/restaurant.

· Event coordinator

· Payroll, on boarding employees, schedules, supply orders. Pre/Post Operative RN

The Gillian Center-Indianapolis,

IN January 2016 to May 2017

Delivery of safe nursing care to cosmetic surgery patients before, during and after surgery.

• Provide education to patients and family/caregiver.

• Prepare patients with medications, circulate in the OR, and post-op surgical care, in accordance with current practice.

Acute Case Manager Nurse/RN

Advantage Health Care-Indianapolis,

IN June 2011 to December 2012

Coordinate member care by providing primary nurse support through all aspects of utilization management.

· Determine medical necessity of inpatient hospitalization and outpatient treatment using Milliman criteria/guidelines.

· Process commercial and Medicare insurance claims for pre-certification, concurrent review, retrospective review, and member enrollment into disease management programs, health coaching, home health, or skilled nursing facility.

· Assist patients telephonically with qualifying benefits and all pertinent policy issues and questions.

· Regular patient follow up. Develop interventions to meet needs of client, caregiver, and provider networks.

· Primary liaison for members as well as company employees.

· Focus on Managed Health Care, transition patients to provide stabilization, prevention of deterioration, and improvement of health status, to avoid hospital readmissions. Nurse Case Manager I

Anthem/WellPoint-Indianapolis, IN

October 2009 to April 2011

Optimize member health care through obtained medical records. Prior Authorization, Utilization Review.

· Clinical and behavioral assessment using established protocols, referrals, and coordinate resources.

· Establish pertinent patient information to apply the appropriate clinical criteria to render coverage determination.

· Professional liaison for the medical management department.

· Presented weekly care conferences to management staff and medical directors.

• Deliver education, triage and/or disease management interventions and perform health coaching, telephonically across multiple medical condition lines.

· Analysis of prior authorization cases based on state regulations.

· Utilization review to ensure compliance with applicable criteria, medical policy and industry standards.

· Ensure member access to quality healthcare in a cost effective setting.

· Collaborate with providers, reviewers and other community programs for a proactive plan for discharge.

Home Health Nurse Case Manager/RN

Nightingale Home Health-Carmel, IN

October 2008 to January 2009

Complete assessments, wound care, blood draws, IV therapies, line maintenance according to the plan of care, in the patient’s home.

· Determine patients eligibility for services as indicated by agency policy and state and federal laws, and regulations.

· Collaborate with multiple disciplines in the healthcare field.

· Used Oasis software to schedule and manage patient appointments. RN Associate Partner

Surgical Intensive Care Unit-IU

Hospital, Indianapolis, IN February

2006 to October 2008

Focus on transplant patients to

perform a full range of surgical

transplant procedures including

liver, kidney, pancreas, intestinal,

and multivisceral transplants.

· Maintained quality working relationships with patients and peers in an extremely ill patient population with focus on postoperative critical care situations. RN/LPN

St. Vincent Hospital-Indianapolis,

IN October 1998 to February 2006

Provide basic nursing duties including daily care, health needs safety and comfort to patients in a medical surgical and acute and non-acute neurology population.

· Utilize critical thinking skills, decisive judgment, and the ability to take appropriate action to work with minimal supervision.

· Assess and coordinate patient's discharge planning needs with members of the healthcare team.

Education

Associate of Science in Nursing

Marian College-Indianapolis, IN

September 1999 to May 2002

LPN /Licensed Practical Nurse

Ivy Tech State College-Indianapolis,

IN January 1996 to December 1998

Nursing Licenses

RN

Indiana

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Skills

• RN

• Presentation skills

• Teaching

• Phone etiquette

• Customer Service

• HEALTHCARE

• Writing skills

• Documentation Review

• Telehealth

• Leadership

• Laboratory Experience

• Experience with children

• Computer skills

• Crisis intervention

• Microsoft Excel

• ICD-10

• EXCEL

• Quality Management

• CPT

• Travel nursing

• Employee Orientation

• DRG

• MDS

• Communication skills

• Infusion

• ICU Experience

• ICD coding

• Data Entry

• ICU experience

• Clinical trials

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• Home & community care

experience

• Financial auditing Behavioral

health

HEALTHCARE (10+ years)

Analysis skills

Patient monitoring

PeopleSoft

SharePoint

Documentation

review

CODING (5 years)

Home care

Typing

Medical Policy

Staff Nurse

• CODING

• Nurse Management

• Hospital experience

• Medical Terminology

• Anatomy Knowledge

• Injection administration

• Auditing

• Intake

• Computer networking • Research

• Quantitative research

• Customer service

• ICD-9

• Data analysis skills

• Medical records

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• Home health

• Content management systems

• Utilization Management

• HCPCS

• Medical-surgical

• CPT coding

• Nursing

• Administrative Experience

• Microsoft Powerpoint

• Patient assessment

• Time Management

• Microsoft Access

• Quality management

Med Surg

Microsoft Office

Microsoft Word

Medical Coding

Computer literacy

EMR Systems

LPN

IV infusion

Milliman/InterQual Care

Guidelines OR experience and

Windows

• Learn Point

• Medical Surgical

• Diagnostic evaluation

• Clinical Trials

• Occupational health

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• Microsoft Outlook

• Home Health

• Acute Care

• Catheterization

• Critical Care

• Leadership Experience

• EXCELLENT COMMUNICATION SKILLS

• Medical terminology

• Utilization Review

• Managed care

• Hospital

• Workers' compensation

• Vital Signs • Epic

• Cardiology

• Outpatient

• Experience Administering

Injections

• Case Management

• Data Collection

• Clinical documentation

• Medical Records

• Patient Care

• English

Medication Administration

Insurance Verification

Clinical research

Medical Billing

Discharge planning

Medical management

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Geriatrics

Cerner

Care plans

Triage

Computer operation

HEDIS

• Quality Assurance

• Quality assurance

• Laboratory experience

• Trauma medicine

• Office management

• Critical care experience

• Supervising Experience

• Medical office experience

• Appeals

• Motivational interviewing

• Operating Room

Languages

• English

Certifications and Licenses

RN refresher course

Present

Completed a year long nurse refresher course through St. Francis, started - June 2017 Ended - June 2018

Driver's License

LPN

BLS, ACLS

Additional Information

SKILLS

• Computer skills and software include: Microsoft Office Suite, Windows, Word, Excel, PowerPoint,Milliman/InterQual Care Guidelines, Medical Policy, Learn Point, Sharepoint, PeopleSoft. Intermediate General Knowledge.

• Working knowledge with healthcare coding principles including ICD-9, ICD-10, CPT, HCPCS, and DRG.

• Knowledge of state and federal healthcare guidelines. URAC

• Ability to make critical decisions in a stressful environment.

• Excellent communication skills including written and verbal.

• Reliable, highly organized with attention to detail and passionate about patient care, safety, andoverall healthcare.

• Self directed and motivated.

• Able to present to large and small groups.

• Ability to multitask and prioritize.

• Effectively adapt to fast paced changing environments.

• Results driven, open minded and team player.

• Passionate about contributing to an organization focused on improving client experiences and maintaining client privacy.

Contact this candidate