Manager Quality Assurance

Susan Karlewicz, RN

* ***** *****, *********, ** 10530 Home- 914-***-**** Cell -201-***-****

E-Mail- **********@*****.***.

Objective: Seeking a challenging position utilizing my extensive clinical background along with my Case Management, Utilization Review experience

Experience: Case Manager

July 2004-Present -Hackensack University Medical Center, Hackensack, NJ

Daily chart reviews for medical necessity, appropriateness of care on a variety of unit including; medical-surgical, ICU, pediatrics, and high risk obstetrics

Utilization review, communicating clinical information to manage

Care plans and all aspects of discharge planning

Chart audits to monitor documentation compliance to meet Joint

Commission standards

Case Manager

July 2003 to July2004- Good Samaritan Hospital, Suffern, NY

Daily chart reviews and case management services to manage care and

Medicare patients

Monitor appropriateness of care and provide insurance companies with necessary clinical information

Participated in weekly interdisciplinary conferences

Per-Diem Nursing Supervisor

Sept. 2003 – July 2004- Good Samaritan Hospital, Suffern, NY

Administrative Supervisor in charge of a 270 bed hospital

Onsite Case Manager

February 2000 – July 2003- Cigna Healthcare

Onsite concurrent review at three large teaching hospitals

Monitor appropriateness of care utilizing Milliman & Robertson

Healthcare Guidelines

Proactively assist in all aspects of discharge planning and outpatient services

Heavy interaction with attending physicians and hospital staff to achieve optimal outcomes

Responsible for monthly cost savings analysis reports with significant

Documented saving

Onsite Case Manager/Manager of Pre-Authorization/Concurrent Review Department

May 1997 – February 2000 -New York Medical Group/HIP

Directly responsible for pre-authorization and concurrent review staff

Developed tools for the on-site review process

Responsible for annual employee evaluations and counseling

On-Site case management/utilization review

Associate Nursing Care Coordinator

May 1991 – May 1997 Westchester County Medical Center

Charge Nurse responsible for forty-four bed medical surgical unit

Weekly interdisciplinary conferences

Hiring and training new staff

Monthly quality assurance reports

Staff RN

May 1985 –May 1991 Westchester County Medical Center

General Staff Nurse duties

Education The College of New Rochelle –Credits towards BSN

Mercy College – Credits towards BSN

Orange County Community College – ASS in Nursing

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