Healthcare professional driven to deliver high-quality patient care and effective case management. Expertise in care coordination and patient advocacy, fostering strong communication and collaboration within multidisciplinary teams. Known for adaptability and results-oriented approach in dynamic healthcare environments.
Overview
4
4
years of professional experience
1
1
Certification
Work History
RN Case Manager Travel Nurse
Memorial Hospital Gulfport
02.2024 - Current
Discharge Planning case management process to assess, develop, implement, monitor, and evaluate care plans designed to optimize the members health across the care continuum, ultimately preventing hospital readmission
Investigates, identifies and reports problems and inefficiencies in existing systems, and recommends changes when appropriate to the Supervisor
Under the guidance of the Supervisor and in consultation with other QRM staff, participates in the coordination, planning, development, implementation, and maintenance of all QRM policies and procedures
Monitors utilization and LOS trends (via InterQual) concerning inpatient and outpatient care in the market area, keeping appropriate management informed
Participated in length of stay meetings, provided barriers to permitting discharge, to assist with creating a plan of care to ultimately discharge patient with complex transitional needs
Refers cases identified as risk management, peer review or quality issues to Quality and Risk Management
RN Case Manager Travel Nurse
TNAA
06.2024 - 08.2024
Discharge Planning case management process to assess, develop, implement, monitor, and evaluate care plans designed to optimize the members health across the care continuum, ultimately preventing hospital readmission
Investigates, identifies and reports problems and inefficiencies in existing systems, and recommends changes when appropriate to the Supervisor
Under the guidance of the Supervisor and in consultation with other QRM staff, participates in the coordination, planning, development, implementation, and maintenance of all QRM policies and procedures
Monitors utilization and LOS trends (via InterQual) concerning inpatient and outpatient care in the market area, keeping appropriate management informed
Participated in length of stay meetings, provided barriers to permitting discharge, to assist with creating a plan of care to ultimately discharge patient with complex transitional needs
Refers cases identified as risk management, peer review or quality issues to Quality and Risk Management
RN Case Manager Travel Nurse
TNAA
11.2023 - 04.2024
Collaborated with the healthcare team to provide referral information and regarding community resource referrals
Built effective working relationships with practitioners and other departments within the health plan
Discharge Planning case management process to assess, develop, implement, monitor, and evaluate care plans designed to optimize the members health across the care continuum, ultimately preventing hospital readmission
Worked in conjunction with disease specific population based care department as appropriate
Consults with Chief of QRM for potential non-approvals, benefit exceptions and other issues as appropriate
Assists in the development of guidelines and protocols
Investigated, identifies and reports problems and inefficiencies in existing systems, and recommends changes when appropriate to the Supervisor
Under the guidance of the Supervisor and in consultation with other QRM staff, participates in the coordination, planning, development, implementation, and maintenance of all QRM policies and procedures
Monitored utilization and LOS trends (via InterQual) concerning inpatient and outpatient care in the market area, keeping appropriate management informed
Participated in length of stay (LOS) meetings, provided barriers permitting discharge to assist IDT with plans of care to ultimately discharge patient with complex transitional needs
Refers cases identified as risk management, peer review or quality issues to Quality and Risk Management
Complete monthly quality related data entry, analysis and reporting
Demonstrate working with accrediting standards, including TJC and CARF
Required 30% direct patient care, medication administration, assessment and discharges risks, EOC etc report to CMS reportable findings
Managing deadlines and progress across the team to ensure the project is delivered on time and on budget
Completes quarterly and annual assessments (OIC, MEC, AD HOC, GB) for adherence to current evidence-based clinical guidelines, standards of care, and standards of practice in the provision of health center services
Monitor (HCAHPS score) Assessing patient satisfaction using satisfaction surveys, focus groups and complaint data
Hearing, resolving, and tracking - trending of patient complaints/grievances
RN Case Manager Travel Nurse
Host Healthcare
05.2023 - 09.2023
Registered Nurse Case Manager Temp at John Hopkins-Baltimore, MD
Develops an individual, mutually established plan of care based on the assessment and utilizing motivational techniques, in conjunction with the Hospitalists and other practitioners that identifies specific interventions, objectives and goals with anticipated targeted dates for accomplishment
Attends patient care conferences (rounds) as scheduled with QRM physicians, and Telephonic IPCC work together to discuss clinical course, discharge planning and provide feedback on planned interventions, or barriers to care for member self-management to avoid delays and promote smooth transition
Proactively, implements the plan of care and specific interventions that will lead to the accomplishment of goals as defined
This may entail implementation prior to member discharge
Coordinates the resources necessary to accomplish the goals, and makes recommendations for modifications to the plan of care as necessary
Performs telephonic outreach to identified members within 48 hours post hospital discharge and completes assessment of member status
Coordinates and communicates plan of care to the Primary and/or Specialist Care providers, including follow-up appointment
Arrange, facilitate appointments for the patient as necessary
Makes referral to other programs for continued care support
Discharge Planning case management process to assess, develop, implement, monitor, and evaluate care plans designed to optimize the members health across the care continuum, ultimately preventing hospital readmission
Monitors utilization and LOS trends (via InterQual) concerning inpatient and outpatient care in the market area, keeping appropriate management informed
Participated in length of stay meetings, provided barriers to discharge to assist with plans of care to ultimately discharge patient with complex transitional needs
Documents all case management interactions and interventions according to departmental guidelines
Coordinates and participates in complex case management conferences on a regular basis for members involved in the care and updates the plan of care as necessary
Continuously coordinates, monitors, tracks and evaluates all care and services rendered to ensure that quality care is being delivered and in the most appropriate setting
Re-assess and reinforce member's self-management skills, including symptom and medication management
Acts as a resource to facility Case Managers and discharge planners
Provides case management updates to practitioners and health care teams
RN Case Manager / Quality Assurance
Select Specialty Hospital
01.2021 - 03.2023
Quality Assurance Manager- Hybrid Select Specialty Hospital - Critical Care Unit-Atlanta, GA
Assisting with survey activities to ensure that the facility maintains accreditation, certification and licensure
Possessed the Director of Quality Management role in the absence of Director of Quality
Assisting with weekly microbial stewardship rounds- interdisciplinary team meetings
Assisting with reviews of quarterly quality improvement reports
Assisting the Medical Director and Quality Program Director with development and implementation of medical staff quality improvement activities
Performing all safety and EOC duties
Performing monthly safety rounds and quality control surveillance
Completing monthly quality related data entry, analysis and reporting
Organizing third-party providers and vendors to deliver elements that can't be produced in-house
Assisting with employee orientation, nursing skills competency, training, and education (35% direct care) in the workplace
Record keeping of employee health
Collaborating with employers, completion LTrax, WOQR, QAPI, IC risk assessment, audits, EOM report, survey readiness, Employee Health files, Complaints and Grievance, competency check off, etc
Rounding tasks with appropriate team members to discourage CLASBI, CAUTI, Isolation, dislodgment
Education
Associate of Science - Nursing
Brown Mackie College
Lenexa, KS
05-2012
Skills
BLS Instructor
Time Management
Leadership
Organizational
Good Documentational
Nurse Management
Nursing
Documentation Review
Infection Control Training
Medication Administration
Vital Signs
EMR Systems
Accomplishments
As a consultant achieved getting a nursing facility in compliance through effectively clearing 37 CFR citations.
Certification
RN License
AED Certification
Compact State Nurse License
Additional Information
InterQual course completion
Personal Information
Work Permit: Authorized to work in the US for any employer
Timeline
RN Case Manager Travel Nurse
TNAA
06.2024 - 08.2024
RN Case Manager Travel Nurse
Memorial Hospital Gulfport
02.2024 - Current
RN Case Manager Travel Nurse
TNAA
11.2023 - 04.2024
RN Case Manager Travel Nurse
Host Healthcare
05.2023 - 09.2023
RN Case Manager / Quality Assurance
Select Specialty Hospital
01.2021 - 03.2023
Associate of Science - Nursing
Brown Mackie College
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