Alexandra Schmidt
Manchester,TN
Summary
Results-oriented RN Case Manager with expertise in patient advocacy, care planning, and case coordination. Demonstrated success in improving clinical outcomes through tailored care strategies and effective utilization review. Strong communication and decision-making skills enhance collaboration with multidisciplinary teams, ensuring compliance with insurance guidelines and optimal patient care.
Overview
12
12
years of professional experience
Work History
RN Case Manager
Key Benefit Administrators
Indianapolis, Indiana
04.2023 - Current
- Assessed patient needs and developed tailored interventions.
- Educated patients and families about care processes and resources.
- Facilitated communication between providers and patients for continuity of care.
- Created discharge plans for patients moving from acute care to home or alternate facilities, ensuring continuity of care.
- Provided education on disease prevention, wellness promotion, and lifestyle modifications to empower patients in self-management.
- Coordinated resources to facilitate seamless transitions between levels of care in managed care environment.
- Identified high-risk cases requiring intensive monitoring or specialized interventions.
- Reviewed medical documentation for compliance with insurance guidelines.
- Communicated with healthcare providers to obtain necessary information.
RN Case Manager
AxisPoint Health
Westminster, CO
03.2021 - 03.2023
- Developed comprehensive patient care plans and conducted thorough health assessments to enhance patient outcomes.
- Incorporated appropriate nursing methods to create individualized care plans.
- Collaborated in consults, patient care plans development, patient monitoring and evaluations.
- Facilitated family and patient planning processes to ensure alignment of care goals and preferences.
- Advocated for patients by identifying insurance coverage, communicating care preferences to practitioners and verifying interventions met patients' treatment goals.
- Guided patients in navigating health care system and options by providing targeted education and addressing treatment-related questions.
- Trained other nurses on patient care and daily tasks, supporting growth and professional development.
Clinical Manager
Suncrest Private Care
Manchester, TN
02.2018 - 03.2021
- Management of all clinical staff including RN’s, LPN’s, HHA and PCA’s
- Oversaw daily patient interactions and coordinated care to enhance patient experience.
- Coordinated nurse schedules to maintain optimal staffing levels and ensure quality patient care.
- Act as a clinical resource for all field staff with shared 24/7 on-call
- Oasis assessments entry / review, POC assessments, coordination of care conferences.
- Collaborated with executive director to assess key performance indicators, identifying areas for clinical improvement.
- Assist with routine auditing, state and JCAHO reviews.
- Employed active listening and interpersonal talents to effectively interact with various individuals, including physicians, patients and fellow employees.
Teacher of Anatomy and Physiology
Tennessee College of Applied Technology
04.2017 - 04.2018
- Educated pre-nursing students on prerequisites for the LPN program at TCAT.
- Developed lesson plans aligned with industry standards and student needs.
- Facilitated hands-on training sessions for technical skills and competencies.
- Assessed student progress through regular evaluations and feedback sessions.
Nurse Manager /MDS Coordinator
Nhc Health Care
08.2016 - 12.2017
- Reviewed care plans and supervised multiple nurses (RN and LPNs) and certified nursing aids to ensure quality patient care.
- Conducted multiple quality assurance studies and implemented infection control measures across all levels of care.
- Provided nurse and dementia training to partners, enhancing staff competency in specialized care.
- Oversaw patient admission and discharge functions, including patient management and care coordination.
- Participated in on-call program to ensure patient care coverage.
- Reviewed patient treatment plans to meet and maintain JCAHO, Medicare and Medicaid requirements.
Patient Safety Nurse Specialist
Corizon Health Inc.
01.2015 - 06.2016
- Conducted reviews of sentinel events to identify safety concerns.
- Identified clinical and system improvement opportunities through quality studies and trend analysis
- Conducted patient litigation reviews for legal team to inform risk management strategies
- Collaborated with medical oncology to develop cancer database for enhanced patient tracking
- Assist with draft for DOC contract for compassionate care / hospice program
- Review and authorize medical requests for inmate patients.
Utilization Review Nurse
Corizon Health, LLC
Brentwood, TN
10.2013 - 01.2015
- Collaborated with providers to obtain clinical information, facilitating timely prior authorization determinations and addressing individual inquiries.
- Evaluated medical necessity and cost-effectiveness of services through comprehensive utilization review processes.
- Conducted comprehensive reviews of patient care plans for appropriateness and medical necessity.
- Collaborated with healthcare teams to ensure compliance with clinical guidelines and policies.
- Utilized electronic health records to document utilization review findings and recommendations.
Education
Bachelor of Science - Nursing
Alverno College
Milwaukee, WI04-1997
Skills
- RN Case Management
- Utilization review
- Clinical quality improvement
- Quality assurance
- Quality analysis and problem-solving
- Auditing
- Insurance Verification
- QA process optimization
- Prioritization and decision-making
- Mentoring and coaching
- Training and mentorship
- Staff development
- Interpersonal communication
- Negotiating skills
- Detail orientation
- Staff liaison
Additional Information
- Registered Professional Nurse License since 06/1997
- TN License # RN0000192224
- CCM certification # 00078109
- Inactive license in IL, CA and NY Licensed in IL
Timeline
RN Case Manager
Key Benefit Administrators
04.2023 - Current
RN Case Manager
AxisPoint Health
03.2021 - 03.2023
Clinical Manager
Suncrest Private Care
02.2018 - 03.2021
Teacher of Anatomy and Physiology
Tennessee College of Applied Technology
04.2017 - 04.2018
Nurse Manager /MDS Coordinator
Nhc Health Care
08.2016 - 12.2017
Patient Safety Nurse Specialist
Corizon Health Inc.
01.2015 - 06.2016
Utilization Review Nurse
Corizon Health, LLC
10.2013 - 01.2015
Bachelor of Science - Nursing
Alverno College