Ann Frances Nelson
Bluffton,SC
Summary
Medical case manager with expertise in care coordination, utilization review, and discharge planning. Known for clear communication, accurate documentation, and smooth patient transitions.
Overview
1
1
Language
1
1
Certification
1
1
year of professional experience
Work History
Medical Case Manager
CorVel Corporation
Lawrenceville, Georgia
02.2026 - 09.2026
- Coordinated telephonic case management for clients, facilitating effective communication among clients, healthcare providers, and claim stakeholders. for CorVel injured workers and claim stakeholders.
- Reviewed treatment plans and medical records to support appropriate case handling.
- Communicated with physicians, adjusters, and employers regarding care needs.
- Educated injured workers on treatment compliance and return-to-work expectations.
- Supported discharge planning and transition planning for CorVel case files.
- Implemented crisis intervention services, addressing clients' urgent needs and stabilizing their situations for better health outcomes.
- Coordinated support services and optimized communication between healthcare workers and patients.
- Reviewed treatment plans against individual goals and healthcare standards.
- Implemented quality disciplinary and team building policies to foster staff satisfaction and productivity.
- Monitored progress of cases and provided feedback on outcomes.
- Maintained accurate records related to patient care, progress notes, referrals and other documentation.
- Actively participated in quality assurance initiatives related to case management services.
- Identified appropriate funding sources for medical treatments or services.
- Ensured compliance with all applicable laws as well as ethical standards within the field.
- Assessed ongoing needs of clients and adjusted treatment plans accordingly.
- Developed comprehensive case plans in collaboration with healthcare teams, ensuring tailored solutions that enhance quality patient care.
- Facilitated communication between patients, families, providers and insurance companies.
- Organized educational programs for staff members on relevant topics such as cultural competency or chronic disease management.
- Optimized program resource utilization to promote timely and cost-effective patient treatment.
- Procured resources from diverse providers to develop specified intervention plans for patrons.
- Adhered to regulations set forth by local, state and federal agencies governing the health care industry.
- Researched information regarding best practices for client care management.
- Educated clients on available community resources and entitlements.
- Informed patients and families about treatment options, medications, and at-home care strategies.
- Evaluated the effectiveness of medical interventions on a regular basis.
- Coordinated discharge planning activities including post-discharge follow up appointments.
- Coordinated psychosocial assessments, treatment plans, and progress notes.
- Guided clients in the development of skills and strategies for dealing with individual problems.
- Ensured confidentiality of case documentation by securely managing sensitive client information..
- Developed individualized care plans in collaboration with healthcare teams.
- Advocated for patient rights and services within the healthcare system.
- Utilized evidence-based practices to inform interventions and care plans.
- Guided patients and families through the healthcare system, including insurance processes.
- Supervised other workers and caregivers who provided services to clients.
Education
Master of Arts - Applied Psychology
University of The Rockies
Denver, CO06-2016
Skills
- Case management
- Care coordination
- Discharge planning
- Utilization review
- Insurance authorization
- Clinical assessment
- Clinical documentation
- Medical documentation
- Quality assurance
- Follow-up care
- Managing records
- Intake procedures
- Gathering referrals
- Patient engagement
- Patient education
- Coaching patients
- Chronic disease management
- Healthcare navigation
- Effective communication
- Interdisciplinary collaboration
- Interdepartmental collaboration
- Multicultural competence
- Attention to detail
- Critical thinking
- Goal setting
- Improving well-being
- Confidentiality
- Conducting assessments
- Gathering referrals
Languages
English
Professional
Certification
- RN Compact State South Carolina
- Certified Case Manager
Accomplishments
- Deans List St Josephs College
Affiliations
- Volunteer with the Carolina Bassett Hound Rescue
Heritage Foundation Volunteer
Timeline
Medical Case Manager
CorVel Corporation
02.2026 - 09.2026
Master of Arts - Applied Psychology
University of The Rockies