Ashley McCarthy
Oshkosh
Summary
Experienced care manager with a proven track record of strong performance at Magellan Health. I have a history of excelling in crisis intervention and patient education, and I am adept at building rapport and utilizing strong communication skills to enhance care management. I am skilled at processing authorizations efficiently and ensuring data integrity while meeting performance metrics. I am committed to optimizing patient outcomes through effective collaboration as well as independent work.
Overview
5
5
years of professional experience
Work History
Care Manager
Magellan Health Service Administrator
10.2022 - Current
- Processed off que tasks such as TMS requests and appeals in a timely manner through both collaboration and independent work.
- Utilized MNC criteria to enter and process authorizations for various levels of care with efficiency and proficiency.
- Educated members and families on community resources, treatment options and health care services to better manage conditions.
- Provided crisis intervention services when necessary by assessing risk levels promptly addressing safety concerns.
- Complete crisis call follow up calls, and other miscellaneous tasks assigned.
- Assessed members and discussed plans/care to meet needs.
- Participated in team meetings and trainings to stay updated on best practices and new developments in care management.
- Trained in correcting authorization errors and assist as needed with correcting errors that could impact claims, correspondence, and data integrity.
- Meet call metrics by processing calls timely and efficiently.
Registered Nurse, Intensive Care Unit
ThedaCare Regional Medical Center-Appleton
12.2021 - 02.2022
- Administered medications and treatments as prescribed by physicians.
- Demonstrated advanced critical thinking skills while managing complex clinical situations involving multiple organ systems failures in critically ill patients
- Reduced patient complications by promptly identifying changes in condition and initiating appropriate interventions.
- Increased family involvement in patient care by providing timely updates on their loved one's progress and addressing any concerns or questions they may have had.
- Collaborated with interdisciplinary teams to establish optimal care plans, resulting in improved patient care.
- Administered medications accurately and effectively, preventing adverse reactions through careful monitoring of drug interactions.
- Cared for wounds such as surgical sites and pressure sores to prevent infection and promote healing.
- Maintained confidentiality of sensitive patient information in accordance with HIPAA regulations while fostering trust between medical staff and patients'' families.
Registered Nurse, Cardiac Telemetry
La Palma Intercommunity Hospital
04.2020 - 09.2021
- Improved patient outcomes by consistently monitoring cardiac telemetry and promptly responding to critical changes.
- Optimized patient outcomes in high-stress scenarios by remaining calm, focused, and utilizing critical thinking skills to provide appropriate interventions.
- Provided comprehensive cardiac education to patients and families, empowering them in self-care management postdischarge.
- Ensured optimal clinical outcomes for cardiac patients through timely identification of potential complications and prompt intervention.
- Demonstrated expertise in various cardiac procedures such as EKG interpretation, defibrillation, cardioversion, and administration of emergency medications.
Education
Associate of Science - Registered Nurse
Stanbridge University
Irvine, CA10-2019
Skills
- Time management
- Ability to de-escalate crisis call members
- Building rapport
- Teaching skills
- Strong communication skills
- Performance metrics
- Flexibility
Timeline
Care Manager
Magellan Health Service Administrator
10.2022 - Current
Registered Nurse, Intensive Care Unit
ThedaCare Regional Medical Center-Appleton
12.2021 - 02.2022
Registered Nurse, Cardiac Telemetry
La Palma Intercommunity Hospital
04.2020 - 09.2021
Associate of Science - Registered Nurse
Stanbridge University
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