Belinda Alayof BSN/CCM
Summary
Dynamic RN Workers Compensation Case Manager with a proven track record in both Federal & Civilian Workers Comp, excelling in expediting injured workers' return to work through strong communication and meticulous documentation. Leveraging diverse clinical experience and critical thinking skills, I cultivate productive relationships with adjusters and physicians, ensuring timely progress and optimal outcomes for patients.
Overview
30
30
years of professional experience
1
1
Certification
Work History
Registered Nurse Field Case Manager
Apogee Solutions
Chesapeake, VA
06.2023 - Current
- Provide nurse case management to Department of Labor injured workers both telephonically and in the field
- Communicate telephonically with medical providers, the employing agency, and injured workers for updated diagnosis, treatment plans, medical progress, and work status.
- Facilitates medical treatment access for injured workers through appointment coordination.
- Maintain and complete the injured worker's file, including medications, care plan, diagnosis, injured worker data, contacts, and relevant documents.
- Provide coordination for diagnostics, therapies, and transportation.
- Maintain communication with the claims examiner for file status updates and recommendations.
- Updated status and progress reports for injured workers' cases.
- Attends MD appointments with injured workers while addressing the diagnosis, treatment plan, response to treatment, return to work, and anticipated return to work dates, as well as MMI.
RN Workers Compensation Case Manager
WrightRehab
Woodstock, GA
04.2021 - Current
- Attend doctors' appointments with injured workers while addressing diagnosis, treatment, return to work and maximum medical improvement
- Coordinate injured workers services enabling return to work: physical therapy, occupational therapy and psychological services
- Work and communicate with adjusters, attorneys and doctors on a weekly basis to progress injured workers file efficiently and effectively for return to work status
- Maintain and complete injured worker's file including medications, care plan, diagnosis, injured worker data, contacts and relevant documents
- Completion of reports for files documenting status and progress of injured workers file
RN Workers Compensation Case Manager
Genex Services LLC
Norcross, GA
12.2019 - 04.2021
- Attend doctors' appointments with injured workers while addressing diagnosis, treatment, return to work and maximum medical improvement
- Coordinate injured workers services enabling return to work: physical therapy, occupational therapy and psychological services
- Work and communicate with adjusters, attorneys and doctors on a weekly basis to progress injured workers file efficiently and effectively for return to work status
- Maintain and complete injured worker's file including medications, care plan, diagnosis, injured worker data, contacts and relevant documents
- Completion of reports for files documenting status and progress of injured workers file
RN Case Manager
Northside Hospital Cherokee
Canton, Georgia
11.2018 - 12.2019
- Review patient admissions and concurrent stays to determine medical necessity as directed by the Interqual criteria
- Collaborate with providers to obtain required clinical information, supporting prior and current authorization determinations and individual inquiries
- Collaborate with interdisciplinary team of professionals, as well as patients and families, to determine appropriate treatment goals and discharge needs
- Review effectiveness of treatment for individual and family situations
- Determine and coordinate appropriate level of care to meet individual patient needs
- Review and record progress of patients including any barriers to discharge and discharge needs
- Collaborate with various healthcare providers to facilitate delivery of services and discharge needs
- Coordinate resources from diverse providers and resources for reducing readmissions and discharge planning
- Participate in weekly outlier meetings to determine barriers to discharge for patients past length of stay
- Collaborate with different disciplines to provide cohesive care to patients
RN Case Manager /Utilization Review Nurse
WellStar North Fulton Hospital
Roswell, GA
08.2016 - 10.2018
- Reviewed patient charts writing admission and concurrent reviews and submitting to various payor sources
- Assessed patients' discharge needs and barriers to provide a timely, safe and appropriate discharge
- Collaborated with different disciplines to ensure patients receive highly-quality, appropriate care in a timely manner
- Contacted insurance carriers to obtain authorizations for services delivered to patients
- Referred cases to secondary review when they did not meet inpatient or admission criteria
- Participated in complex case meetings to identify barriers to discharge and identify cost-effective solutions
- Formed effective collaborative relationships with interdisciplinary team, payor sources, patients and their support systems
Post Anesthesia Care Unit Registered Nurse
University of Virginia Health System
Charlottesville, VA
03.2000 - 09.2001
- Assessed, monitored and administered medications for one to two post-operative patients
- Educated patients and their families regarding surgical procedures, medications and disease process
- Provided emotional support for critically ill patients' families
- Skilled in extubation, titrating drugs,pain control and monitoring experience
- Designated preceptor and on-boarder for new nurses
- Achieved department goals and objectives by instituting new process and standards for in-patient care for a Magnet Status hospital
- Actively participated in unit-based Quality Assurance Program
- Positively interacted with numerous and various departments within the hospital
Medical Intensive Care Registered Nurse
University of Virginia
Charlottesville, VA
01.1998 - 03.2000
- Delivered high quality intensive care nursing to one to two critically ill patients
- Managed care through extensive use of various monitoring including swan-ganz catheters, chest tubes, endotrachael tubes, arterial and central lines
- Titrated various intravenous medications to maintain hemodynamic stability and ventilation
- Provided extensive teaching to family members regarding disease process, medications and medical/nursing interventions
- Coordinated with numerous other disciplines (physicians, pharmacists, physical therapist, nutritionists) to develop care plans for patients
- Acted as a patient advocate in family meetings when reviewing and determining plan of care
- Established open, positive communication with families with loved ones in the intensive care; fostering relationships allowing teaching and emotional support
- Volunteered RN team participant in various unit research studies involving improving ventilation in ventilated septic patients
Cardiology Registered Nurse
Wake Medical Center
Raleigh, NC
04.1997 - 12.1998
- Assessed ,monitored and documented telemetry cardiac care for 5-6 patients pre and post cardiac catherizations, coronary bypasses,electrophysiology procedures and myocardial infarction.
- Educated patients and their families regarding cardiac disease process, medications, diet and post-procedural care and instructions
- Initiated and finalized discharge needs
- Organized and presented cardiac topics for "in-services' to fellow nurses
- Pulled sheaths post-cardiac caths and monitored/ maintained hemodynamic stability
Home Health Registered Nurse
Olsten Home Health Services
Raleigh, NC
04.1996 - 04.1997
- Provided nursing care and case management for case load of 20 post hospitalized patients with a range of medical surgical issues including acute and chronic conditions
- Instructed and trained family members and patients about chronic conditions(diabetes, CHF, COPD, HTN,etc.) medicine adherence and side effects, wound care and available community resources
- Supported patients with customized learning tools
- Supervised and evaluated group of certified nursing assistants
Medical/Surgical Registered Nurse
Wake Medical Center
Raleigh, NC
01.1995 - 04.1996
- Provided and coordinated the nursing care for 6-7 high acuity patients with various medical and or surgical issues including diabetes, COPD, CHF, pancreatitis and renal failure
- Taught patients and their families about medical conditions/issues including all medicine regimen adherence and side effects
- Initiated the discharge process for patient assignment along with consistent discharge phone call follow-up
- Coordinated with doctors and other disciplines to develop care plans
Education
Bachelor of Science - Nursing
University of North Carolina Wilmington
Wilmington, NC4 2016
Associate of Science - Registered Nursing
Wake Technical Community College
11.1994
Psychology Studies
North Carolina State University
Raleigh,NCSkills
- Strong results oriented focus on progressing files in a timely matter
- Appreciation of the importance of cultivating and maintaining productive relationships with all relevant parties including; adjusters, inured workers, attorneys and physicians
- Attention to detail, timely documentation/ reports and excellent organization skills
- Solid effective communication skills with injured workers , adjusters and physicians
- Diverse clinical experience provides a broad clinical and patient knowledge base, as well as critical thinking skills
- Understanding the importance of expediting updates and following through with carriers and employers
Certification
Certification Case Management/CCM - 4244628
George Registered Nurse License 196393
Timeline
Registered Nurse Field Case Manager
Apogee Solutions
06.2023 - Current
RN Workers Compensation Case Manager
WrightRehab
04.2021 - Current
RN Workers Compensation Case Manager
Genex Services LLC
12.2019 - 04.2021
RN Case Manager
Northside Hospital Cherokee
11.2018 - 12.2019
RN Case Manager /Utilization Review Nurse
WellStar North Fulton Hospital
08.2016 - 10.2018
Post Anesthesia Care Unit Registered Nurse
University of Virginia Health System
03.2000 - 09.2001
Medical Intensive Care Registered Nurse
University of Virginia
01.1998 - 03.2000
Cardiology Registered Nurse
Wake Medical Center
04.1997 - 12.1998
Home Health Registered Nurse
Olsten Home Health Services
04.1996 - 04.1997
Medical/Surgical Registered Nurse
Wake Medical Center
01.1995 - 04.1996
Bachelor of Science - Nursing
University of North Carolina Wilmington
Associate of Science - Registered Nursing
Wake Technical Community College
Psychology Studies
North Carolina State University
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