Work Preference
Summary
Overview
Work History
Education
Skills
Affiliations
Certifications And Licensure
Timeline
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BETHANY ELLIS RN
Open To Work

BETHANY ELLIS RN

Cumberland,RI

Work Preference

Job Search Status

Open to work
Desired start date: Flexible

Desired Job Title

Registered Nurse Case Manager / Unit SupervisorUtilization Review NurseClinical Nurse ReviewerClinical Nurse Liaison

Work Type

Full TimePart TimeContract WorkGig WorkConsulting

Location Preference

RemoteHybridOn-Site
Location: Cumberland, RI, US
Open to relocation: No

Important To Me

Work-life balance

Summary

Compassionate Registered Nurse Case Manager with extensive experience in coordinating complex patient care, implementing treatment plans, and leading healthcare teams. Proven expertise in managing high-risk populations, conducting comprehensive assessments, and ensuring CMS, NCQA, and HIPAA compliance. Skilled in improving patient satisfaction and streamlining case management processes in high-stress environments.

Overview

17
17
years of professional experience

Work History

Registered Nurse Case Manager / Unit Supervisor

Saint Antoine Residence
North Smithfield, RI
11.2024 - Current
  • Lead comprehensive care management for skilled nursing and transitional care residents, conducting 24-hour assessments.
  • Facilitate weekly utilization review and interdisciplinary team (IDT) meetings to ensure compliance and plan for discharge.
  • Collaborate with insurance providers and hospital case managers to support authorization requests, appeals, and peer reviews.
  • Perform admission chart audits within 24 hours to ensure regulatory compliance and documentation accuracy.
  • Advocated for medically appropriate lengths of stay, successfully obtaining multiple authorization extensions through clinical review.
  • Provide clinical representation and nursing input in third-level managed care appeals and hearings.
  • Transitional Care Unit – North Smithfield, RI

RN Integrated Case Manager (High Risk)

Neighborhood Health Plan of Rhode Island
Smithfield, RI
01.2020 - 11.2024
  • Managed high-risk members through risk stratification, comprehensive assessments, and ongoing monitoring.
  • Evaluated eligibility for transition programs including Money Follows the Person and Nursing Home Transition Program.
  • Coordinated utilization management, including prior authorizations, appeals, and grievance support.
  • Applied case management principles to reduce hospital readmissions and coordinated care with interdisciplinary teams.
  • Assisted on special projects, including a pilot program for unreachable high-risk members.
  • Smithfield, RI

RN Case Manager

VNA of Northern Rhode Island
Lincoln, RI
03.2018 - 01.2020
  • Developed individualized care plans for high-risk patients with multiple comorbidities.
  • Coordinated transitions of care from inpatient to home and community-based settings.
  • Conducted OASIS assessments ensuring compliance with Medicare and Medicaid guidelines.
  • Provided IV therapy management, PICC care, and wound care.
  • Hope Health – Lincoln, RI

RN Case Manager / Hospice & Home Health RN

Community VNA
05.2012 - 06.2018
  • Managed home health, palliative, and hospice patients through discharge or end-of-life care.
  • Delivered skilled services including IV therapy, phlebotomy, and wound-vac care.
  • Supervised LPNs and CNAs and served as a preceptor for new hires.
  • Amedisys – RI & MA

RN Case Manager

Concord Home Health
07.2009 - 06.2015
  • Delivered home health and acute care services including TPN administration and assessments.
  • Served as Charge Nurse in a 50-bed acute care facility, overseeing nursing staff and assignments.
  • Ensured compliance with CMS guidelines and documentation standards.

Charge Nurse

Trinity Health
RI
06.2009 - 01.2011
  • Oversaw nursing staff and patient assignments in a 50-bed acute care facility while ensuring documentation standards.
  • RI

Education

Associate Degree - Nursing

Community College of Rhode Island
RI, USA
01-2009

Skills

Case Management

Care Coordination

Utilization Review

Medical Necessity

Transitions of Care

Discharge Planning

High-Risk Populations

Complex Populations

Prior Authorizations

Appeals

Grievances

Medicare

Medicaid

Managed Care

CMS Compliance

NCQA Compliance

HIPAA Compliance

MDS 30 Assessments

OASIS Assessments

EMR Documentation

EHR Documentation

Interdisciplinary Team Leadership

Affiliations

  • ANA
  • OWCN
  • Alzheimer’s Association
  • ADCES

Certifications And Licensure

  • Registered Nurse (RN), Rhode Island, RN-47609, Yes
  • BLS/CPR, American Heart Association, 2026

Timeline

Registered Nurse Case Manager / Unit Supervisor

Saint Antoine Residence
11.2024 - Current

RN Integrated Case Manager (High Risk)

Neighborhood Health Plan of Rhode Island
01.2020 - 11.2024

RN Case Manager

VNA of Northern Rhode Island
03.2018 - 01.2020

RN Case Manager / Hospice & Home Health RN

Community VNA
05.2012 - 06.2018

RN Case Manager

Concord Home Health
07.2009 - 06.2015

Charge Nurse

Trinity Health
06.2009 - 01.2011

Associate Degree - Nursing

Community College of Rhode Island