Experienced healthcare professional with a strong background in clinical leadership, quality improvement, and staff development, bringing over two decades of expertise in patient care and healthcare administration. Proven ability to manage interdisciplinary teams, optimize operational efficiency, and ensure compliance with healthcare standards. Seeking to leverage skills and experience to drive success as an Medical Professional.
Overview
36
36
years of professional experience
1
1
Certification
Work History
Medical Manager of Clinical Operations
Optum Home and Community Care Transitions
04.2020 - 01.2025
Performed quality assurance reviews of patient charts on a regular basis in order to ensure accuracy and completeness of documentation
Demonstrated excellent organizational, communication and interpersonal skills while managing a team of medical personnel
Facilitated communication between physicians, nurses, technicians, and other health professionals involved in providing care for patients
Reviewed insurance coverage requirements prior to authorizing certain treatments or procedures for patients
Ensured that all policies and procedures were followed according to established standards of practice within the facility or organization
Conducted periodic meetings with staff members in order to discuss any changes in policy or procedure
Created reports detailing the performance of medical staff in order to identify areas needing improvement or additional training
Established positive rapport with clients and their families while maintaining professional boundaries at all times
Ensured the timely delivery of essential services to patients by maintaining efficient schedules for staff members, prioritizing workload based on urgency and resource availability.
Developed targeted intervention programs to address specific healthcare needs of at-risk patients and reduce overall costs.
Directed staff training sessions on relevant topics such as new treatment protocols or regulatory updates to ensure consistent application of best practices throughout the organization''s medical management efforts.
Improved employee retention rates by cultivating a positive work environment through open communication channels, recognition of achievements, and opportunities for professional growth.
Conducted regular performance evaluations for team members, identifying strengths, areas for improvement, and creating tailored development plans.
Care Coordinator, RN
Optum Home and Community Care/Unitedhealthcare
07.2018 - 01.2020
Used company software and databases to maintain records of services performed and patient conditions.
Managed patient caseloads effectively, ensuring timely follow-up and appropriate interventions.
Developed strong relationships with community partners, facilitating referrals and collaboration on behalf of patients.
Conducted regular evaluations of care plan effectiveness, making necessary adjustments based on feedback from patients and providers.
Assessed patient needs and connected them with appropriate resources to ensure optimal health outcomes.
Monitored progress towards patient goals, adjusting care plans as needed to achieve desired results.
Advocated for patients'' rights within the healthcare system, working diligently to address concerns or barriers to care.
Improved communication among healthcare providers, streamlining the coordination of services for patients.
Coordinated discharge planning efforts with social workers, case managers, and other multidisciplinary team members for smooth transitions posthospitalization.
RN, Case Manager
Carolina Case Management
01.2006 - 01.2018
Conducted comprehensive assessments of patient's current health status to determine eligibility for case management services
Collaborated with physicians, nurses, and other healthcare professionals to ensure the best outcomes for patients
Reviewed medical records regularly in order assess appropriateness of care rendered by providers
Utilized critical thinking skills when making decisions concerning patient care needs while adhering to established standards of practice
Maintained accurate documentation of patient progress notes according to departmental policies and procedures
Delegated tasks appropriately according to staff competencies while ensuring safe delivery of care
Developed strong relationships with patients and their families to provide emotional support throughout treatment process
Managed multiple tasks simultaneously while remaining organized and prioritizing duties efficiently
Proficient in utilizing electronic medical records systems for documentation of patient care
Educated patients regarding disease processes, treatments options and follow up instructions
RN Floor Nurse
Catawba Women's Center
01.2001 - 01.2006
Reported symptoms, condition changes and vital signs to primary care doctors, patients, and families
Kept accurate records and charts related to medications and treatments according to policies, procedures, and physician orders
Performed ongoing patient assessments, notifying supervising clinician of abnormal findings
Liaised with multidisciplinary teams to organize and coordinate health and care services to meet patients' complex care needs
Built strong relationships with internal teams by providing clear direction and support when needed
RN Health Occupations Teacher
Lincoln County Schools
08.2000 - 05.2001
Organized and facilitated interactive, engaging lessons on nutrition, hygiene, physical activity, mental health, and other topics related to health education
Maintained records for each student according to district policies and procedures for tracking student performance data
Adapted lesson plans based on the needs of different age groups within a single classroom setting
Attended professional development workshops related to new developments in the field of Health Education
Utilized technology such as PowerPoint presentations to enhance classroom instruction
RN Assistant Director of Nursing
Belaire Healthcare
01.1999 - 05.2000
RN Floor Nurse
Edwards Clinic, PA
01.1989 - 05.1999
Established work procedures and schedules to organize daily work of administrative staff
Participated in continuing education programs to stay abreast of latest advances in nursing practice
Utilized critical thinking skills to assess and develop individualized plans of care for a wide variety of patient populations
Demonstrated skill in providing quality patient care, including assessing and monitoring vital signs, administering medications, and performing treatments
Proficient in utilizing electronic medical records systems for documentation of patient care
Managed multiple tasks simultaneously while remaining organized and prioritizing duties efficiently
Education
Bachelor of Science (B.S.) - Healthcare Management
Pfeiffer University
Charlotte, NC
06.2004
Associate in Arts (A.A.) - Nursing
Gardner Webb University
Boiling Springs, NC
06.1997
Skills
Clinical leadership
Quality improvement
Teamwork and collaboration
Problem-solving
Self motivation
Time management
Attention to detail
Multitasking Abilities
Excellent communication
Organizational skills
Adaptability and flexibility
Certification
RN
CCM
Timeline
Medical Manager of Clinical Operations
Optum Home and Community Care Transitions
04.2020 - 01.2025
Care Coordinator, RN
Optum Home and Community Care/Unitedhealthcare
07.2018 - 01.2020
RN, Case Manager
Carolina Case Management
01.2006 - 01.2018
RN Floor Nurse
Catawba Women's Center
01.2001 - 01.2006
RN Health Occupations Teacher
Lincoln County Schools
08.2000 - 05.2001
RN Assistant Director of Nursing
Belaire Healthcare
01.1999 - 05.2000
RN Floor Nurse
Edwards Clinic, PA
01.1989 - 05.1999
Associate in Arts (A.A.) - Nursing
Gardner Webb University
RN
CCM
Bachelor of Science (B.S.) - Healthcare Management
Pfeiffer University
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