Summary
Overview
Work History
Education
Skills
Accomplishments
Certification
Timeline
Generic

Brittany C. Cox

Katy

Summary

Board- certified Case Manager and Registered Nurse with 22 + years of diversified healthcare experience across utilization review, discharge planning, school and home health nursing, and home health marketing. Proven leader in interdisciplinary care coordination and patient advocacy with a strong track record of optimizing patient outcomes, exceeding performance benchmarks, and streamlining care transitions.

Overview

24
24
years of professional experience
1
1
Certification

Work History

Consultant

Paloma Trails, Equestrian facility
11.2018 - Current
  • Provided organizational revamping for feed storage room for 27 head of horses.
  • Organized, designed, printed rules of the barn for strategic employee engagement role out.
  • Helped develop curriculum for youth classes and camps.
  • Organized, designed, printed, and educated staff on appropriate equestrian stalling and turn out procedures.
  • Designed and marketed new logo campaign.
  • Media promotion - photoshoot, magazine article.
  • Organized horse show strategies- pre planning with students for weekly preparation schedules, payment scheduling, packing list of supplies, cleaning tack plans and packing plans, packing equipment, transportation, unpacking, show set up, tack room on site design and supplies needed, multiple horse stall designation, horse carriage set up for class and timeliness of preparation of class schedules for multiple students and show horses, preparation of show horses and preparation of students for show classes over 3 day show weekend, then breaking down all equipment, packing up and reloading to return to stable, unloading and assisting in storage of all equipment appropriately.
  • Provided on site maintenance of routine care of 27 head of horses for morning or evening feeding routine, turn out and stable cleaning.
  • Provided resources, ideas, strategies for birthday party expansion for increased revenue at the stable.
  • Provided feedback about community events and resources for marketing opportunities.
  • Assisted in staff member moral parties, involvement and implementation of strategies suggested by staff for process improvements.
  • Helped with inventory maintenance.
  • Liaised with customers, management, and sales team to better understand customer needs and recommend appropriate solutions.
  • Educated staff on organizational mission and goals to help employees achieve success.
  • Cultivated positive relationships with vendors to deliver timely and cost-effective supply of services and materials.
  • Developed effective improvement plans in alignment with goals and specifications.

Registered Nurse, Clinical Case Manager

Domestic Case Management
05.2015 - Current
  • After relocating to Texas from Birmingham, AL, due to my spouse's relocation, successfully managed the care of our daughter through stage 4 ovarian cancer. After an open left salpingo-oophorectomy and stage 4 immature teratoma debulking, four rounds of chemotherapy followed.
  • Throughout the treatment she was on homebound schooling through the school district.
  • Communication between medical providers, insurance companies, school personnel, and family and friends became paramount in aiding in progression of successful remission.
  • Skills gained include working under intense emotional pressure as well as superior efficiency of managing tasks within constantly changing and unforgiving timelines.
  • Also had the opportunity to assist remotely in case managing care for an elderly aunt through transition from home, to assisted living, to sub acute rehab, and then eventually to hospice services.
  • Case managed my father through an intensive ICU hospitalization due to bilateral pulmonary embolisms and the subsequent medication regimen to transition back home.
  • Invaluable opportunity to utilize my bachelors of science in nursing degree, to care for some of my most treasured patients, family.
  • Advocated for patients by communicating care preferences to practitioners, verifying interventions met treatment goals and identifying insurance coverage limitations.
  • Evaluated healthcare needs, goals for treatment, and available resources of each patient and connected to optimal providers and care.
  • Authored initial assessments of patients and family to develop plans for individual home care needs.
  • Responded promptly and professionally to patient questions and concerns.
  • Completed initial assessments of patients and family to determine and address individual home care needs. ·
  • Administered medications and treatments as prescribed by physicians.
  • Coordinated with interdisciplinary professionals to develop plans of care, administer tests and monitor patient status.
  • Effectively communicated with physicians regarding patient needs, performance, medications and changes.
  • Conducted regular re-evaluations to address changes in needs and conditions, introducing revisions to care plans.
  • Liaised with physicians regarding patient needs, performance and changes.
  • Examined patients and documented history of current and previous conditions, illnesses, injuries, and current medications.

Clinical Service Coordinator, Medically Dependent Children’s Program (MDCP)

United HealthCare
04.2022 - 03.2023
  • Maximized member’s health, well-being, and independence, addressing the Member’s situation as a whole. including his/her medical, behavioral, social, and educational needs utilizing electronic medical records, telehealth platform interview with member and Legal authorized representative (LAR).
  • Focused on evidence-based practices in case management for children and young adults with disabilities, including Person-Centered Planning.
  • Provided support services in the community to prevent unnecessary placement of an individual in a long-term care facility and to support deinstitutionalization of individuals who may have resided in a nursing facility.
  • Enabled children and young adults (under the age of 21) through the goals of medically dependent children’s program by offering cost effective alternatives to placement in nursing facilities and hospitals by effective case management.
  • Supported families in their role as the primary caregiver for their children and young adults who are medically dependent.
  • Full working knowledge of STAR Kids and MDCP service array, provider requirements for each service, the Consumer Directed Services (CDS) option, eligibility and assessment requirements and monitoring and reporting requirements.
  • Obtained a 2 year RUG certification for this role.
  • Trained and proficient in SK- SAI and ISP.
  • Participated in patient education to reduce hospital readmissions and interdisciplinary team conferences for identified members.
  • Case managed a caseload of about 35-40 member.
  • Provided notice of non covered services and review appeal process with members/Legal authorized representative (LAR)
  • Coordinated, monitored, assigned, and documented patient and clinical care activities.
  • Implemented new policies and educated staff on changes.
  • Supervised and managed daily activities of clinical team consisting of a diverse group of physicians, nurses, and support staff.
  • Supervised and managed daily activities of clinical team consisting of physicians, nurses, and support staff.
  • Supervised and managed daily activities of clinical team consisting of [Number] physicians, nurses, and support staff.
  • Assessed clinical policies and procedures for compliance with changing regulations.
  • Built strong relationships with patients and families for optimized care satisfaction.
  • Established and maintained effective communication with staff, physicians and community organizations to promote high quality patient care.
  • Ordered all pharmacy supplies and kept check on inventory levels.
  • Liaised with other healthcare professionals to develop comprehensive patient care plans and provide highest quality of care.
  • Created customized care plans, working with hospital staff and families to assess and meet individual needs.

Elementary level school nurse

Alachua County School Board
11.2021 - 04.2022
  • Coordinate, perform, document and report results of required student health screenings.
  • Provide to parents a list of possible community and state agencies available to assist in healthcare needs. Assist and educate parents on how to acquire health insurance, free or low cost healthcare as needed.
  • Document health interventions and medications provided to students in appropriate district-provided format using acceptable nursing terminology. Skyward software.
  • Coordinate with local agencies and district personnel to assure a smooth and disruption-free scheduled school health clinic.
  • Contact parent/guardian as needed.
  • Provide routine first aid and health procedures, including proper referral of serious illnesses or injury.
  • Administer medications following school and county policies, provide medication teaching to students.
  • Review health records and immunization for compliance, increased compliance rate by 20% in 3 months.
  • Counsel students and parents concerning health conditions.
  • Establish safe-clinic procedures, maintaining a sanitary clinic between student visits.
  • Maintain a current list of students with acute and/or chronic conditions, food allergies, routine medications.
  • Identify and report any communicable disease or other conditions affecting school population to supervisor and appropriate agencies.
  • Provide nursing assessment and health appraisals of students to identify existing or potential health problems, high risk behavior, communicable disease or other conditions affecting school performance.
  • Completed nursing care plans for appropriate health conditions, per policy.
  • Serve as a health liaison between home and school.
  • Maintain confidentiality regarding school/workplace matters.
  • Participated in development of school safety plans to address areas of concern.
  • Worked with multidisciplinary team to carry out successful treatment plans for diverse acute and chronic conditions.
  • Oversaw health services for school of approximently 500 students and faculty.
  • Developed care plans and made referrals as necessary for students with health concerns or injuries.
  • Served as liaison between families, school personnel, and other healthcare providers on behalf of students.
  • Educated students on various health topics to promote overall health and wellbeing.
  • Administered medication to students as prescribed by physicians to provide necessary treatment and manage health conditions.
  • Documented patient vitals, behaviors, and conditions to communicate concerns to supervising nurse.
  • Screened for infectious diseases to help prevent spreading within school community.
  • Implemented emergency protocols in medical emergencies to promote safety for students and staff.

Case Management / Discharge planning

University of Florida, Shands Hospital
09.2021 - 11.2021
  • PRN role.
  • Was working with a caseload of about 15-20 patients on the oncology unit and the trauma ICU for discharge planning needs.
  • Performed initial discharge assessment to determine discharge needs.
  • Coordinated with the medical team for discharge orders to facilitate discharge appropriate needs, DME, home health care, hospice, oxygen, acute rehabilitation facility, sub acute rehabilitation facility, transportation needs, infusion therapy, assisted living facility.
  • Communication with patients and families about transitions of care from acute setting to post acute care.
  • Documentation of needs within EPIC software system, able to utilize EPIC software system to review medical history and compile initial need assessment before physical interview of patient and family.
  • Utilized KEPRO software system for discharge planning needs.
  • Attended weekly LOS (Length of Stay) meetings and able to articulate barriers to discharge planning for assigned patient load.
  • Responsible for coordination, development, execution, monitoring care coordination and transition/discharge planning. Knowledgeable in acute and sub-acute levels of care.
  • Completed initial assessments in the initial case management treatment plan within the scope of the company’s policy.
  • Provided patient choice for discharge needs, as per company policy, while utilizing the discharge software implemented by the company.
  • Promoted interdepartmental communication and collaborative problem solving about discharge planning needs and discharge planning.
  • Actively coordinated and finalized discharge plans to ensure smooth and timely discharge of patients with all appropriate services and equipment in a safe environment appropriate for patient and family needs.

Utilization Review/Case Management

Viva Health, a member of UAB health systems
08.2013 - 04.2015
  • Recruited by an employee of the company that worked on site at the hospital I was providing PRN coverage for in Utilization Review/Case Management department.
  • Provided all admission reviews to assigned facilities utilizing InterQual criteria to assess the appropriateness of inpatient vs observation status. Reviewed on average about 30-50 admissions daily, and assisted in concurrent reviews of members.
  • Discussed appropriate cases with the medical director, per company policy or per member’s plan policy.
  • Provided reviews for Managed Medicare plan members as well as about 23 private plan policy members.
  • Actively and effectively communicating with the facilities case management department about members status and authorization numbers.
  • Provided onsite visits to dual enrolled members (Medicare and Medicaid) who were hospitalized to perform a case management assessment for appropriate discharge planning, per company policy.
  • Attended in services per requested by the company.
  • Participated in initial multidisciplinary team conferences and ongoing team conferences on members identified by company policy as high risk members.
  • Identified barriers and obtained appropriate medical director guidance/approval when necessary.
  • Worked well in a team setting, providing support and guidance.
  • Completed paperwork, recognizing discrepancies and promptly addressing for resolution.

Case Management/Utilization Review

MEDICAL WEST, an affiliate of UAB
03.2012 - 08.2013
  • Provided utilization management activities that involved preauthorization of inpatient and outpatient medical services. Including but not limited to surgical case reviews.
  • Performed concurrent review and monitored patients’ progress in hospital to assure appropriateness of admission, continued stay, and discharge using InterQual criteria, CMS guidelines and administrative guidelines and policies.
  • Performed appeals concurrently and retrospectively.
  • Identified, collected, reported and assisted in analyzing utilization and quality performance data, such as delays in service, avoidable days, re-admissions, and LOS.
  • Worked with all members of the health care team, including physicians, patient, patient’s family, and internal and external customers to achieve optimal patient outcomes.
  • Responsible for coordination, development, execution, monitoring care coordination and transition/discharge planning. Knowledgeable in acute and sub-acute levels of care.

Home Care Consultant

COMFORT CARE HOME HEALTH AND HOSPICE
05.2011 - 03.2012
  • Recruited by a former co worker to join the sales and marketing team for home health and hospice.
  • Managed multi agency’s inquiry and admission process for home health and hospice services.
  • Assisted in providing continuity of medical care and organization of family resource.
  • Managed multiple accounts in assigned territory to establish new relationships in medical practices, case management departments, skilled nursing facilities, assisted living facilities, independent living facilities as well as community education.
  • Contributed to a 50% increase in a agency’s PPS census.
  • Facilitated multiple meetings with key decision makers in case management departments about preferred provider status and post-acute continuity of care.
  • Maintained knowledge of federal and state regulations and reimbursement for home health and hospice services.
  • Participated in team conferences to assure appropriate and efficient decisions were made about patient care. Offered community contacts to ensure that the most appropriate level of care was provided to patients.

Inpatient Rehab Liaison

MEDICAL WEST, an affiliate of UAB
09.2010 - 05.2011
  • Responsible for coordinating the admission of patients for the 18 bed Inpatient Rehabilitation Unit.
  • The Liaison receives referrals, performs detailed preadmission evaluations of patient's clinical and functional status and acts as a liaison between referring facilities, payers, Medical West, and the Director of Rehab Services.
  • Performed pre admission screen utilizing InterQual criteria, CMS guidelines and administrative guidelines and policies.
  • Developed and implemented a business plan for Inpatient Rehabilitation by utilizing market analysis data in the target territory. The completed plan identified new business and potential opportunities.
  • Recognizes barriers to admission, responds appropriately and follows up on admissions variables.
  • Able to effectively communicate these barriers to the Director of Rehab Services and Medical Director, and explore opportunities to overcome these barriers.
  • Extensive experience in healthcare operations, legal guidelines, competitive analysis, marketplace dynamics, and being able to implement the knowledge to acquire referrals and maintain relationships.
  • Developed a guide for Rehabilitation services and incorporated Medicare coverage and benefits for each level. Presented to the case management department of the hospital.

Manager of Clinical Practice

MIDSOUTH HOME HEALTH (A Gentiva Company)
05.2008 - 07.2010
  • Manage a team of multi licensed personnel in assessments and reassessments of patients, including updating plan of care and interpreting patient’s needs, while upholding company policies and physician orders.
  • Interpret standards, company policies and procedures to ensure compliance with external regulatory authorities.
  • Audit records to ensure that caregiver clinical documentation meets internal standards and compliance with completeness of Medicare guidelines.
  • Participates in the interviewing and orientation of team members, evaluates their performance relative to job goals and requirements.
  • Participates in the orientation of staff regarding Medicare requirements for care and documentation.
  • Coaches staff and facilitates in-service education programs.
  • Assigned to the Performance Improvement Committee overseeing plans to enhance efficiency of patient care.
  • Maintain ongoing clinical knowledge through internal and external training programs; provide interpretation of knowledge and direction to staff.
  • Identify clinical problem areas and help inform staff and train in the correction of the deficiencies.
  • Function in a supervisory nurse capacity to assure quality of care is maintained.

Home Care Specialist

CAROLINA HOME HEALTH (A Gentiva Company)
01.2006 - 02.2008
  • Manage 20 key facility and physician accounts including home health agencies and hospitals/clinics by overseeing delivery of discharge planning and case management services.
  • Responsible for full cycle delivery of care, including determination of eligibility, care plan development and clinical coordination/communication to ensure quality care and regulatory compliance.
  • Assigned to Performance Improvement Committee overseeing plans to enhance efficiency of patient care.
  • Proactively address clinical issues in patient care conferences and provide input to senior management on operational issues.
  • Conduct inservice training for health care providers and participate in various health-related community education events.
  • Contributed to 10% growth in profitable Medicare admissions and a 64% increase in EBITDA in 2007.

Patient Care Coordinator

HOME HEALTH INC.
01.2005 - 01.2006
  • Promoted home health agency services and coordinated home care planning with physicians, hospital discharge planners, patients and families upon discharge from referring facility.
  • Conducted needs assessments and participated in multi-disciplinarian conferences to enhance quality of care.
  • Increased referrals by 111% in the target market.
  • Established and maintained referral relationships through regularly scheduled visits and diligent follow up.

Registered Nurse – 7th Floor Medical Staff

LEXINGTON MEDICAL CENTER
01.2002 - 01.2004
  • Company Overview: 292-bed multi-service medical center with skilled nursing facility and urgent care outpatient center offering some of the most advanced technology in South Carolina
  • Executed Charge Nurse responsibilities in addition to routing and acute clinical patient care.
  • Multifaceted responsibilities included conducting patient examinations, administration of medications, interpretation of laboratory tests values for each assigned patient.
  • Collaborated with physicians and hospital personnel to establish a strong professional working relationship.
  • 292-bed multi-service medical center with skilled nursing facility and urgent care outpatient center offering some of the most advanced technology in South Carolina

Education

Bachelor of Science - Nursing

University of South Carolina
Columbia, SC
05.2002

Skills

  • Health plan evaluation
  • Comprehensive case coordination
  • Comprehensive discharge process management
  • Community health nursing
  • Home health service coordination
  • Strategic account oversight
  • Strategic marketing planning
  • Clinical information systems expertise
  • EMR / EHR -EPIC, ECIN, KEPRO, Skyward

Accomplishments

  • Quality Assurance - Ensured and enforced medical office compliance with HIPAA, OSHA and CLIA regulations for maximum quality and control.
  • Training - Trained team of staff nurses in medical office procedures to ensure consistent quality of care.
  • Human Resources - Assisted in new hire process by calling and scheduling appointments with candidates, filling out required paperwork and preparing new hire manuals.
  • Supervision - Headed onboarding process for new nursing staff.
  • Documentation - Ensured charting accuracy through precise documentation.

Certification

  • CCM - Certified Case Manager, The Commission for Case Manager Certification, 05/31/30
  • Registered Nurse, State of Texas, 1026487, 11/30/26

Timeline

Clinical Service Coordinator, Medically Dependent Children’s Program (MDCP)

United HealthCare
04.2022 - 03.2023

Elementary level school nurse

Alachua County School Board
11.2021 - 04.2022

Case Management / Discharge planning

University of Florida, Shands Hospital
09.2021 - 11.2021

Consultant

Paloma Trails, Equestrian facility
11.2018 - Current

Registered Nurse, Clinical Case Manager

Domestic Case Management
05.2015 - Current

Utilization Review/Case Management

Viva Health, a member of UAB health systems
08.2013 - 04.2015

Case Management/Utilization Review

MEDICAL WEST, an affiliate of UAB
03.2012 - 08.2013

Home Care Consultant

COMFORT CARE HOME HEALTH AND HOSPICE
05.2011 - 03.2012

Inpatient Rehab Liaison

MEDICAL WEST, an affiliate of UAB
09.2010 - 05.2011

Manager of Clinical Practice

MIDSOUTH HOME HEALTH (A Gentiva Company)
05.2008 - 07.2010

Home Care Specialist

CAROLINA HOME HEALTH (A Gentiva Company)
01.2006 - 02.2008

Patient Care Coordinator

HOME HEALTH INC.
01.2005 - 01.2006

Registered Nurse – 7th Floor Medical Staff

LEXINGTON MEDICAL CENTER
01.2002 - 01.2004

Bachelor of Science - Nursing

University of South Carolina

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