CAREY DUCOMMUN
Summary
Experienced healthcare professional with strong background in utilization review, care coordination and working closely with physicians. Proven ability to assess medical necessity, optimize resource use, and ensure compliance with healthcare regulations. Focused on team collaboration and achieving results, adapting to changing needs efficiently. Highly skilled in clinical guideline adherence, patient advocacy, and effective communication.
Overview
31
31
years of professional experience
Work History
Case Management/Utilization Review Coordinator
Cherokee Regional Medical Center
04.2023 - Current
- Conduct comprehensive reviews of patient care plans to ensure compliance with regulatory guidelines.
- Collaborate with healthcare teams to optimize resource utilization and enhance patient outcomes.
- Analyze medical records and documentation for accuracy, ensuring alignment with established criteria.
- Lead training sessions for staff on utilization review processes and best practices.
- Develop and implement strategies to improve workflow efficiency within the review department.
- Monitor trends in care patterns, providing insights for quality improvement initiatives.
- Facilitate communication between clinical staff and payers to resolve authorization issues promptly.
- Evaluate new clinical protocols and their impact on utilization management practices across the organization.
- Collaborate with care team on patient assessments, identifying opportunities for improvement in care transitions and reducing avoidable delays.
- Optimize resource allocation by analyzing data trends in service utilization and recommending necessary adjustments to improve overall performance.
Adjunct Nursing Instructor
Western Iowa Technical Community College
01.2022 - Current
- Currently teaches Advanced Nurse Aide theory and Med-Surg Clinicals in the College Now program
- Teach Medication Administration Aide as needed
- Cherokee Campus-PRN
RN BSN Specialty Clinic Staff Nurse
Cherokee Regional Medical Center
05.2011 - Current
- Current certifications, ACLS, BLS. Cardiac Rehab, Employee and Occupational Nursing, Chemotherapy, and Infusion nurse.
- Satellite clinic nursing services provided for OB/GYN, Pulmonology, Cardiology, ENT, Hematology/Oncology, and other various clinics as needed.
- Administered patient care, ensuring adherence to established protocols and safety standards.
- Collaborated with interdisciplinary teams to develop comprehensive care plans tailored to individual patient needs.
- Mentored junior nursing staff on best practices, enhancing team performance and patient outcomes.
- Conducted thorough assessments, identifying critical health issues and implementing timely interventions.
- Streamlined medication administration processes, improving efficiency and reducing errors in patient treatment plans.
- Implemented quality improvement initiatives that enhanced service delivery and patient satisfaction ratings.
- Trained new nurses on hospital policies, promoting a culture of compliance and excellence in care delivery.
- Improved patient outcomes by providing high-quality nursing care and implementing evidence-based practices.
- Developed strong relationships with patients'' families, providing emotional support while addressing concerns or questions about care plans.
- Served as a liaison between physicians and patients'' families to facilitate clear communication regarding treatment options and progress updates.
- Managed patient caseloads effectively, ensuring timely interventions and thorough follow-ups to mitigate potential complications.
- Provided emotional support to patients during challenging times, fostering a sense of trust and rapport that contributed to better overall wellbeing.
- Part time-regular time until April 2023, I continue to work PRN in this department.
PRN RN/Call Nurse
The Gardens Assisted Living
01.2009 - 06.2017
RN, BSN Clinic Staff Nurse
PJ Harrison, MD, PC
01.2000 - 05.2011
- My responsibilities were to manage the lab daily, triage phone nurse, vaccine program, handling day in and day out duties.
- Also working closely with physicians and providers.
- Fulltime and part time
LPN, RN, BSN
Sioux Valley Memorial Hospital, now CRMC
07.1996 - 07.1997
- Medical-Surgical Nurse, LPN, July 1997-May 1999, RN, Graduated from University of Iowa BSN program on May 14th, 1999.
- SVMH July 1997-December 1999 Med Surg
- Cross trained into Obstetrics, Labor and Delivery, and Postpartum
Home Health/Hospice Aide
Sioux Valley Memorial Hospital, now CRMC
12.1994 - 07.1996
Education
Master of Science in Nursing - Clinical Nurse Leader Program
University of Iowa Graduate College
Iowa City, IA05.2022
Bachelor of Science - Nursing
University of Iowa-College of Nursing
Iowa City, IA05.1999
Associate Degree in Nursing - ADN
Western Iowa Technical Community College
Sioux City, Iowa05.1997
Licensed Practical Nurse - LPN
Western Iowa Technical Community College
05.1996
Skills
- Health information privacy
- Process enhancement
- Knowledge of healthcare regulations
- Interdepartmental cooperation
- Effective utilization management
- Clinical necessity assessment
- Case review expertise
- Discharge planning coordination
- Clinical assessment
- Insurance verification
- Records analysis
- Documentation and reporting
Timeline
Case Management/Utilization Review Coordinator
Cherokee Regional Medical Center
04.2023 - Current
Adjunct Nursing Instructor
Western Iowa Technical Community College
01.2022 - Current
RN BSN Specialty Clinic Staff Nurse
Cherokee Regional Medical Center
05.2011 - Current
PRN RN/Call Nurse
The Gardens Assisted Living
01.2009 - 06.2017
RN, BSN Clinic Staff Nurse
PJ Harrison, MD, PC
01.2000 - 05.2011
LPN, RN, BSN
Sioux Valley Memorial Hospital, now CRMC
07.1996 - 07.1997
Home Health/Hospice Aide
Sioux Valley Memorial Hospital, now CRMC
12.1994 - 07.1996
Master of Science in Nursing - Clinical Nurse Leader Program
University of Iowa Graduate College
Bachelor of Science - Nursing
University of Iowa-College of Nursing
Associate Degree in Nursing - ADN
Western Iowa Technical Community College
Licensed Practical Nurse - LPN
Western Iowa Technical Community College
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