Experienced Case Manager with a demonstrated history of working in the hospital & health care industry. Skilled in Disease Management, Nursing Education, Medical-Surgical, Case Management, and Utilization Management. Strong community and social services professional.
Conduct Initial Assessment of patients with Complex Care or Disease management needs
Direct patient care in a Home care setting
· Discharge planning for patients in a rehabilitation setting
· Utilization review and authorization for inpatient and outpatient services
· Discharge planning for patients in a rehabilitation setting
· Utilization review and authorization for inpatient and outpatient services
· Utilization review for managed care organization
· Direct patient care in a Home care setting
Clinical care: Initial patient assessments, Complex care and disease management, Direct patient care in a home care setting, Discharge planning (rehabilitation) Indentification of care gaps and barriers
Care Coordination: Service coordination(therapy, DME, social services), Referrals to internal/external services, Collaboration with interdisciplinary teams, Coordination with primary care providers, Participation in Team conferences
Patient Education and Engagement: Motivational interviewing, Health Education, Benefit education,Support for lifestyle and Behavior changes
Utilization Management: Utilization Review (inpatient and outpatient) Authorization of Services, Managed Care collaboration
Leadership and Training: Mentoring and precepting staff, Orientation and training of paraprofessionals, Development of training guides, Clinical Nurse II (Clinical Ladder)
Technical Skills: Microsoft Outlook, Word, Basic Excell