Christina Brown
Roswell,NM
Summary
Registered Nurse with 27 years of experience in both clinical and non-clinical settings. Accomplished Senior Medical Management Specialist with a proven track record at Blue Cross and Blue Shield/HCSC, enhancing patient care coordination and healthcare management while also fostering improved health outcomes. Expertise in HIPAA compliance and interpersonal communication, coupled with a track record of developing strong healthcare provider relationships, enhances the ability to deliver high-quality member care. Professionally manage multiple tasks, am PC proficient to include Word, Excel, and PowerPoint, utilize electronic medical record systems, effectively troubleshoot issues, and provide excellent customer service to members. Demonstrate exceptional attention to detail and a commitment to high-quality member care. Foster significant improvements in patient health outcomes and advocate effectively for member rights and enhance care delivery.
Overview
27
27
years of professional experience
1
1
Certification
Work History
Senior Medical Management Specialist-PH
Blue Cross And Blue Shield/HCSC
2014.08 - Current
- Collaborate with healthcare providers for better coordination of comprehensive care plans, resulting in improved overall health.
- Manage patient caseloads effectively, ensuring timely follow-up and appropriate interventions.
- Develop strong relationships with community partners, facilitating referrals and collaboration on behalf of members.
- Conduct regular evaluations of care plan effectiveness, making necessary adjustments based on feedback from members and providers.
- Build strong relationships with members to deliver emotional support.
- Educate members on self-care strategies, promoting independence and empowering them to manage their health conditions.
- Assess member's needs and connect them with appropriate resources to ensure optimal health outcomes.
- Advocate for member's rights within the healthcare system, working diligently to address concerns or barriers to care.
- Coordinate discharge planning, ensuring a smooth transition from hospital to home or other facilities.
- Complete assessments in accordance with current regulations and guidelines.
- Facilitate appointments and transportation for members, streamlining access to essential medical services.
- Establish and maintain effective communication with staff, physicians and community organizations to promote high quality member care.
- Contact identified members to inform and educate them on health care programs to address their personal health plan needs.
- Perform assessments, care planning, and care coordination in the member/family home and telephonically.
Nurse Case Manager
Eastern New Mexico Medical Center
2007.02 - 2013.06
- Coordinated care with staff nurses, physicians, physical therapy, occupational therapy, patients, and their families to create the best and safest hospital experience and discharge plan for each individual patient.
- Educated patients and caregivers on healthcare protocols and processes.
- Served as a liaison between patients and various support services such as financial assistance programs, community resources, and mental health counseling to ensure holistic care was provided.
- Collaborated with healthcare leaders and physicians to support and offer resources in performance of duties to maintain high-quality and efficient patient care.
- Applied critical thinking skills during case reviews to identify potential risks or challenges before they escalated into larger issues.
- Promoted continuity of care by coordinating with healthcare providers, social workers, and family members in the development of discharge plans.
- Optimized resource utilization by identifying opportunities for cost containment without compromising care quality.
- Facilitated smooth transitions between healthcare settings by effectively communicating pertinent information to receiving facilities or home health agencies.
- Enhanced interdisciplinary team communication, ensuring timely and accurate updates on patient progress.
- Collaborated with multidisciplinary teams to devise evidence-based treatment plans that improved patient satisfaction scores.
- Managed caseloads efficiently, prioritizing high-risk cases while ensuring all patients received appropriate attention and support.
- Advocated for patient needs, addressing concerns with healthcare providers and insurance companies to ensure optimal care was received.
- Followed all personal and health data procedures to effectively comply with HIPAA laws and prevent information breaches.
- Managed support services and fostered communication among social workers, therapists, hospital staff, and patients.
- Set up Home Health Care Services, filed CYFD and APS referrals, and obtained PA for specialized medications and services.
- Obtained continued-stay authorization for hospital admissions as a Utilization Review Nurse.
Registered Charge Nurse, Emergency Department
Eastern New Mexico Medical Center
1997.06 - 2007.02
- Oversaw daily shift operations including managing staff schedules, coordinating patient assignments, and monitoring equipment maintenance needs.
- Managed emergency department operations, ensuring adequate staffing levels and appropriate allocation of resources.
- Promoted patient safety with strict adherence to infection control measures and protocols.
- Collaborated with hospital leadership to develop strategies for addressing challenges specific to the emergency department setting.
- Contributed to positive workplace culture by fostering an environment that encouraged open communication, collaboration, and mutual respect among team members.
- Provided thorough documentation of patient encounters, ensuring accurate record-keeping for billing purposes.
- Mentored new nurses, providing guidance on best practices and clinical decision-making skills.
- Served as a clinical resource for staff members, answering questions related to policy, procedure, or practice.
- Answered codes quickly and orchestrated efficient, skilled medical care.
- Administered medications via oral, IV, and intramuscular injections and monitored responses.
- Teamed on trauma and emergency interventions involving serious head injuries, gunshot wounds, and thoracic trauma.
- Educated family members and caregivers on patient care instructions.
- Delivered important IV and venous medications to control symptoms and provide effective treatments.
- Collaborated with physicians to quickly assess patients and deliver appropriate treatment while managing rapidly changing conditions.
- Monitored medication dosages to prevent critical and potentially fatal patient incidents.
- Delivered high level of quality care to diverse populations while overseeing patient admission and triaging based on acuity and appropriate department admission.
- Documented treatments delivered, medications and IVs administered, discharge instructions, and follow-up care.
- Provided skilled, timely and level-headed emergency response to critically-ill patients.
- Followed all personal and health data procedures to effectively comply with HIPAA laws and prevent information breaches.
- Performed triage on incoming patients and determined severity of injuries and illnesses.
- Performed frequent checks on life support equipment and made necessary adjustments to preserve optimal patient conditions.
- Facilitated effective communication between physicians, patients, families, and other healthcare professionals to ensure optimal patient outcomes.
- Initiated IV's and Foley catheters, completed blood draws, assisted with conscious sedation, ortho splinting, wound care/dressings, and intubations, assisted with temporary pacemaker placement, administered thrombolitics, member of Code Blue Team, completed EKG's and Arterial Blood Gases and nebulizer treatments, assisted with pelvic exams, suturing, and central line placement, accessed central lines, assisted with chest tube placement, completed gastric lavage, placement of N-G tubes, care of critical and non-critical patients, and administration and calculation of a wide variety of medications.
Education
Associate of Science - Nursing
Eastern New Mexico University - Roswell
Roswell, NM05.1997
Skills
- Member Care Coordination
- HIPAA Compliance
- Microsoft Office
- Microsoft Excel
- PowerPoint
- Healthcare Management
- Attention to Detail
- Medical Terminology
- Medical Release of Information ROI processes
- Interpersonal Communication
- Records Accuracy
- Patient Information Verification
- Medical History Recording
Certification
RN - Licensed Registered Nurse - 1997 to Present
Timeline
Senior Medical Management Specialist-PH
Blue Cross And Blue Shield/HCSC
2014.08 - Current
Nurse Case Manager
Eastern New Mexico Medical Center
2007.02 - 2013.06
Registered Charge Nurse, Emergency Department
Eastern New Mexico Medical Center
1997.06 - 2007.02
Associate of Science - Nursing
Eastern New Mexico University - Roswell
RN - Licensed Registered Nurse - 1997 to Present
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