Organized and dependable candidate successful at managing multiple priorities with a positive attitude.
15 years of Case Management and Utilization Management experience.
Overview
30
30
years of professional experience
Work History
Case Manager Supervisor
Christian Hospital Northeast
St. Louis, MO
01.2007 - Current
Initial role as a Case Manager, then added Utilization management duties.
Lead CM/UM - 4/2013
Supervisor CM/UM - 4/2017
Provides ongoing support to the care coordination program and CM/UM staff by providing mentoring, oversight, training, and ongoing staff development. Works with departmental management to ensure designated aspects of the program are functioning in highest quality.
Streamlined, standardized and implemented case management processes and techniques to maximize revenue cycle.
Structured standardized case management processes to comply with regulatory agency statutes and standards.
Provide annual Interqual training.
Work the one day stay Medicare cases.
Manages the CM/UM schedules.
Completes the daily assignments.
Covers UM/CM/Certification Coordinator when needed.
Dialysis Registered Nurse
DaVita
Alton, IL
06.2001 - 01.2007
Oversaw administration of hemodialysis treatments, including monitoring patients, administering medication and educating patients and their families in an outpatient dialysis clinic.
Staff Nurse
Christian Hospital Northeast
St. Louis, Missouri
11.1993 - 06.2001
Directed patient care by initiating and following through with plan of care, continuing care and discharge instructions on a medical unit.
Preceptor for newly hired registered nurses.
Relief Charge Nurse
Home Health Nurse
Great Rivers Home Health
Alton, IL
10.1996 - 03.1998
Provided physical assessments, medication and chronic disease management to home health patients.
Determined and addressed individual home care needs by completing detailed assessments and reviewing documentation.
Education
Bachelor of Science - Nursing
Southern Illinois University Edwardsville
Edwardsville, IL
08.1993
Associate of Science -
Lewis And Clark Community College
Godfrey, IL
12.1990
Skills
Utilization Management
Case Management
Certified Interqual Instructor
Knowledgeable in completing admission and continued stay reviews that determine medical necessity
Obtaining insurance authorizations for hospital admissions