CLAIRE MARIANO SERGUS
Travelers Rest,SC
Summary
Dynamic and dedicated healthcare professional with extensive experience as a Registered Nurse, Clinical Social Worker, and Nationally Certified Medical Case Manager. Expertise in healthcare coordination, behavioral health counseling, utilization review, discharge planning, and chronic disease management has consistently improved patient outcomes. A strong advocate for patients, leveraging interdisciplinary collaboration and program development to deliver evidence-based care. Proficient in managing complex cases across diverse settings, including acute care, home health, behavioral health, and community environments.
Overview
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1
Certification
Work History
Certified Case Manager / Nurse Coordinator
MICHIGAN EDUCATION SPECIAL SERVICES ASSOCIATION (MESSA)
East Lansing, MI
- Developed and maintained NCQA-accredited Asthma and Certified Case Management programs.
- Reviewed disability charts, medical claims, appeals, and grievances for benefit determinations.
- Coordinated care across the healthcare continuum, including home, residential, and healthcare facility settings.
- Negotiated treatment, service, and medical equipment coverage with vendors and providers.
- Expanded healthcare access for underserved populations through community partnerships.
- Reduced emergency room visits and hospital readmissions through asthma education and disease management counseling.
Clinical Therapist / Behavioral Health Counselor
GROW THERAPY | SAGINAW PSYCHOLOGICAL COUNSELING | END VIOLENT ENCOUNTERS (EVE)
- Provided telehealth and in-person counseling for individuals experiencing homelessness, domestic violence, trauma, and crisis situations.
- Conducted individual and group therapy sessions, including weekly women’s support groups.
- Assisted clients with anxiety, depression, stress, chronic pain, adjustment disorders, and co-dependency.
- Completed comprehensive biopsychosocial and cultural assessments.
- Utilized CBT, DBT, and psychodynamic therapeutic interventions.
- Maintained HIPAA-compliant clinical documentation and treatment plans.
Discharge Planner / Medical Case Manager
VISITING NURSE SERVICES (VNS) OF LANSING
Lansing, MI
- Developed and expanded discharge planning services at McLaren Lansing Hospital.
- Coordinated post-discharge care with providers, agencies, rehabilitation facilities, and outpatient programs.
- Educated patients and families on disease management, wellness, and self-care practices.
- Promoted continuity of care and reduced readmissions.
Medical Case Manager
SPARROW HOME CARE AGENCY
Lansing, MI
- Coordinated patient care across rehabilitation facilities, nursing homes, residential settings, and temporary housing environments.
- Managed wound care, IV infusions, PICC line maintenance, tracheostomy care, and tube feeding services.
- Collaborated with Protective Services Agencies and the Tri-County Office on Aging to ensure comprehensive patient support.
Pre- and Post-Procedural Care Nurse
ST. MARY’S HOSPITAL
- Delivered nursing care in a fast-paced same-day procedure unit.
- Educated patients and families regarding procedural preparation and recovery.
- Administered medications and provided dressing and tube care.
- Collaborated with surgeons, anesthesiologists, and interdisciplinary healthcare teams.
Charge Nurse | Staff Nurse | Utilization Reviewer
ST. JOSEPH MERCY HOSPITAL
- Managed patient care priorities in high-acuity healthcare settings.
- Administered medications and treatments while ensuring regulatory compliance.
- Served as liaison between physicians, nursing staff, patients, and leadership.
- Coordinated staffing assignments and daily surgical unit operations.
- Performed utilization review to support quality outcomes and appropriate resource utilization.
Education
Master of Social Work - Clinical
Michigan State University
Bachelor of Science - Nursing
Oakland University
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Saginaw Valley State University
Secondary Education - Biology, General Science
Skills
- Medical Case Management
- Behavioral Health Counseling
- Program Development
- Discharge Planning
- Utilization Review
- Chronic Disease Management
- Clinical Assessment
- Leadership & Team Development
- Patient Advocacy
- Critical Thinking & Decision Making
- Effective Communication
- Interdisciplinary Collaboration
Affiliations
- Case Management Society of America
- Association of Asthma Educators
- Michigan Department of Health & Human Services Asthma Task Force
- American Lung Association
Certification
- Active South Carolina Registered Nurse License
- Active South Carolina Clinical Social Work License
- Active Michigan Registered Nurse License
- Active Michigan Clinical Social Work License
- National Certification in Medical Case Management
Timeline
Clinical Therapist / Behavioral Health Counselor
GROW THERAPY | SAGINAW PSYCHOLOGICAL COUNSELING | END VIOLENT ENCOUNTERS (EVE)
Discharge Planner / Medical Case Manager
VISITING NURSE SERVICES (VNS) OF LANSING
Medical Case Manager
SPARROW HOME CARE AGENCY
Pre- and Post-Procedural Care Nurse
ST. MARY’S HOSPITAL
Charge Nurse | Staff Nurse | Utilization Reviewer
ST. JOSEPH MERCY HOSPITAL
Bachelor of Science - Nursing
Oakland University
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Saginaw Valley State University
Secondary Education - Biology, General Science
Certified Case Manager / Nurse Coordinator
MICHIGAN EDUCATION SPECIAL SERVICES ASSOCIATION (MESSA)
Master of Social Work - Clinical
Michigan State University