Connie Burton, RN CCM
Maryville,TN
Summary
Detail-oriented Registered Nurse with strong organizational skills. Ability to handle multiple projects simultaneously with a high degree of accuracy.
Overview
27
27
years of professional experience
1
1
Certification
Work History
RN Case Manager
Commonwealth Care Alliance
04.2022 - 12.2022
- Managed patients with complex chronic conditions.
- Completed medication reconciliations and provided education on medication.
- Educated to prevent unnecessary Emergency Department visits and hospitalizations.
- Completed post discharge hospital and Emergency Department assessments, PHQ9 and Social Determinants of Health assessments.
- Performed evaluations on consistent basis to address changes in patient needs, conditions and medications, altering care plans when required.
- Developed and modified patient care plans and assisted interdisciplinary team in identifying client needs and goals to determine priorities of care
RN Case Manager
Monogram Health, Inc
12.2021 - 03.2022
- Managed members with chronic kidney disease and multiple co-morbidities.
- Performed telephonic and in home visits.
- Completed assessments, medication reviews and care plans.
- Provided education on kidney disease.
- Completed hospital discharge visits.
- Effectively communicated with physicians regarding patient needs, performance, medications and changes.
Nurse Case Manager
Landmark Healthcare
02.2020 - 09.2020
- Managed patients with complex chronic conditions.
- Screened medical records and information for necessity and appropriateness and referred for physician review cases not meeting medical criteria.
- Followed up on Emergency department visits and hospitalizations.
- Completed post discharge calls and completed medication reconciliations.
- Completed human factor assessments and care plans.
- Participated in weekly IDT meetings.
- Collaborated with healthcare leaders and physicians to support and offer resources in performance of duties to maintain high-quality and efficient patient care.
RN Case Manager
Buckeye HealthPlan
11.2016 - 11.2019
- Managed Medicaid waiver members with chronic disease.
- Completed disease and post hospital assessments.
- Coordinated care to prevent unnecessary hospital re- admissions.
- Developed care plans.
- Education on disease management and medications.
- Advocated for patients by communicating care preferences to practitioners, verifying interventions met treatment goals and identifying insurance coverage limitations.
RN Case Manager
Molina Healthcare
08.2015 - 11.2016
- Managed Medicaid waiver members with chronic disease in Long Term Care facilities.
- Completed disease assessments, care plans, and medication reconciliations
- Member assessed for appropriate level of care.
- Responsible to complete post discharge assessment after hospitalization.
- Follow up on frequent infections, falls and any issues with members' care.
Telephonic Nurse Case Manager
Humana
01.2014 - 04.2015
- Contacted patients by telephone to provide education on chronic disease management.
- Completed health assessments, post discharge assessments, and care plans.
- Referred patients to appropriate resources such as Social Worker to assist with needs such as financial or medical supplies.
Telephonic Nurse Case Manager/Utilization
American Health Holding
07.2012 - 01.2014
- Patients contacted by telephone to provide support and education.
- Completed health assessments and care plans to meet patient needs
- Provided teaching on medications and completed medication reconciliations.
- Reviewed hospital documentation for medical necessity to support patient hospital stay by using Milliman Guidelines.
- Completed concurrent review by using Milliman guidelines.
- Assisted with hospital discharge of patient.
- Verified in network providers, assisted patient with finding in network provider.
- Completed monthly reports and notified claims payor of patient progress.
Registered Nurse Case Manager
Vitas Innovative Hospice
04.2005 - 04.2012
- Responsible for terminally ill patients.
- Provided care for symptom management.
- Managed medications.
- Coordinated care of patient.
- Provided education, support and compassion to patient and family throughout the disease process.
- Updated physician of changes in patient condition.
Registered Nurse Case Manager
Lifesphere Home Health
04.2004 - 04.2005
- Responsible for medication management and primary care of home patients.
- Assessed patients and documented medical history.
- Experience with various chronic medical conditions.
Registered Nurse Manager
Twin Towers Nursing Home
04.2003 - 04.2004
- Managed clinical oversight for assisted living unit
- Delegated staff nurse duties
- Evaluated patient careneeds, prioritized treatment, and provided support and education to patients, families and staff.
Registered Nurse/Staff Nurse
American Nursing Care Agency
04.2000 - 04.2003
- Worked as RN in various facilities, hospitals, and inpatient hospice units due to staffing shortages.
- Utilized strong assessment skills to determine necessary patient care.
- Reviewed patient chart and followed all orders as directed by physician.
Registered Nurse
Mercy Hospital
05.1996 - 04.2000
- RN staff nurse on a medical/oncology floor.
- Administered medications via oral, IV, and intramuscular injections and monitored responses.
- Collaborated with physicians to quickly assess patients and deliver appropriate treatment while managing rapidly changing conditions.
Education
Associate Degree - Nursing
Miami University
05.1994
Skills
- Hospice and Palliative Care
- Strong Clinical Judgment
- EMR Systems
- Determine Medical Necessity
- Patient Assessments
- Chronic Disease Management
- Patient Education
- Care Plan Development
- Case Conferences
- Patient and Family Advocacy
Certification
- Certified Case Manager
Additional Information
- Active RN compact license
Work Availability
monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
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Quote
I dwell in possibility.
Emily Dickinson
Timeline
RN Case Manager
Commonwealth Care Alliance
04.2022 - 12.2022
RN Case Manager
Monogram Health, Inc
12.2021 - 03.2022
Nurse Case Manager
Landmark Healthcare
02.2020 - 09.2020
RN Case Manager
Buckeye HealthPlan
11.2016 - 11.2019
RN Case Manager
Molina Healthcare
08.2015 - 11.2016
Telephonic Nurse Case Manager
Humana
01.2014 - 04.2015
Telephonic Nurse Case Manager/Utilization
American Health Holding
07.2012 - 01.2014
Registered Nurse Case Manager
Vitas Innovative Hospice
04.2005 - 04.2012
Registered Nurse Case Manager
Lifesphere Home Health
04.2004 - 04.2005
Registered Nurse Manager
Twin Towers Nursing Home
04.2003 - 04.2004
Registered Nurse/Staff Nurse
American Nursing Care Agency
04.2000 - 04.2003
Registered Nurse
Mercy Hospital
05.1996 - 04.2000
Associate Degree - Nursing
Miami University
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