Courtney Kohler
Fair Oaks,CA
Summary
Driven and self-motivated Care Coordinator with extensive expertise in contract negotiation and benefits management. Proven track record in implementing strategic solutions to overcome barriers in the healthcare continuum. Strong communicator and innovative problem-solver seeking a new challenge within a collaborative, forward-thinking team to exceed industry standards.
Overview
17
17
years of professional experience
1
1
Certification
Work History
Nurse Manager
Kaiser Permanente
Walnut Creek, CA
02.2024 - Current
- Strategic Planning: Develop and implement departmental strategies to optimize patient flow and increase in-network utilization, aligning with organizational goals.
- Program Development: Design and oversee initiatives aimed at improving patient repatriation processes, enhancing collaboration with in-network providers and community resources.
- Data Analysis and Reporting: Analyze utilization trends, patient outcomes, and referral patterns to inform decision-making and drive quality improvement initiatives.
- Stakeholder Engagement: Build and maintain relationships with key stakeholders, including physicians, administrators, and external partners, to facilitate seamless patient transitions back to in-network services.
- Regulatory Compliance: Ensure that departmental practices align with regulatory standards and organizational policies, maintaining compliance across all activities.
- Training and Mentorship: Provide ongoing education and mentorship to nursing staff on utilization management best practices and effective strategies for patient repatriation.
- Budget Management: Participate in budget planning and management, ensuring that departmental resources are allocated efficiently to meet patient needs and operational goals.
Assistant Nurse Manager
Kaiser Permanente
Walnut Creek, CA
06.2023 - 02.2024
- Patient Discharge Planning: Coordinate and oversee discharge processes, ensuring timely and safe transitions for patients back to their homes or other care facilities.
- Team Leadership: Supervise nursing staff, providing guidance and support to ensure high-quality patient care and adherence to departmental policies.
- Interdisciplinary Collaboration: Collaborate with healthcare teams, including physicians, social workers, and case managers, to develop comprehensive discharge plans tailored to individual patient needs.
- Quality Assurance: Monitor and evaluate discharge procedures and patient outcomes to identify areas for improvement and implement best practices.
- Crisis Management: Address and resolve any issues that arise during the discharge process, advocating for patients and facilitating communication among stakeholders.
- Data Management: Collect and analyze data related to discharge metrics and patient satisfaction, using findings to inform operational improvements.
- Training and Development: Facilitate training sessions for nursing staff on discharge protocols, patient safety, and effective communication strategies.
- Policy Implementation: Assist in the development and implementation of departmental policies and procedures related to patient discharge and repatriation.
- Compliance Oversight: Ensure adherence to regulatory standards and organizational policies regarding patient care and discharge processes.
- Resource Coordination: Collaborate with external agencies and community resources to facilitate patient repatriation and ensure continuity of care post-discharge.
Liaison
Kaiser Permanente
Sacramento, CA
02.2023 - 06.2023
- Conduct comprehensive reviews of patient cases to ensure appropriate utilization of services and compliance with clinical guidelines.
- Collaborate with healthcare teams, including physicians, nurses, and social workers, to coordinate care plans and ensure seamless transitions.
- Manage complex cases from admission to discharge, advocating for patients and facilitating access to necessary resources and services.
- Analyze utilization data to identify trends, assess performance metrics, and develop strategies for quality improvement.
- Ensure adherence to regulatory standards and organizational policies related to patient care, documentation, and billing practices.
- Monitor healthcare costs and resource utilization, implementing cost-effective strategies to optimize care delivery.
Patient Care Coordinator, Placement Specialist Lead
Eldercare Services, Kaiser Permanente
Sacramento, CA
08.2016 - 02.2023
- Expertise with every type of California insurance, all covered/non-covered benefits/criteria, contracting, negotiations; networking, interdisciplinary team leadership/training, and most healthcare technology applications
- Acted as a primary regional placement consultant that supported director level escalations for exceptionally complex cases
- Supported service area acute Continuity of Care teams (ROS, SAC, SSC COC) and Complex HUB as benefit/placement specialist
- Created service area protocols that overcame barriers by recognizing opportunities for improvement and finding solutions that has been shared and adopted in various departments/regions
- Assisted with Quality Review that investigated and resolved complaints
- Conducted cost/benefit analysis that assisted in measurable positive outcomes and supported direct and upper leadership
Inpatient Care Coordinator
Dignity Health, Mercy San Juan Hospital
Carmichael, CA
08.2015 - 09.2016
- Secured safe discharges as acute case manager in acute setting while maintaining appropriate length of stay and working with closely with interdisciplinary teams
Utilization Manager
Dignity Health
Rancho Cordova, CA
09.2013 - 08.2015
- Facilitated acute to acute repatriation returns to in-network providers by verifying stability and coordination across multiple healthcare systems
- Conducted highest level reviews for escalated claim requests for all levels of care and various services based on Milliman and InterQual Criteria
Case Manager
Health by Design
Sacramento, CA
10.2012 - 09.2013
- Conducted concurrent review for Medical Group patients in acute setting
- Directed discharge planning, provided authorizations, and lead acute interdisciplinary team
Nurse Clinical Liaison Lead
Kindred Hospital
Folsom, CA
03.2011 - 10.2012
- Excelled as marketer, educator/speaker, assessor, benefit specialist, and intake coordinator for Long Term Acute Care and Acute care coordination
- Acted as physician liaison, contract negotiator and staff trainer
Clinical Liaison Intake Coordinator
Atrium Medical Center
Corinth, TX
07.2010 - 03.2011
- Served as key corporate representative, liaising with various parties in support of operational excellence
Registered Nurse
Denton Regional Medical Center
Denton, TX
05.2008 - 01.2010
- Patient Assessment: Conduct comprehensive assessments of critically ill cardiac patients, including monitoring vital signs, interpreting cardiac rhythms, and evaluating laboratory results.
- Critical Care Management: Administer medications, IV therapies, and treatments as prescribed, ensuring adherence to protocols for managing cardiac conditions.
- Monitoring: Utilize advanced monitoring equipment to track patient status and respond promptly to changes in condition, including arrhythmias and other cardiac complications.
Education
RN-MSN -
Western Governors University
01.2023
Associate Degree - Nursing (ADN)
North Central Texas College
01.2008
Certified Nursing Assistant -
Mesa Community College
01.2006
Skills
- Team Leadership and Development
- Complex Care Coordination
- Strategic Project Management
- Interdisciplinary Collaboration
- Contract Negotiation and Development
- Financial Operations Oversight
- Quality Assurance and Compliance
- Resource Allocation and Budget Management
- Staff Training and Mentorship
- Stakeholder Engagement
Certification
Case Management Certification - CCMC, 2021-Present
Thrive Super User - Kaiser, 2021-Present
Certified Life Care Planner – Kaiser, 2019-Present
Health Connect Epic Super User – Kaiser, 2017-Present Team
Technology Department Super User – Kaiser, 2017-Present
Awards
- Kaiser Thrive Top Performer 2021
- National Student Nurse Association- 2008
Timeline
Nurse Manager
Kaiser Permanente
02.2024 - Current
Assistant Nurse Manager
Kaiser Permanente
06.2023 - 02.2024
Liaison
Kaiser Permanente
02.2023 - 06.2023
Patient Care Coordinator, Placement Specialist Lead
Eldercare Services, Kaiser Permanente
08.2016 - 02.2023
Inpatient Care Coordinator
Dignity Health, Mercy San Juan Hospital
08.2015 - 09.2016
Utilization Manager
Dignity Health
09.2013 - 08.2015
Case Manager
Health by Design
10.2012 - 09.2013
Nurse Clinical Liaison Lead
Kindred Hospital
03.2011 - 10.2012
Clinical Liaison Intake Coordinator
Atrium Medical Center
07.2010 - 03.2011
Registered Nurse
Denton Regional Medical Center
05.2008 - 01.2010
RN-MSN -
Western Governors University
Associate Degree - Nursing (ADN)
North Central Texas College
Certified Nursing Assistant -
Mesa Community College
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