
Dynamic Nurse Case Manager Lead Analyst at Cigna Healthcare with expertise in clinical assessment and care coordination. Proven track record in managing complex cases and enhancing patient outcomes through effective provider negotiations and utilization management. Adept at educating patients and families, ensuring adherence to accreditation standards while delivering compassionate care.
Case Management Referral Screening and Assessment
Management of Customers with Acute, Chronic, and Catastrophic Conditions
Care Coordination
Collaborated with Physicians, Medical Directors, and Multidisciplinary teams on Plan of Care
Medical Case Management
Customer and Family referrals as appropriate
Adhered to Accrediation standards and best practices
Utilization Management
Provider Negotiations
Claims Assistance
Nurse visits in the home for Customers with Acute, Chronic,Catastrophic, and Terminal Dx
Documentation and Certification Of Plan of Care and Referrals as appropriate for customer and families
Coordinated care with Physicians,Providers, Infusion Companies, DME companies
Administration of medications and infusions
Supervisory visits for LPNs and CNAs
Provided care to patients on a medical floor with acute deviations in their healthcare
Patient assessments
Administration of medications and blood products
Wound care
Neurological
Cardiac
Endocrine
Respiratory
Gastrointestinal
Urinary
Medical-Surgical
Receives Cigna Champion Awards Annually