Dawn Barnes
Niceville
Summary
Compassionate Telephonic Registered Nurse known for high productivity and efficient task completion. Skilled in patient assessment, telehealth technology, and case management, ensuring optimal patient care and support. Excel in communication, empathy, and problem-solving, critical for managing diverse patient needs remotely.
Overview
31
31
years of professional experience
Work History
Case Management
WellMed
Irving
05.2022 - Current
- I currently manage a caseload between 50-80 patients. Following up after hospitalizations, High risk chronic condition cases. Provide education, support to ensure understanding on diagnosis, treatment plan to prevent readmissions and to try and help patients have better quality of life. Help with scheduling follow up PCP, specialist visits. Ensure patients have access to community resources as needed. Provide referrals to team SW to work collaboratively when needed. Advocate for appropriate medical equipment, assistance with obtaining authorization, assistance with contacting Medicare or Medicaid authorization departments for guidelines, advising PCP of required documentation need. Following up with DME, pharmacy etc to ensure the receive required information to fill scripts, referrals etc.
- Monitored and evaluated performance metrics to identify areas for improvement in case management services.
- Provided case management services by linking clients with appropriate community resources.
- Provided case management services to individuals with intellectual and developmental disabilities and their families.
- Facilitated case management services, including referrals to community resources.
- Entered data into computerized case management system to maintain accurate records.
- Maintained up-to-date knowledge on current trends in healthcare industry related to case management practices.
- Collaborated with other clinicians in team meetings to discuss case management strategies.
- Provided ongoing case management services to ensure client progress.
- Provided case management services to ensure continuity of care across multiple settings.
- Trained new employees on policies and procedures relevant to their roles within the Case Management Department.
- Provided case management services including crisis intervention counseling when appropriate.
- Ensured compliance with regulations related to Long-Term Care Case Management.
- Developed and implemented case management plans tailored to the unique needs of each client.
- Provided case management services, including referrals to other community resources as needed.
- Assessed patient and delivered comprehensive case management services.
- Actively engaged in case management activities including referral tracking, follow-up calls.
- Provided case management services to ensure that all needed services are provided effectively and efficiently.
- Ensured compliance with all applicable laws, regulations and ethical standards governing the practice of case management.
- Provided individual and group psychotherapy, crisis intervention, and case management services to clients.
- Provided ongoing case management support to ensure access to appropriate services and resources.
- Developed systems for tracking performance metrics related to case management services.
- Maintained accurate records according to state and federal requirements pertaining to case management activities.
- Developed and maintained relationships with external stakeholders to ensure successful case management outcomes.
- Designed and implemented effective case management strategies for challenging cases.
- Attended professional trainings related to best practices in case management techniques.
- Provided direct case management services to individuals and families in need of support.
- Provided case management services including referrals to community resources and follow up contact with clients.
- Provided case management services including referrals to outside agencies, follow up appointments, and monitoring of medication compliance.
- Maintained accurate records of student progress using a case management system.
- Attended meetings with other healthcare providers to discuss case management issues.
- Provided case management services to individuals, families and groups within a community setting.
- Participated in team meetings and provided input regarding case management strategies or interventions.
Case Management Specialist RN, CCM
Sedgwick
Tallahassee
06.2019 - 05.2022
- I carried a caseload of 60-75 injured workers; help with coordinating RTW LD, FD and MMI through organization of Primary Treating Providers office visits, diagnostics, therapy visits, etc. Communicate with IW, Providers, Therapist, Vendors, Claims Adjusters, and Employers throughout the injured workers recovery period. I complete utilization review process to determine authorization for recommendations per providers. Approved surgeries, therapy, SNF, DME etc. Submit peer reviews when outside of guidelines. Assisted with appeals process. I carry licenses in compact state and at the time multiple non -compact states.
- Coordinated client intake and assessment processes for case management services.
- Developed personalized care plans in collaboration with clients and healthcare providers.
- Monitored client progress and adjusted plans based on evolving needs.
- Provided resources and referrals to support clients' health and wellness goals.
- Collaborated with multidisciplinary teams to ensure comprehensive care delivery.
- Facilitated communication between clients, families, and service providers for effective case management.
- Documented case notes and maintained accurate records in compliance with company policies.
- Conducted follow-up assessments to evaluate client satisfaction and service effectiveness.
- Coordinated referrals between outside agencies when needed.
- Assessed risk factors associated with each case in order to create an effective safety plan.
- Educated clients on how they can best manage their own care plan.
- Facilitated group meetings and workshops on topics related to mental health issues, substance abuse prevention and treatment, parenting skills.
- Maintained case notes, records, and documentation according to agency policies and procedures.
- Collaborated with community partners such as hospitals, schools, social service agencies, and probation departments to coordinate appropriate services for clients.
- Ensured that all required paperwork is completed accurately and submitted timely.
- Protected patient data in alignment with HIPAA privacy protocols.
- Provided education about available resources within the community for clients who are transitioning from institutional care back into the community setting.
- Developed comprehensive client-driven case plan with short and long-term goals.
- Advocated for members and families to coordinate care and navigate resources within system.
- Facilitated ongoing case management services to support successful outcomes and meet stabilization goals.
- Advocates for client rights while providing support to ensure access to needed services.
- Provided counseling and advocacy for clients in order to assist them in meeting their goals.
- Monitored client progress through regular contact with family members or other significant persons in the client's life.
- Evaluated effectiveness of interventions by tracking outcomes of cases managed.
- Developed benchmarks for measuring and monitoring strategic changes and organizational goals.
- Educated patients and families on health management and post-discharge care instructions.
- Maintained accurate patient records using electronic health record systems efficiently.
- Responded promptly to medical emergencies, utilizing critical thinking skills in urgent situations.
- Assisted in training new nursing staff on best practices and organizational policies.
- Participated in quality improvement initiatives to enhance patient care standards consistently.
- Utilized critical thinking skills to assess clinical situations quickly and accurately.
- Collaborated with physicians, nurses, therapists, social workers and other healthcare professionals to develop individualized treatment plans for each patient.
- Provided emotional support and comfort to families during difficult times.
- Monitored patients after surgery, answered questions, and provided home care strategies.
HCMRN
Humana
Saint Petersburg
08.2014 - 05.2019
- I currently carry a caseload of 585 SNP members. I communicate telephonically with members who have chronic conditions and or duel eligible. Complete assessment, complete care plans and ICT per CMS requirements. We educate members and connect them with resources to help them manage chronic conditions. I review medications and make referrals. Follow up with member's pre-post discharge from inpatient acute care, SNF, behavioral health. Communication with PCP, specialist, DME, pharmacy etc. I am point person when coach away, mentor new associates and take part in special pilot programs.
Case Manager
Hospice of The Bluegrass
Cynthiana
11.2008 - 08.2014
- Case manage terminally ill patients. Work collaboratively with interdisciplinary team to ensure quality of life. Oversee meds, complete comprehensive assessments. Complete computerized charting to follow Medicare requirements.
- CHPN certification.
- CPR instructor.
Owner/Operator
A Step Ahead
Cynthiana
02.2004 - 11.2008
- Case manage a group of 40 children and 10 employees. Followed state regulations to run daycare center. Participated in the national food program. Completed all required paperwork and computer charting needed.
- Organizational skills, managerial skills.
Staff Nurse
Harrison Memorial Hospital
Cynthiana
05.2001 - 05.2002
- Staff nurse med surg and of. Assessment of patient, medication administration. Attended c-sections, newborn care. Float nurse. Completed computer charting.
- Basic nursing skills.
Case Manager
Wedco Home Health
Cynthiana
03.1997 - 05.2001
- Case manage about 30 patients. Worked collaboratively with physicians and community resources to help patients back to a healthy lifestyle. Provided education on disease specific.
- Assessment, communication, v/s, IVs lab work etc.
Staff Nurse
Dover Manor
Georgetown
05.1995 - 03.1997
- Manage geriatric patients daily needs. Administered meds, completed assessments, communicated with physician's families. Completed MDS paperwork, conducted family meetings, completed care plans.
- Basic nursing skills.
Education
Associates in early childhood ed - Early childhood
Ashworth College
Norcross, GAAssociates in applied Science - Nursing
Maysville Community College
Maysville, KYSkills
- Experience in Interqual and Milliman
- CCM
Personal Information
Work Permit: Authorized to work in the US for any employer
Timeline
Case Management
WellMed
05.2022 - Current
Case Management Specialist RN, CCM
Sedgwick
06.2019 - 05.2022
HCMRN
Humana
08.2014 - 05.2019
Case Manager
Hospice of The Bluegrass
11.2008 - 08.2014
Owner/Operator
A Step Ahead
02.2004 - 11.2008
Staff Nurse
Harrison Memorial Hospital
05.2001 - 05.2002
Case Manager
Wedco Home Health
03.1997 - 05.2001
Staff Nurse
Dover Manor
05.1995 - 03.1997
Associates in early childhood ed - Early childhood
Ashworth College
Associates in applied Science - Nursing
Maysville Community College