Delia Larson, BSN, RNC-OB, CBC, CCM
Cherry Hill,NJ
Summary
Experienced and highly motivated nurse care manager with a proven track record of excelling in outcomes. Strong leadership skills and valuable resource in managing clinically complex patients. Effective collaboration with physicians, nurses, and other healthcare team members through excellent interpersonal and team-building abilities. Proficient in utilizing computer databases, electronic medical record systems, and information technology in various healthcare and insurance industry settings. Certified in inpatient obstetric care as RNC-OB, breastfeeding counseling as CBC, and case management as CCM. Compact state licensed as well as licensing in NY and MA.
Overview
24
24
years of professional experience
3
3
National Certifications, RNC-OB, CBC, CCM
Work History
Nurse Care Manager
Point C Health
08.2022 - 06.2024
- Consistently exceeded both utilization and quality metrics.
- Coordinated and analyzed sustainable person-centered care plans involving internal and external providers.
- Reduced hospital readmissions by closely monitoring patient progress and adjusting care plans as needed.
- Assisted in orientation of new staff.
- Coordinated referrals to specialists, hospitalizations, ER visits, ancillary testing, and other enabling services for patients.
- Health Claims Management was acquired by Point C Health in August 2022.
Nurse Case Manager & Supervisor
Health Claims Management
01.2018 - 08.2022
- Responsible for complex medical case management for a major insurance carrier, claim negotiations, reviews for medical necessity, reinsurance, insurance underwriting reports, utilization review, drug optimization and coordination of benefits
- Promoted to supervisor after 1-year to assist with training new case management nurses and processing reports.
- Educated patients and caregivers on healthcare protocols and processes.
- Served as a liaison between patients and various support services such as financial assistance programs, community resources, and mental health counseling to ensure holistic care was provided.
- Collaborated with healthcare leaders and physicians to support and offer resources in performance of duties to maintain high-quality and cost-efficient patient care.
- Educated patients on disease management techniques, empowering them to take control of their health and reduce complications.
- Applied critical thinking skills during case reviews to identify potential risks or challenges before they escalated into larger issues.
Peri-Operative Nurse
Virtua Hospital - Summit Surgical Center
01.2017 - 11.2021
- Virtua Hand Surgery & Rehabilitation Center was acquired in 2017 by Summit Surgical
- Provided Pre & Post-Operative Care to pediatric, adolescent, adult, and geriatric patients within the freestanding multi-specialty ambulatory surgical center
- I was recruited to train Summit staff regarding best practices in caring for Hand Surgery patients.
Perioperative Registered Nurse
Somnia Anesthesia
01.2015 - 12.2017
- Per diem RN responsible for educating and preparing patients for procedures utilizing conscious sedation; general / regional anesthesia within outpatient Specialty Surgery Centers/Offices
- Coordinated safe patient recovery and discharge.
- Provided compassionate, individualized care for each patient while in operating and recovery rooms.
- Maintained compliance with facility policies, state regulations, and national nursing standards through diligent adherence to established protocols.
- Supported surgical teams under high-pressure situations while maintaining composed demeanor, contributing to optimal patient outcomes.
Perioperative Registered Nurse
Virtua Hand Surgery & Rehabilitation
01.2016 - 01.2017
- Assessed, planned, implemented, evaluated, patient care
- Collaborated with physicians, medical professionals, and other staff utilizing surgical or nonsurgical methods to treat patients’ hands, wrists and forearms.
- Maintained compliance with facility policies, state regulations, and national nursing standards through diligent adherence to established protocols.
- Supported surgical teams under high-pressure situations while maintaining composed demeanor, contributing to optimal patient outcomes.
- Provided quality perioperative care by closely monitoring patients throughout their surgical experience.
High Risk OB; L&D
Cooper University Hospital
01.2000 - 01.2016
- Delivered comprehensive nursing care and ongoing patient education to women throughout various stages of pregnancy including: prenatal care, OB triage, labor & delivery, recovery, and operative procedures
- Highlights: Selected by ABC’s “The Revolution” to lead a hospital-wide “Revolution” toward healthier lifestyles & weight loss resulting in a hospital-wide weight loss of +3K lbs.
- Supported patients' mental health by identifying signs of postpartum depression and connecting them with appropriate resources for further evaluation and treatment.
- Maintained detailed documentation of patient progress throughout the course of their pregnancy, facilitating effective communication among healthcare providers involved in their care.
- Participated in ongoing professional development opportunities focused on caring for individuals experiencing a high-risk pregnancy, continuously enhancing knowledge and skills in this area.
- Improved patient outcomes through the development and implementation of individualized care plans for high-risk pregnancies.
- Obtained certification and acted as a Certified Breastfeeding Counselor to facilitate in successful Baby-Friendly initiatives and increased success with breastfeeding.
- Obtained and acted as RNC-OB, National Certified Inpatient Obstetrics Nurse for the unit to ensure increased compliance with standards and quality of care.
Registered Nurse Patient Care Coordinator
Cherry Hill Women’s Center
01.2007 - 12.2012
- Identified potential patient care issues; recommended possible options and courses of action as appropriate; implemented physician directives
- Established a compassionate environment by providing emotional and psychological support to patients; comforted patients by anticipating their anxieties and answering questions and concerns
- Assisted physician with in-office procedures
- Coordinated follow-up care.
- Managed sensitive patient information with strict adherence to HIPAA guidelines, maintaining confidentiality and privacy at all times.
- Provided exceptional customer service by addressing concerns, answering questions, and ensuring patient satisfaction with their care experience at the clinic.
- Enhanced patient satisfaction by efficiently scheduling appointments and managing patient flow.
Education
Bachelors of Science - Nursing
Thomas Jefferson University
Philadelphia, PA05.1999
Skills
- Chart Reviews
- Supervisory Duties
- Review for Medical Necessity
- Concurrent Reviews
- Appeals
- Medical Claim Negotiations
- Industry Standard Coverage Guidelines
- Coordination of Care
- EMR
- Fiscal Accountability
- Insurance Verification
- Multi-Disciplinary Collaboration
- Patient Education
- Performance Improvement
- Proficient in Microsoft Office
- Working knowledge of Insurance Processing & Claims
- Utilization Review/Management
- InterQual/MCG
- Excellent Customer Service, Communication & Interpersonal Skills
- Analytical
- Compassionate
- Team Player
- Active Listener
- Concise Written/Oral Communicator
- Self-Starter
- Adaptable
- Independent Worker
- Strong Problem Solver
- Health Promotion
- Quality Improvement
Certification
- NCC RNC-OB for Inpatient Obstetric Nursing
- Certified Breastfeeding Counselor
- Certified Case Manager
- NJ, 26NR09920400
- NY, 800071-01
- MA, 2338403
Timeline
Nurse Care Manager
Point C Health
08.2022 - 06.2024
Nurse Case Manager & Supervisor
Health Claims Management
01.2018 - 08.2022
Peri-Operative Nurse
Virtua Hospital - Summit Surgical Center
01.2017 - 11.2021
Perioperative Registered Nurse
Virtua Hand Surgery & Rehabilitation
01.2016 - 01.2017
Perioperative Registered Nurse
Somnia Anesthesia
01.2015 - 12.2017
Registered Nurse Patient Care Coordinator
Cherry Hill Women’s Center
01.2007 - 12.2012
High Risk OB; L&D
Cooper University Hospital
01.2000 - 01.2016
Bachelors of Science - Nursing
Thomas Jefferson University
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