
Dynamic RN Case Manager with extensive Case Management and Administrative experience in the Acute And Post-Acute Care, Home Health and Workers Compensation settings . Proven track record of reducing length of stay and hospital readmissions through effective discharge planning and patient education. Strong clinical judgment and critical thinking skills drive quality improvement and enhance patient outcomes in multidisciplinary settings.
Performed admission and continued stay reviews to determine appropriateness for Observation and Inpatient admissions and continued stay, utilizing Milliman criteria
Obtained precertification and continued stay authorizations from managed care entities on hospital and swing bed admissions
Conducted weekly interdisciplinary team meeting, reviewing swing bed patients progress to goals and readiness for discharge
Screened referrals to Swing Bed for appropriateness of admission and obtained pre certification from managed care when needed.
Arranged Home Health, DME, Hospice, medications and transportation for discharged patients. Arranged safe transfer of patients to Skilled Nursing Facilities.
Monitored length of stay and conferenced with physicians regarding transition and discharge plans on all patients
CCM Certification