Denise Jegede
Glen Burnie,MD
Summary
Diligent and responsible Registered Nurse Case Manager skilled in care coordination, patient care, and, delivering necessary nursing services and tracking outcomes. Looking to leverage diverse skills in challenging new position.
Overview
16
16
years of professional experience
1
1
Certification
Work History
Nurse Case Manager/Patient Care Coordinator
Kimbrough/Fort Meade-40 Hours Worked Per Week
Fort Meade , MD
05.2019 - Current
- Facilitates fulfillment of mission, vision, and values of VA Maryland Health Care System. Demonstrates proficiency in delivering and improving care through collaborative strategies with other members of healthcare team.
- Performs activities appropriate to grade as outlined in Nurse Qualification Standards. Responsible for consistent standards of nursing practice and of nursing care. Responsible for provision of high-quality, customer focused, cost effective patient care as it relates to his/her role within Ambulatory and Emergency Care Clinical Center.
- Possesses strong core knowledge base in nursing and has expanded clinic knowledge women's health and case management. Involved in indirect practice activities including staff and patient education, research and performance improvement activities.
- Consult with experts in delivery of nursing services and health care to obtain information or assistance related to issues of concern
- Ensures patient safety and timely follow-up through case management process. Collaborates with Women Veterans Program Manager, Health care providers throughout V AMHCS, Non-VA Care Office, Pharmacy, Social Work, Nursing service as well as community providers for care coordination purposes and exchange of clinical knowledge and expertise.
- Analyze and evaluate Army Medical Command and Behavioral Health Service Line policies and regulations that impact health care and provision of services
- Managed over 40 patients on high interest list' care per month which improved safety of patients.
- Ensures high quality care that is appropriate and within established timeframes.
- Assists in identifying strategies designed to improve patient access, improve adherence to population health metrics, and reduce administrative burdens for beneficiaries and imprcost effectiveness for civilian/military health care delivery system. Obtain feedback from Fiscal Intermediary, TRICARE and Health Care Finders to identify problem areas. Proposes regulatory and administrative changes to resolve identified problems
- Communicate with healthcare team members to plan, implement and enhance treatment strategies
- Followed all personal and health data procedures to effectively comply with HIPAA laws and prevent information breaches
- Participated in education activities, including evidence-based practice project implementation, nursing competency development and nursing simulation activities.
- Attends multidisciplinary meetings, identifies potential case management clients through health planning assessments, review of multiple databases and points of contacts available for specified population
- Engages in problem-solving, exploring options to care when available and alternative plans when necessary to achieve desired outcomes. Encourages appropriate use of healthcare services and strives to improve quality of care and maintain cost effectiveness. Empowers patients and serves as advocate for both patients and healthcare team to facilitate positive outcomes
- Acts as Nurse Consultant through holistic approach to address health care needs in collaboration with all health team members to include patient and patient's family as warranted. Provides education and clinical assistance through advanced nursing knowledge, skills and techniques to nursing personnel, medical students, interns/residents, staff physicians and administrators
Referral Management Nurse Reviewer
IRMAC/Walter Reed -40 Hours Worked Per Week
Bethesda, MD
02.2018 - 05.2019
- Lead Nurse Reviewer for Neurology and Behavioral Health Product Lines. Managed routing of referrals for Active Duty Service Members, Retirees and their dependents and families in National Capital Region
- Manage routing of referrals for Active Duty Service Members, Retirees and their dependents and families in National Capital Region
- Reviews referrals and ensures both routine and non-routine are processed appropriately and routed to appropriate clinics or network provider
- Works collaboratively with all members of clinical leadership team to ensure referrals are managed appropriately and patients get care needed.
- Provides guidance on establishing appointment protocols to match patients' needs with available resources in a timely manner
- Coordinates with medical staff to determine medical appropriateness of selected appointment alternatives in relation to timeliness of available care
- Provides education to ordering providers re appropriateness and medical necessity for consults commensurate with referral guidelines (SRGs) including required laboratory, radiology and previous care records for continuity of care rendered to patient as needed
- Provides advanced practice clinical nursing, administrative and organizational skills in managing continuity of care for beneficiary populations
- Plans with patient, Family, physician/provider, other healthcare providers, payer, and community, to maximize healthcare response and quality, cost effective outcomes. Facilitates communication and coordination between members of the healthcare team
- Educates both the patient and members of the healthcare delivery team about case management, healthcare and treatment options, community resources, insurance benefits, psychosocial concerns, etc., so that informed decisions can be made
Quality Improvement Specialist/Nurse Case Manager
Johns Hopkins Hospital-40 Hours Worked Per Week
Baltimore, MD
12.2012 - 02.2018
- Lead abstractor for Core measure abstractions, concurrently and retrospectively
- Maintained communication between governing boards, medical staff, and department heads
- Prepared activity reports to inform management of status and implementation plans of programs, services, and quality initiatives
- Developed risk mitigation strategy and abstraction plan for Perinatal Care PC-01 measure performance as it pertains to Quality Based Reporting program
- Reviewed measure performance, perceived risks and mitigation plans during quarterly meetings with manager and champions
- Provided oversight and input to nursing practice matters
- Participated in identification processes, systems, and practice metrics; and in determining measures of care outcomes for population served
- Attended multidisciplinary meetings, identified potential case management clients through health planning assessments, review multiple databases and points of contacts Position available for specified population
- Introduced innovative nursing techniques, practices, and approaches in collaboration with health care providers to identify, assess, educate, plan, and coordinate care through programs designed to provide efficient, comprehensive and cost effective service for case managed patients
- Assisted in identifying strategies designed to improve patient access, improve adherence to population health metrics, and reduce administrative burdens for beneficiaries and improve cost effectiveness for health care delivery system
- Acted as Nurse Consultant through holistic approach to address health care needs in collaboration with all health team members to include patient and patient's family as warranted
- Directed and managed case managed patient population
- Engaged in problem solving, exploring options to care when available and alternative plans when necessary to achieve desired outcomes
- Encouraged appropriate use of healthcare services and strived to improve quality of care and maintain cost effectiveness
- Empowered patients and served as advocate for both patients and healthcare team to facilitate positive outcomes
Registered Nurse/Nurse Case Manager
Johns Hopkins Bayview Hospital- 36 Hours Worked Per Week
Baltimore, MD
09.2010 - 12.2012
- Managed all aspects of patient care to surgical and medical patients to include, medicating, ADLs, education, assessment, trach care, nasal gastric tube care, tube feeding, equipment management and care coordination prior to discharge
- Liaised between patients and physicians to ensure comprehension of treatment plans
- Conducted a comprehensive assessment of beneficiary's health needs to develop a plan of care
- Plans with the patient, the Family, the physician/provider, other healthcare providers, the payer, and the community, to maximize healthcare response and quality, cost effective outcomes
- Coordinated with patient-focused multidisciplinary teams of clinicians to develop timeline protocols/clinical guidelines which delineate the expected process of care delivery for selected case managed patients and provide high quality affordable health care to its beneficiaries
- Conducted evaluation of case management patients to establish in detail and specificity the nature of their continuity of care needs as well as causal and contributing conditions and circumstances
Registered Nurse
Kent General Hospital-36 Hours Worked Per Week
Dover, DE
08.2008 - 09.2010
- Provided comprehensive care to medical surgical patients. Care provided consisted of, dressing changes, medicating, pain management, respiratory care, lab draws and assisting with physical therapy
- Coordinated with patient-focused multidisciplinary teams of clinicians to develop a plan of care for patients
- Contributed substantially to successful department The Joint Commission Accreditation
- Liaised between patients and physicians to ensure patient comprehension of treatment plans
- Educated and worked with patients to help them navigate the healthcare system and adhere to their care plan
- Effective counseling in health maintenance and disease management
Education
Master of Science - Health Informatics
Drexel University
2018
Bachelor of Science - Nursing
Delaware State University
2018
Associate of Arts - General Arts, pre
Columbus State Community College
2005
Skills
- Care coordination Expert
- Patient Care
- Performance Improvement
- Patient Safety
- Follow-Up
- Health Care System
- Women's Health
- Emergency Care
- Knowledge Base
- Case Management
- Social Work
Certification
Basic Life Support (BLS)
Advanced Cardiac Life Support (ACLS)
Timeline
Nurse Case Manager/Patient Care Coordinator
Kimbrough/Fort Meade-40 Hours Worked Per Week
05.2019 - Current
Referral Management Nurse Reviewer
IRMAC/Walter Reed -40 Hours Worked Per Week
02.2018 - 05.2019
Quality Improvement Specialist/Nurse Case Manager
Johns Hopkins Hospital-40 Hours Worked Per Week
12.2012 - 02.2018
Registered Nurse/Nurse Case Manager
Johns Hopkins Bayview Hospital- 36 Hours Worked Per Week
09.2010 - 12.2012
Registered Nurse
Kent General Hospital-36 Hours Worked Per Week
08.2008 - 09.2010
Master of Science - Health Informatics
Drexel University
Bachelor of Science - Nursing
Delaware State University
Associate of Arts - General Arts, pre
Columbus State Community College