Doris Lohman
Westland,MI
Summary
Compassionate healthcare professional with 18 years of nursing experience and the proven ability to provide quality care within dynamic environments. Excellent and sound communication skills established with strong emphasis on being adaptable within complex and challenging situations. Excellent time management skills with a self-directed, reliable, and positive attitude expected. Proficient in medical record documentation to ensure accuracy and patient confidentiality, including experience in Kinnser software, Microsoft Office Suite, and OASIS documentation. Applied extensive knowledge of patient care, medical treatments, and hospital procedures for informed clinical review. Analyzed clinical data utilizing InterQual criteria in making clinically appropriate medical utilization decisions regarding approvals, denials, secondary review, and appeals for acute and post-acute admissions. Oriented to the role of Case Manager for the Medicare insured senior population for one of the largest health insurers in Michigan. Overall, a hardworking employee with customer service, multitasking and time management abilities.
Overview
18
18
years of professional experience
Work History
Nurse Care Manager
Blue Cross Blue Sheild of Michigan
03.2023 - 03.2024
- Tracked referrals from primary care providers to specialty services in order to ensure timely follow up appointments were scheduled.
- Participated in interdisciplinary meetings to discuss individual cases and devise appropriate interventions for complex patients.
- Provided education to patients on self-management of chronic conditions, as well as health promotion and disease prevention strategies.
- Actively participated in weekly team meetings by sharing ideas and offering solutions when needed.
- Conducted comprehensive patient assessments telephonically and identified health risks and potential barriers to treatment utilizing motivational interviewing strategies.
- Assisted with the coordination of post-discharge services such as home health care visits or community resources.
- Collaborated with case managers, social workers, pharmacists, registered dieticians and other team members to facilitate transitions between levels of care and optimize patient outcomes.
- Utilized electronic medical records and Microsoft Office for accurate charting and reporting.
- Developed strong rapport with patients and caregivers telephonically through active listening skills.
Home Health Care Nurse
The Medical Team
04.2019 - 03.2023
- Conducted educational sessions with patients and family members on topics such as chronic disease management, medications and self-care techniques.
- Provided wound care management including changing dressings, applying topical ointments, creams, gels., as prescribed by physicians.
- Coordinated with other healthcare providers involved in patient care to ensure continuity of service delivery.
- Completed initial assessments of patients and family to determine and address individual home care needs.
- Answered patient calls, identified issues and determined how best to provide assistance within agency parameters
- Participated in on-call rotations and delivered after-hours care.
Utilization Review Nurse
Blue Cross Blue Shield of Michigan
07.2017 - 06.2018
- Maintained up-to-date knowledge of Medicare health plan benefits, policies, procedures, and regulations.
- Reviewed patient admissions to determine medical necessity as directed by InterQual criteria and referred cases for secondary review when appropriate.
- Conducted reviews of inpatient utilization for compliance with admission criteria and concurrent review requirements.
- Monitored pre-authorization requests to ensure that all necessary information was received prior to approval or denial of services.
Staff Nurse
Beaumont Hospital-Farmington Hills
01.2006 - 01.2017
- Provided emotional support to family members during difficult times or end-of-life situations.
- Utilized EPIC electronic medical record system
- Implemented infection control measures to reduce the spread of contagious diseases.
- Provided direct patient care including wound dressing, administering medication and IV therapy.
- Facilitated transition to home care by providing patients with continued care information and discharge instructions.
- Addressed rapid response and code situations by strategically organizing and delegating tasks.
- Educated nursing students on proper care procedures and prioritization strategies.
Staff Nurse
Regency of Ann Arbor
01.2014 - 01.2015
- Provided direct patient care including wound dressing, blood draw, administering medication and IV therapy.
- Assessed patients to determine their physical condition, health status and rehabilitative needs.
- Helped patients and families feel comfortable during challenging and stressful situations, promoting recovery and reducing compliance issues.
Education
Some College (No Degree) - Bachelor of Science in Nursing
Chamberlin University
Associate of Applied Science - Nursing
Henry Ford College
05-2006
Associate of Arts - General Studies
Schoolcraft College
Livonia, MI06-2003
Skills
- Home Health Care
- Telephonic nursing
- Oasis Documentation
- Interpersonal skills
- Microsoft office
- Certified in CPR/AED
- Patient education
- Task Prioritization/Problem-Solving
- InterQual criteria
- Home safety evaluation
- Health promotion
- Utilization review
- Care coordination
- Care planning
Timeline
Nurse Care Manager
Blue Cross Blue Sheild of Michigan
03.2023 - 03.2024
Home Health Care Nurse
The Medical Team
04.2019 - 03.2023
Utilization Review Nurse
Blue Cross Blue Shield of Michigan
07.2017 - 06.2018
Staff Nurse
Regency of Ann Arbor
01.2014 - 01.2015
Staff Nurse
Beaumont Hospital-Farmington Hills
01.2006 - 01.2017
Associate of Applied Science - Nursing
Henry Ford College
Associate of Arts - General Studies
Schoolcraft College
Some College (No Degree) - Bachelor of Science in Nursing
Chamberlin University
Similar Profiles
Doris LohmanDoris Lohman
Nurse Care Manager at Blue Cross Blue Sheild of MichiganNurse Care Manager at Blue Cross Blue Sheild of Michigan
Samson OwingsSamson Owings
Associate System Engineer at Blue Cross BLue Sheild Of North DakotaAssociate System Engineer at Blue Cross BLue Sheild Of North Dakota
Vashty BrownVashty Brown
Customer Care Representative at Blue Cross And Blue Sheild Of North CarolinaCustomer Care Representative at Blue Cross And Blue Sheild Of North Carolina