FELICIA BROXEY RICHARDSON
Ft. Pierce
Summary
Experienced Registered Nurse and Certified Case Manager with over 27 years of progressive leadership in managed care, nursing education, and clinical practice. Demonstrated expertise in adult and geriatric (Medicare) care management and pediatric population health, managing high-risk patients with complex comorbidities and chronic conditions. Proven ability to manage high-volume caseloads, coordinate transitions of care, mentor interdisciplinary teams, and develop training programs that enhance clinical documentation, regulatory compliance, and patient outcomes. Doctor of Nursing Practice candidate in Educational Leadership with a strong focus on workforce development, quality improvement, and evidence-based practice.
Overview
9
9
years of professional experience
1
1
Certification
Work History
Medicaid Care Manager I – Pediatrics
Centene Corporation – Sunshine Health Plan
West Palm Beach
06.2025 - Current
- Managed caseload of 170–180 pediatric members with complex medical, behavioral, and social needs, ensuring comprehensive support
- Provided telephonic and face-to-face case management services, enhancing care for members with special healthcare needs and chronic conditions
- Develop and implement individualized, patient-centered care plans addressing clinical, psychosocial, and environmental factors
- Coordinated care among primary care providers, specialists, and community resources, ensuring continuity and quality of care
- Reinforce clinical documentation standards and ensure compliance with organizational and regulatory requirements
- Support families in improving health behaviors, care plan adherence, and long-term health outcomes
Faculty Lead Instructor (ASN Program) & BSN Instructor – Ethics in Healthcare & Nursing
Keiser University
Port St. Lucie
05.2024 - 06.2025
- Led ASN program as Faculty Lead Instructor, ensuring academic excellence and fostering a supportive learning environment.
- Instructed BSN students in Ethics in Healthcare and Nursing, cultivating ethical decision-making and professional accountability.
- Delivered clinical and classroom instruction for Fundamentals and Medical-Surgical Nursing, facilitating clinical skill development and preparing students for safe, competent entry into practice and NCLEX success
- Directed and managed clinical instructors across hospital clinical sites, ensuring consistency in instruction and adherence to academic and patient safety standards
- Provided direct supervision of clinical instruction in healthcare facility settings, ensuring safe and evidence-based patient care delivery
- Supervised, evaluated, and mentored students in clinical environments, enhancing critical thinking and clinical judgment
- Applied adult learning principles and active teaching strategies to improve student engagement and outcomes
Medicaid Care Manager II – Pediatrics
Centene Corporation – Sunshine Health Plan
West Palm Beach
03.2021 - 05.2024
- Managed a high-acuity caseload of 170+ pediatric members with complex and chronic conditions
- Coordinated and enhanced patient-centered care plans during interdisciplinary care rounds.
- Mentored and onboarded new care managers on workflows, documentation standards, and performance expectations.
- Coached staff to enhance competency, time management, and compliance with care management processes
- Assisted with auditing documentation and improving quality and regulatory compliance
- Contributed to workflow enhancements and initiated quality improvement initiatives
Medicaid Care Manager I – Pediatrics
Centene Corporation – Sunshine Health Plan
West Palm Beach
03.2019 - 03.2021
- Provided comprehensive care coordination for pediatric members with complex and chronic health needs
- Developed individualized, patient-centered care plans addressing medical, social, and environmental needs
- Facilitated access to healthcare providers, specialty services, and community resources to enhance care for pediatric members
- Educated families on disease management and care plan adherence to empower self-management and improve health outcomes
- Monitored member progress and collaborated with interdisciplinary teams to ensure coordinated care and achieve optimal health outcomes
Graduate Teaching Assistant – RN-BSN Program
Chamberlain University
Downers Grove
09.2020 - 12.2020
- Delivered instruction through an online Learning Management System (LMS) platform
- Facilitated online discussions and assignments to enhance student engagement
- Provided ongoing follow-up and academic support to ensure student success
- Evaluated and graded assessments, written coursework, and projects
- Delivered timely, constructive feedback to guide improvement in student performance
- Promoted critical thinking and active participation in virtual learning environments
Medicare RN Case Manager
Aetna Health Plan
Sunrise
11.2017 - 03.2019
- Provided case management for the adult and geriatric Medicare population, including high-risk members with chronic conditions
- Managed patients with cardiovascular disease, diabetes, COPD, and other complex conditions
- Coordinated transitions of care following hospital discharge to enhance continuity and minimize gaps in care
- Conducted comprehensive health assessments and developed individualized care plans
- Educated patients on disease management and medication adherence to empower self-care
- Identified and addressed social determinants of health (SDOH) to improve patient outcomes
- Ensured compliance with regulatory and organizational standards
Clinical Nursing Instructor – Fundamentals & Medical-Surgical Nursing
HCI Healthcare Institute
West Palm Beach
08.2017 - 05.2018
- Delivered clinical and classroom instruction aligned with program objectives and accreditation standards
- Supervised students in clinical settings, promoting safe and competent patient care delivery
- Facilitated development of clinical skills and critical thinking through hands-on learning experiences
- Provided mentorship and feedback, enhancing student progression and readiness for NCLEX
- Integrated adult learning strategies to enhance engagement and knowledge retention
Utilization Review Pediatric Care Coordinator
EQ Health Solutions
Tampa
04.2017 - 12.2017
- Conducted utilization reviews for pediatric services to ensure medical necessity and appropriate level of care
- Reviewed clinical documentation, treatment plans, and provider requests to ensure alignment with care standards
- Collaborated with medical directors on second-level review and case determinations to uphold quality of care
- Applied evidence-based guidelines and Medicaid regulations
- Coordinated services to support appropriate and cost-effective care delivery
- Maintained accurate documentation of all review activities
Education
Doctor of Nursing Practice (DNP) - Educational Leadership
Chamberlain University
Addison, IL07-2027
Master of Science in Nursing - Nursing Education
Chamberlain University
03-2020
Bachelor of Science in Nursing -
Florida Atlantic University
08-2007
Associate of Science in Nursing -
Broward College
07-1999
Skills
- Case Management
- Care Coordination
- Population Management
- Transitions of Care
- Readmission Prevention
- Chronic Disease Management
- Utilization Review
- Medical Necessity Determination
- Staff Training
- Onboarding
- Mentorship
- Curriculum Design
- Adult Learning Principles
- Online Instruction
- Learning Management Systems
- Clinical Documentation Improvement
- Quality Assurance
- Regulatory Compliance
- Performance Coaching
- Evaluation
- Interdisciplinary Collaboration
- Training Needs Analysis
- Workforce Development
- Adult Learning Theory
- Curriculum Development
- LMS Platforms
- Online Learning
- Performance Improvement
- Quality Auditing
- Medicaid Compliance
- Managed Care Compliance
- Medicare Case Management
- Care Management Workflows
- Documentation Standards
- Interdisciplinary Training
Certification
- Certified Case Manager (CCM), 12/31/27
- Registered Nurse (RN), Florida
- AAPC Medical Coding Certification, 05/31/26
Professional Development Leadership
- Developed and delivered a comprehensive professional development course for interdisciplinary team members focused on clinical documentation, regulatory compliance, and quality improvement
- Utilized adult learning principles and real-world case scenarios to enhance engagement, critical thinking, and staff competency
- Mentored and trained new care managers, strengthening onboarding effectiveness and workflow adherence
- Supported development and improvement of case management workflows and operational processes
- Reinforced best practices in documentation, compliance, and quality across care management operations
Keywords Expertise
- Training Needs Analysis
- Workforce Development
- Adult Learning Theory
- Curriculum Development
- LMS Platforms
- Online Learning
- Performance Improvement
- Quality Auditing
- Medicaid/Managed Care Compliance
- Medicare Case Management
- Care Management Workflows
- Documentation Standards
- Interdisciplinary Training
Timeline
Medicaid Care Manager I – Pediatrics
Centene Corporation – Sunshine Health Plan
06.2025 - Current
Faculty Lead Instructor (ASN Program) & BSN Instructor – Ethics in Healthcare & Nursing
Keiser University
05.2024 - 06.2025
Medicaid Care Manager II – Pediatrics
Centene Corporation – Sunshine Health Plan
03.2021 - 05.2024
Graduate Teaching Assistant – RN-BSN Program
Chamberlain University
09.2020 - 12.2020
Medicaid Care Manager I – Pediatrics
Centene Corporation – Sunshine Health Plan
03.2019 - 03.2021
Medicare RN Case Manager
Aetna Health Plan
11.2017 - 03.2019
Clinical Nursing Instructor – Fundamentals & Medical-Surgical Nursing
HCI Healthcare Institute
08.2017 - 05.2018
Utilization Review Pediatric Care Coordinator
EQ Health Solutions
04.2017 - 12.2017
Doctor of Nursing Practice (DNP) - Educational Leadership
Chamberlain University
Master of Science in Nursing - Nursing Education
Chamberlain University
Bachelor of Science in Nursing -
Florida Atlantic University
Associate of Science in Nursing -
Broward College