Knowledgeable Case Manager with solid history of managing complex caseloads and providing comprehensive support to diverse client populations. Proven ability to assess client needs and develop tailored action plans that drive positive outcomes. Demonstrated strong communication and problem-solving skills in high-pressure environments.
Overview
15
15
years of professional experience
1
1
Certification
Work History
Consulting Case Manager
AETNA
08.2018 - Current
Consulting Case Manager (CM) provides long-term care management support 200 members through a collaborative process of assessment, planning, facilitation, care coordination, evaluation, and advocacy. Case Manager connects members to resources and services available in their own community, to support members comprehensive health needs while promoting quality care and cost-effective outcomes.
Responsible for long-term care management of eligible Aetna members with complex care needs; partners with an interdisciplinary team to deliver comprehensive, community-based Case management services focused on helping member maximize best health outcomes.
Community Health Nurse/Nurse Consultant
PUBLIC HEALTH MANAGEMENT CORPORATION
05.2017 - 11.2019
Investigation a large caseload cases of medical neglect and attending court hearings for placement of neglected children with serious illnesses into home and facilities while managing a case load of 75
Responsible for conducting assessments and health screenings for children Philadelphia County. Observe behavioral health concerns; communicate with clients to make appropriate referrals to community agencies. Working closely with the certified Medical Homes and Program Manager to complete assessments and reports for the Department of Health.
Conducted home visits for at-risk patients, providing necessary medical care and support for improved wellbeing.
Clinical Quality Nurse Educator
PEDIATRIC SPECIALTY CARE
11.2016 - 05.2017
Assist the Quality Department in planning for 3 facilities with 100+ children, organizing, developing and directing staff development and skill competency of the Nursing and Respiratory Department in accordance with current federal, state, and local standards, guidelines, and regulations that govern the facility, to ensure that the highest degree of quality care is maintained at all times.
Prepare audit reports of findings and recommendations to management caseload/reports.
Reduced knowledge gaps by creating customized training plans that addressed specific needs within the nursing team.
Pediatric DHS Nurse Consultant/Supervisor
PHILADELPHIA DEPARTMENT OF HUMAN SERVICES CHILD WELFARE
01.2011 - 01.2016
Acted as a Consultant and offered Medical Consultation to the Philadelphia Department Human Services, Child Welfare. Identified and Investigate cases of Medical Neglect. Assessed medical needs of children and families with chronic and acute illness, while assisting and managing their medical needs. Assist social workers with understanding high risk cases, scheduling visits, and advocating the organizational mission and public health care importance. Supported DHS Social workers and staff to incorporate medical information into Family and Individual Service Plans.
Managed approximately 20 incoming referrals, home-visits, emails, faxes per day from consulting staff daily.
Education
Bachelor of Science - Nursing
THOMAS JEFFERSON SCHOOL OF NURSING
PHILADELPHIA, PA
01.2006
Skills
Problem-solving
Case management
Time management
Case documentation
Relationship building
Conflict resolution
Client advocacy
Community outreach
Certification
Registered Nurse, State of Pennsylvania (Oct 2021) & Florida - Multistate (July 2022)
Timeline
Consulting Case Manager
AETNA
08.2018 - Current
Community Health Nurse/Nurse Consultant
PUBLIC HEALTH MANAGEMENT CORPORATION
05.2017 - 11.2019
Clinical Quality Nurse Educator
PEDIATRIC SPECIALTY CARE
11.2016 - 05.2017
Pediatric DHS Nurse Consultant/Supervisor
PHILADELPHIA DEPARTMENT OF HUMAN SERVICES CHILD WELFARE