Glenda Clark
Hanover,PA
Summary
Registered Nurse with 21 years of experience. Certified Nurse Case Manager(CCM), Workman's Compensation Case Manager (WCCM certification), and Maryland Certified Rehabilitation Service Practitioner (MCRSP). Four and half years of workman's compensation experience; nine years of case management experience with both inpatient and insurance based case management. Duties included coordinating care for the injured workers. Worked as a liaison between the insurance company, employer, injured worker, and attorneys office to provide quality care, cost savings and best outcomes for the injured worker. Organized and knowledgeable Registered Nurse experienced in treating and caring for patients. Successful in providing fast and accurate assessments and working calmly under pressure. Recognized for collaborating well with doctors to maintain top-notch healthcare practices.
Overview
23
23
years of professional experience
Work History
Workman’s Compensation Nurse Case Manager
Aurora Case Management
Lancaster, PA
09.2019 - Current
- Case Management Services uses clinical and nursing skills to assist in coordinating the individual's treatment program while maximizing cost containment.
- Coordinates injured workers' appointments and attends his/her appointments to obtain a return to work status and maximum medical improvement.
- Coordinates, documents case activities, and inputs case information into the designated system.
- Analyzed data from various sources including claims information, laboratory results and medication histories to identify potential risks or gaps in care.
- Maintains contact via email and telephone with adjusters, attorneys, employers, providers, and injured workers to monitor, update, and assess the cases' progress.
- Provide telephonic and field case management services.
- Completes monthly reports and submits to the state.
- Coordinate services such as doctors' appointments, independent medical examinations, physical therapy, work hardening, and other appointments as deemed necessary.
- Assessed patient needs through comprehensive medical evaluations.
- Educated patients and families on treatment options and resources.
Telephonic RN Case Manger
United Health Care
Baltimore, MD
06.2014 - 09.2019
- Commutates telephonically with patients and caregivers/families monthly to establish relationships to coordinate care
- Assess the adequacy of the discharge plan and the risk associated with compliance
- Complete assessments address any identified barriers to adherence across the continuum
- Develop a care plan and interventions with patient and family input
- Coordination of post-discharge care with primary care physicians
- Interact in a collegial and collaborative fashion with doctor's office staff including RNs, physicians, and nonclinical support staff to close GAPs in care
- Promote cost-effective health care with aligned health system networks.
- Conducted comprehensive assessments of patient health over the phone.
RN Case Manager/utilization Management
Northwest Hospital Center
Randallstown, MD
11.2012 - 06.2014
- Assessment of the individual's personal and medical history, status, prognosis, and current treatment plans, and care provider's expertise level
- Determines the appropriateness of care and timeliness of testing
- Identifies appropriate intervention and alternate, cost-effective treatment modalities to promote recovery and timely discharge
- Liaison between the medical staff, the patients, and the family
- Provides availability of resources for medical, social support, and education
- Coordinate services in a proper and timely manner and facilitates discharge planning
- Completes utilization to ensure hospitals receive payment from insurance companies
- Milliman Care in use when completing a concurrent review.
RN Clinical Leader/Nursing Staff Member
Northwest Hospital Center
Baltimore, MD
06.2003 - 10.2012
- Partnered with nurse manager to raise standards of practice by monitoring, analyzing and correcting staff performance.
- Liaised with physicians and ER staff to reduce critical minutes between admission and treatment and boost patient outcomes.
- Supervised nursing care staff in the provision of patient therapy.
- Assisted the development and maintained departmental policies, procedures, or patient care standards based on evidence-based practice guidelines, or expert opinion.
- Resolved staffing issues by recruiting and hiring top-level talent.
- Educated the nursing department to bolster knowledge of health conditions.
- Coached and mentored other caregivers to facilitate professional growth and development.
- Cared for cardiac stroke and step-down surgical patients.
- Monitored patient vital signs and reported changes to medical staff.
- Assisted in developing and implementing patient care plans.
- Educated patients and families on health management and recovery processes.
- Maintained accurate patient records in electronic health systems.
- Trained new nursing staff on protocols and best practices for care delivery.
- Collaborated with physicians, nurses, therapists, social workers and other healthcare professionals to develop individualized treatment plans for each patient.
- Advocated for patients by supporting and respecting basic rights, values, and beliefs.
Education
Bachelor's - Nursing
Stevenson University
12.2013
Associate Degree - Nursing
05.2003
Master's - Nursing Education
Walden University
trueSkills
- RN Case Management
- Nursing Consultation to insurance carriers
- Strong clinical background
- Effective Troubleshooting
- Effective Communication
- Quick study
- Highly motivated
- Autonomous
- Treatment Recommendations
- Care Coordination
Certifications
- RN-WCCM with the Maryland Workman's Compensation.
- Certified Nurse Case Manager (CCM)
- Maryland Certified rehabilitation Service Practitioner (MCRSP)
Timeline
Workman’s Compensation Nurse Case Manager
Aurora Case Management
09.2019 - Current
Telephonic RN Case Manger
United Health Care
06.2014 - 09.2019
RN Case Manager/utilization Management
Northwest Hospital Center
11.2012 - 06.2014
RN Clinical Leader/Nursing Staff Member
Northwest Hospital Center
06.2003 - 10.2012
Bachelor's - Nursing
Stevenson University
Associate Degree - Nursing
Master's - Nursing Education
Walden University