RN case manager in the National Medical Excellence unit responsible for UM and CM functions for members undergoing bone marrow transplants and cellular therapy.
RN Clinical Review Manger
BlueCross BlueShield TN
Remote
08.2022 - 09.2024
Review medical and pharmacy claims along with clinical received by utilization management
Compile and condense information on an Excel spreadsheet to present via Microsoft Teams meeting
Collaborate with case management, medical director, pharmacist, account, and leadership team
RN Telephonic/Digital Case Manager
BlueCross BlueShield TN
Remote
11.2019 - 08.2022
Telephonic and digital outreach to members for care coordination and chronic condition management
Team preceptor
RN/Case Manager
CHI Memorial Hospital
Chattanooga, TN
06.2018 - 11.2019
Discharge planning from cardiac floor
Collaborated with nursing staff, medical director, providers, utilization management, and social worker
RN/Patient Intake Center
CHI Memorial Hospital
Chattanooga, TN
03.2017 - 11.2019
Coordinated bed placement for ER admits, level of care transitions, and outside facility transfers
STEMI and Stroke alert coordination
RN/Emergency Room
Erlanger East Chattanooga, TN
12.2016 - 03.2017
RN/Medical Intensive Care Unit
Parkridge Medical Center Chattanooga, TN
05.2016 - 01.2017
RN/Emergency Room
Highlands Medical Center Scottsboro, AL
04.2015 - 11.2016
Education
Associates Applied Science: Nursing -
Northeast Alabama Community College
Rainsville, AL
05.2014
Advanced Diploma/Valedictorian -
Pisgah High School
Pisgah, AL
05.2010
Skills
Experience with Microsoft, Excel, and PowerPoint
Strong customer service and telephonic skills
Computer skills
Multitasking
Clinical judgment
Discharge planning
Research
Team collaboration
Patient education
Precepting
Licensed RN
Case management
High level of autonomy
Remote work
Chronic disease management
Emergency care
Critical care
Managing deadlines
Palliative care awareness
Coordinating referrals
Certification
CCM May 2021
Georgia eNLC RN
Additional active RN license in the following states: Alaska, California, Connecticut, District of Columbia, Hawaii, Illinois, Michigan, Minnesota, Nevada, New York, & Oregon