Summary
Overview
Work History
Education
Skills
Timeline
Generic

Jeaneen Russell

Mentor,Ohio

Summary

Compassionate Nurse Case Manager offering 12 years of experience working with patients and families to facilitate smooth transitions following discharge from medical facilities. Committed to working collaboratively with health plan, leadership, and department coordinators to achieve highest quality of patient satisfaction. Well-versed in developing individualized care plans and advocating patient welfare.

Overview

16
16
years of professional experience

Work History

Nurse Case Manager

Optum
01.2023 - Current

Manages a panel of medically complex patients to ensure individual needs are met.

complete transition of care calls to ensure members receive the necessary services and resources according to transition plan

Create individualized care plans and follow up

Engage members telephonically to assure that a well coordinated action plan is established.

Continually assess health status

Make referrals to community resources and programs identified for members

Case Manager/Admissions Coordinator

UNIVERSITY HOSPITAL-LAKE CENTER FOR COMPREHENSIVE REHABILITATION
07.2011 - 10.2022
  • Dual role position acting as Clinical Liaison and Admissions Coordinator in addition to Case Manager/ Discharge Planner
  • Seeks out and evaluates appropriate patients for acute rehabilitation
  • Coordinates intake and complete pre-admission screen process
  • Effectively communicates with Medical Director, therapists and nurses at team meetings and daily to ensure the best plan of care and outcome for each patient
  • Manages insurance pre-certifications and continued-stay authorizations
  • Coordinates transition of care to home including setting up home health care, ordering DME, oxygen, follow up appointments
  • Performs prospective, concurrent and retrospective utilization reviews, and first level determination approvals for members, using BSC evidenced based guidelines, policies and nationally recognized clinical criteria, across lines of business, or for a specific line of business, such as Medicare and FEP
  • Works in conjunction with physicians, nurses, Care Management Team and others to assess, plan and initiate patient plan of care.
  • Worked well in a team setting, providing support and guidance.
  • Resolved problems, improved operations and provided exceptional service.

Clinical Liasion-Acute Rehab Units

CLEVELAND CLINIC
01.2009 - 09.2011
  • Functioned as a Clinical Liaison for patients transitioning from an acute care hospital setting to post acute rehabilitation setting in 3 area hospitals (Marymount, Southpoint and Huron) Followed the daily census, attended medical daily rounds and communicated with appropriate Case Mangers and Social Workers to capture appropriate patients for the unit
  • Completed preadmission screen, communicated with medical director and obtained insurance prior authorizations.

Education

Diploma of Nursing -

HURON SCHOOL OF NURSING
01.2007

Bachelor's - Psychology

KENT STATE UNIVERSITY
01.1994

Skills

  • Quality Improvement
  • Policy Adherence
  • Care Coordination
  • Patient Counseling

Timeline

Nurse Case Manager

Optum
01.2023 - Current

Case Manager/Admissions Coordinator

UNIVERSITY HOSPITAL-LAKE CENTER FOR COMPREHENSIVE REHABILITATION
07.2011 - 10.2022

Clinical Liasion-Acute Rehab Units

CLEVELAND CLINIC
01.2009 - 09.2011

Diploma of Nursing -

HURON SCHOOL OF NURSING

Bachelor's - Psychology

KENT STATE UNIVERSITY
Jeaneen Russell