Motivated Case Manager and Utilization Reviewer committed to building integrated nursing teams and improving patient outcomes at hospital level. Detail oriented professional with exemplary skills in delegating tasks, data analysis to close gaps and improve outcomes.
Overview
10
10
years of professional experience
1
1
Certification
Work History
Clinical Manager of Case Management
Ridgecrest Regional Hospital
06.2014 - Current
Improved patient outcomes by implementing evidence-based clinical practices and protocols.
Enhanced staff performance through regular training, mentoring, and professional development opportunities.
Streamlined clinic operations for increased efficiency by optimizing patient flow and appointment scheduling processes.
Developed interdisciplinary care plans with input from physicians, nurses, therapists, and other healthcare providers for optimal patient results.
Oversees and assists in facilitation of patient hospitalization from pre-admission to discharge.
Manages department to work with other healthcare providers to expedite medically appropriate, cost effective care.
Acts as a resource for the Case Management department and represents the department for projects and at meetings.
Working knowledge of the facility's third-party payors and the State of California's reimbursement systems.
Collects data to assist Senior Leadership in assessing the financial status, monitoring the facility's potential financial risks on a concurrent basis and the review of facility and physician case-mex financial data to identify trends and problem areas.
Reduced hospital readmission rates by prioritizing discharge planning and effective communication between patients, families, and healthcare providers.
Identified areas for cost savings without compromising quality of care through regular financial analysis and budget reviews.
Education
Master of Science - Nursing, Leadership And Management
Walden University
Minneapolis, MN
06.2017
Associate of Science - Nursing
Bakersfield College
Bakersfield, CA
05.2012
Associate of Science - Nursing
Cerro Coso Community College
Ridgecrest, CA
05.2009
Skills
Patient Health Education
Meeting participation
Records Management
HIPAA Compliance
Resource Management
Recruitment and retention
Patient Education
Clinical Leadership
Quality Improvement
Staff Development
Administrative Oversight
Utilization review
Team Management
Reimbursement tracking
Case Management
Certification
CCM- Certificate Number 4248107/Sept 2020
Registered Nurse- 821944/ Jun 2012
Timeline
Clinical Manager of Case Management
Ridgecrest Regional Hospital
06.2014 - Current
Master of Science - Nursing, Leadership And Management
Walden University
Associate of Science - Nursing
Bakersfield College
Associate of Science - Nursing
Cerro Coso Community College
CCM- Certificate Number 4248107/Sept 2020
Registered Nurse- 821944/ Jun 2012
Similar Profiles
MARCELLE MUNSONMARCELLE MUNSON
Charge Nurse Labor and Delivery at Ridgecrest Regional HospitalCharge Nurse Labor and Delivery at Ridgecrest Regional Hospital