Jo Tangel
Summary
Self-motivated professional promoting attention to detail and the drive to resolve issues effectively. Calm and poised in the most stressful environments. Seeking the opportunity to join new organization in the role of a Case Manager or Utilization Review Nurse.
Overview
2025
2025
years of professional experience
Work History
RN Case Manager/ Trauma
Delray Medical Center
06.2022 - Current
- Reduced hospital readmission rates through effective case management and patient education on self-care techniques.
- Streamlined discharge planning processes, ensuring a smoother transition for patients back to their homes or other facilities.
- Advocated for patients'' rights and preferences, working diligently to align care with individual values and goals.
- Coordinated care conferences with interdisciplinary team members, ensuring all perspectives were considered in the development of comprehensive treatment plans.
- Coordinated with healthcare providers for enhanced patient care, ensuring all treatments aligned with prescribed care plans.
- Obtained authorizations from multiple insurance carriers for various levels of care.
Case Manager/ Utilization Review RN
North Suburban Medical Center
10.2021 - 06.2022
- Worked with utilization review to establish prior authorization for timely discharges.
- Solved problems related to abrupt changes in discharge, coordinated updates and communicated discharge plans.
- Coordinated individualized discharge plans to manage safe transition back into community and home environments.
- Worked with medical teams, patients and families to implement effective treatment plans.
- Authored initial assessments of patients and family to develop plans for individual home care needs.
Utilization Review Manager
ProActa HMO
1996 - 2000
- Determined medical necessity and cost-effectiveness of services through utilization review processes.
- Managed ProActa and Medical Management processes pertaining to denials and potential denials as outlined by insurance carriers.
- Collaborated with providers to obtain required clinical information, supporting prior authorization determinations and individual inquiries.
- Recruited, hired and trained new employees, including monitoring and review of individual performance.
- Interacted with prospects and customers at various events, including trade shows, seminars and workshops.
Case Manager/ Marketing
Vencor Hospital
1993 - 1996
- Informed patients and families of treatment options and at-home care strategies to reduce unnecessary burden on hospital resources.
- Collaborated with various healthcare providers to facilitate delivery of services.
- Optimized program resource utilization to prevent unnecessary hospital admissions.
- Lowered costs while improving care quality by coordinating services and collaborating with dedicated healthcare team.
- Participated in case conferences with multi-disciplinary team to discuss client care planning and progression.
- Conducted assessments to obtain information for participant-centered plan of care.
Utilization Review Nurse
Metlife Medical Management HMO/PPO
1991 - 1993
- Collaborated with providers to obtain required clinical information, supporting prior authorization determinations and individual inquiries.
- Determined medical necessity and cost-effectiveness of services through utilization review processes.
- Applied medical criteria and clinical judgement to researched cases to evaluate and establish determinations.
ICU Nurse
Denver Health Medical Center
1987 - 06.1991
- Performed nursing care following prescribed rules, policies, protocol and procedures.
- Developed and maintained professional relationship with members of health care team, patient and patient's family.
- Functioned as charge nurse and assumed patient care in absence of nurses ending or arriving for shifts.
- Participated in monitoring, maintaining and improving nursing sensitive indicators, core measures and other identified outcome measures.
Education
Bachelor of Science - Nursing
University of Colorado
Denver, CO06.1987
Skills
- Continuous assessments
- Utilization review
- Patient transfers and transitions
- Friendly, positive attitude
Timeline
RN Case Manager/ Trauma
Delray Medical Center
06.2022 - Current
Case Manager/ Utilization Review RN
North Suburban Medical Center
10.2021 - 06.2022
Utilization Review Manager
ProActa HMO
1996 - 2000
Case Manager/ Marketing
Vencor Hospital
1993 - 1996
Utilization Review Nurse
Metlife Medical Management HMO/PPO
1991 - 1993
ICU Nurse
Denver Health Medical Center
1987 - 06.1991
Bachelor of Science - Nursing
University of Colorado
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