JOYCE CARTER
Baltimore,Maryland
Summary
Share expertise in healthcare with others to promote positive outcomes for patients, staff and the community. Talented Case Manager adept at handling high caseloads without sacrificing quality of care. Operates in high-pressure environments while recommending best resources and courses of action to benefit patient needs and return each to optimal quality of life. Work with highly complex populations who are dealing with social issues, knowledge deficits and behavioral health disorders. Multi-faceted Casework Supervisor with 10+ years of experience in nursing services field. Managed anywhere from 2-20+-person nursing team and provided services to average caseload of 20+ clients. Excellent organizational and collaborative skills leading to effective service delivery.
Overview
34
34
years of professional experience
Work History
Utilization Review/Case Manager Coordinator
Lifebridge Health
08.2022 - Current
- Conducted thorough assessments of client needs, strengths, and risks to inform appropriate interventions and support services.
- Assisted caseworkers with regular visits to homes and schools to evaluate child safety and quality of care.
- Mentored new case managers, sharing valuable insights from years of hands-on experience in the field.
- Established strong community partnerships to broaden available resources for clients and their families.
- Collaborated with Home Health Agency and State Agency resource providers to offer clients access to community services.
- Maintained familiarity with Maryland foster care and adoption regulations and laws to facilitate resolution of client-related issues.
- Intervened in urgent and crisis situations and provided services in compliance with Maryland and federal regulations and laws.
- Championed a positive work environment by fostering open communication channels among colleagues at all levels within the organization.
- Contributed substantially to achieving departmental goals through unwavering commitment to excellence in case management and client service.
UNIT MANAGER
STAFFING PLUS
07.2018 - 06.2022
- Contract assignment at Keswick MultiMedical to manage a 58 bed unit and the staff providing direct care to include RNs, LPNs and GNAs
- Ensure the unit is in compliance with government guidelines to meet survey compliance.
- Oversaw recruitment efforts within the nursing unit, selecting highly skilled candidates who would contribute positively to the team dynamic.
- Facilitated smooth transitions between shifts, ensuring seamless continuity of care for all patients on the unit. Contractual position.
- Established a strong rapport with patients and their families, addressing concerns and providing valuable support throughout the treatment process. Additional contractual assignments under this agency to include travel assignments.
FIELD NURSE
COMMUNITY HOME HEALTHCARE
01.2018 - 07.2018
- Home visits to address skilled care needs based on the orders from a physician
- The goal is to teach caregivers to manage care of the patient in the home
- After 2 months, I have taken on the role of Clinical Manager.
UNIT MANAGER
MANOR CARE ROSSVILLE
09.2017 - 01.2018
- Manage care of residents in long term care and the staff who provide care
- This involves audits, coordination of appointments, training and necessary follow-up on issues and appointments that impact care.
NURSE COORDINATOR
SINAI HOSPITAL
06.2014 - 09.2017
- Manage nursing services provided to persons who are in recovery from substance abuse
- This includes the direct supervision of Licensed Practical Nurses who provide medication and assessments of persons who present for treatment
- I facilitate the hiring and orientation of new nursing staff
- Conduct annual performance evaluations and suggest opportunities for performance improvement.
- Improved patient outcomes by developing and implementing comprehensive care plans tailored to individual needs.
- Minimized potential barriers to care access by collaborating with social workers, financial counselors, and community partners in addressing patients'' socio-economic challenges.
- Maintained thorough documentation of clinical assessments, interventions, evaluations, and recommendations in accordance with regulatory requirements.
INTERIM UNIT MANAGER
360 HEALTHCARE SERVICES
06.2017 - 09.2017
- Current travel assignment at Augusta Nursing and Rehab in Waynesboro, VA
- Manage issue cited by the state and work on plan of corrections
- Educate staff while continuing to audit for compliance prior to re-survey
- Anticipate return to Maryland at the end of the contractual assignment.
INTERIM UNIT MANAGER
360 HEALTHCARE SERVICES
03.2017 - 05.2017
- Current travel assignment at Covington Heights Nursing and Rehab in Souix Falls, S.D
- Manage Nursing care at the unit level for a census of 25 or more residents in long term care and a short stay rehab level of care
- Assigned to a facility that has a ban on admissions until a re-survey and now admissions are permitted
- Considerable teachable moments for a contingent of staff who are traveler and facility staff
- Anticipate return to Maryland at the end of the contractual assignment.
DIRECTOR OF NURSING
GOOD SHEPHERD SERVICES
05.2016 - 01.2017
- Manage RN and LPN staff who provide direct care to youth in a Residential Treatment Program
- The Nursing services are available 24 hours daily to youth who are sent to the facility by the Department of Juvenile Justice and the Department of Social Services
- This position has full responsibility for nursing practice, management of outside appointments and supplies
- Hiring and arranging an orientation of new employees is a responsibility of this position.
UNIT MANAGER
FUTURE CARE IRVINGTON
10.2015 - 04.2016
- Manage RN, LPN, Nursing Assistants and one Clinical Supervisor on a 50 bed Pulmonary Care Unit
- This includes interviews, orientations, mentoring, monitoring of practice and utilization of resources and addressing customer service issues
- This is done in collaboration with the Director of Nursing and the multidisciplinary team.
CLINICAL DOCUMENTATION SPECIALIST
LEVINDALE HOSPITAL
09.2014 - 10.2015
- Review clinical documentation throughout the acute cate setting of the facility for opportunities to query physicians for clarification prior to coding of the record for billing
- Participate in instruction of physicians on the importance of capturing key areas of clinical documentation to maximize revenue for the facility
- Work on quality projects as assigned to include restraint audits and blood transfusion audits.
Health Manager
Chimes Medical Day Program
04.2010 - 12.2014
- Manager health care needs of 200+ developmentally disabled adults ages 21-90
- Coordinate care by contacting providers as necessary to facilitate health care needs
- Teach Medication Administration as designed by DDA
- Provide delegating nurse follow through.
- Reviewed work procedures and operational problems to determine ways to improve service, performance and safety.
- Recruited, hired and trained all staff, providing direct supervision, ongoing staff development and continuing education to employees.
ASSISTANT DIRECTOR OF NURSING
09.2011 - 06.2013
- Manage care of residents in long term care and on a skilled care unit
- Work with a multidisciplinary team to coordinate discharges to a lower level of care, admissions and transfers internally and externally
- Update team at Utilization Review meeting
- Facilitate the hiring and the performance of staff through performance improvement tools as well as evaluations.
CLINICAL CASE MANAGER
SINAI HOSPITAL
05.2010 - 09.2011
- Coordinate discharge planning for patients in the acute hospital to alternative levels of care up to and including home
- Involve caregivers, equipment and service providers, the medical team as well as the nursing team in the process
- The goal is to maximize customer satisfaction while facilitating the shortest length of stay medically appropriate
- This included a knowledge of Utilization Review, processing of forms for a level of care and an understanding of Interqual.
OPERATIONS MANAGER
UNIVERSITY OF MD. MEDICAL CENTER
05.2007 - 05.2010
- Started this position under Interim Healthcare within the facility to manage office staff that provide scheduling and payroll distributions for supplemental staff to the acute hospital
- Managed a pool of hospital supplemental staff who administer healthcare services to acutely ill individuals
- Ensured that capable and competent supplemental staff available and working in the hospital
- Audit staff files as indicated to ensure compliance internally and at local contract agency sites
- After several months, the hospital took over the contract with Interim and my roll continued with responsibility for 11 FTEs internally and 320+ FTEs supplemental staff and float pool plus agencies
- Gradually I became solely responsible for getting a new software system up and running for staffing and another manager took over the day to day interactions with staff and the units to which they were assigned.
CLINICAL DOCUMENTATION SPECIALIST
SINAI HOSPITAL
09.2005 - 05.2007
- Review clinical documentation throughout the acute care setting for opportunities to query physicians for clarification prior to coding of the record
- Participate in the instruction of physician groups on the importance of capturing key areas of clinical documentation to maximize revenue for the hospital.
PROGRAM MANAGER
VA MARYLAND HEALTHCARE SYSTEM
05.2001 - 09.2005
- Manage a team of nursing supervisors who covered the three VA facilities in Maryland
- Coordinate the contract process for supplemental nursing staff through agencies contracted with the VA
- Manage the compliance of these agencies
- Ensure nursing administrative coverage is in place to support nursing
- Position directly reported to the Chief Nurse of the VA Maryland Health Care System
- Responsible for the Patient Transfer Coordinator and the Quality Review Coordinator.
Case Manager/Utilization Review
NYL Care/Aetna/Prudential insurances
01.1991 - 01.2001
- Role to facilitate the most cost effective quality care in the least restrictive environment
- Utilizing the Medical Director, Peers and Interqual/Milliman criteria as a guideline.
Education
DIPLOMA REGISTERED NURSE - Focus was on obtaining a basic registered nurse education to practice.
Maryland General Hospital School of Nursing
BALTIMORE, MDMASTER OF SCIENCE NURSING - Focus of my degree was on Nursing Administration
UNIVERSITY OF MARYLAND
BALTIMORE, MD01.2004
BACHELOR OF SCIENCE NURSING - Focus was on improved knowledge of the scope of nursing to include management.
TOWSON UNIVERSITY
TOWSON, MD01.1985
Skills
- I have knowledge of the clinical case management of complex cases as well as rehab case mix as an internal case manager for insurances with experience in utilizing Milliman and Interqual I am also knowledgeable on obtaining authorization for services My diverse nursing experiences range from direct care of medical surgical patients, adult day care, summer camp nurse, care of youth in a foster care group home I have taught medication administration and I have been the delegating nurse in group homes for developmentally challenged individuals I have extensive experience managing groups of staff with varied levels of education and experience My success has been in mentoring staff to perform at a higher level of excellence in varied settings with several staff going forward to advance their education
- Resource referrals
- Client Advocacy
- Interviewing
- Ethical Practice
- Service planning
- Policy Knowledge
- Care Plan Evaluation
- Discharge Planning
- Utilization review
- Home visits
- Group Dynamics
Communication Skills
I have educated laypersons working with the developmentally challenged to equip them to administer medications in the residences.
Leadership Experience
Member of the Maryland Nurse’s Association. I have coordinated various health fairs, presentations that enhance the knowledge of staff as well as the community. Provided leadership by mentoring nursing students in their Leadership Development clinical practicum.
References
- DENISE GASTON, DIRECTOR OF NURSING, FORMER MANAGER AMBULATORY CARE, VA MARYLAND HEALTHCARE SYSTEM, 301-490-2371
- Robin Martinez, FORMER STAFF NURSE, VISITING NURSE ASSOCIATION, 209-535-8395
- Clotilde Griguiolo, FORMER STAFF NURSE, THE CHIMES, 410-979-5890
Affiliations
- Appointed by Governor to Citizens Review Board for Foster Care
Member of the Citizens Review Board for Foster Care
The board meets monthly with a multidisciplinary team involved in the care of youth in foster care. Recommendations are made by the board if certain mandatory task are not completed for the youth to be successful living when they are no longer assisted by state funding and programs. This could be regarding health, education, independent living skills and more.
Timeline
Utilization Review/Case Manager Coordinator
Lifebridge Health
08.2022 - Current
UNIT MANAGER
STAFFING PLUS
07.2018 - 06.2022
FIELD NURSE
COMMUNITY HOME HEALTHCARE
01.2018 - 07.2018
UNIT MANAGER
MANOR CARE ROSSVILLE
09.2017 - 01.2018
INTERIM UNIT MANAGER
360 HEALTHCARE SERVICES
06.2017 - 09.2017
INTERIM UNIT MANAGER
360 HEALTHCARE SERVICES
03.2017 - 05.2017
DIRECTOR OF NURSING
GOOD SHEPHERD SERVICES
05.2016 - 01.2017
UNIT MANAGER
FUTURE CARE IRVINGTON
10.2015 - 04.2016
CLINICAL DOCUMENTATION SPECIALIST
LEVINDALE HOSPITAL
09.2014 - 10.2015
NURSE COORDINATOR
SINAI HOSPITAL
06.2014 - 09.2017
ASSISTANT DIRECTOR OF NURSING
09.2011 - 06.2013
CLINICAL CASE MANAGER
SINAI HOSPITAL
05.2010 - 09.2011
Health Manager
Chimes Medical Day Program
04.2010 - 12.2014
OPERATIONS MANAGER
UNIVERSITY OF MD. MEDICAL CENTER
05.2007 - 05.2010
CLINICAL DOCUMENTATION SPECIALIST
SINAI HOSPITAL
09.2005 - 05.2007
PROGRAM MANAGER
VA MARYLAND HEALTHCARE SYSTEM
05.2001 - 09.2005
Case Manager/Utilization Review
NYL Care/Aetna/Prudential insurances
01.1991 - 01.2001
DIPLOMA REGISTERED NURSE - Focus was on obtaining a basic registered nurse education to practice.
Maryland General Hospital School of Nursing
MASTER OF SCIENCE NURSING - Focus of my degree was on Nursing Administration
UNIVERSITY OF MARYLAND
BACHELOR OF SCIENCE NURSING - Focus was on improved knowledge of the scope of nursing to include management.
TOWSON UNIVERSITY