Katie Jones MHA, RN, CCM
Hamilton,OH
Summary
Seasoned RN Case Manager offering 15 years of planning, assessing and reporting experience with high visibility clients. Proficient in documentation and compliance management. Experienced professional proficient in strategies for mitigating risk, reducing costs and enhancing customer satisfaction. Strong planner and problem-solver with excellent analytical, verbal and written communication, organizational and leadership skills.
Overview
20
20
years of professional experience
1
1
Certification
Work History
Complex Case Manager
OptumHealth
Eden Prairie, MN
05.2011 - Current
- Complex Case Management for VIP, Escalated Cases, High Cost Claimants, & Longitudinal Case Management
- Complex Case Manager Trainer for Case Managers/Disease Management Nurses
- Developed & Implemented training program for Complex Case Management 2020
- Global Optum Services Mentor
- Executive Concierge Referral Service (ECRS) Nurse Care Coordinator
- EVI to ICUE Convergence SME for Complex Case Managers/Disease Management Nurses
- PULSE SME
- ISET SME
- EMS Cheerleader
- Vital Signs Committee Representative
- Created and maintained Excel document for CCM to ensure NCQA compliance
- Planned and executed Alternate Care Proposals
- Mentored and coached junior staff members
- Effectively controlled release of proprietary and confidential information
- Consulted with clinicians to devise and manage effective ongoing care plans for at-risk patients.
- Reduced care costs without sacrificing quality through effective service coordination and multidisciplinary collaboration.
- Updated documentation and wrote reports detailing treatment plans and progress
- Developed patient care plans, including assessments, evaluations and nursing diagnoses
- Determined and coordinated appropriate level of care to meet individual patient needs
- Collaborated with various healthcare providers to facilitate delivery of services
- Coordinated support services and optimized communication between healthcare workers and patients
- Optimized program resource utilization to prevent unnecessary hospital admissions
- Lowered costs while improving care quality by coordinating services and collaborating with dedicated healthcare team
Team Lead Registered Nurse Operating Room
TriHealth
Cincinnati, OH
05.2006 - 03.2013
- General Vascular & Bariatric Services
- Team Lead of 15 staff members
- Wrote and updated training manuals for new RN hires
- Chaired Shared Leadership Committee
- Charge Nurse on Weekends running up to three Operating Rooms simultaneously
- Preceptor new hires
- Conducted analysis to address room turnover times by 40%
- Oversaw various cost reduction projects from conceptualization to completion
- Contributed to development, planning and completion of project initiatives
- Demonstrated leadership by making improvements to work processes and helping to train others
- Demonstrated self-reliance by meeting and exceeding workflow needs
Education
Master Of Health Administration - Health Administration
Ohio University
Athens, OH2012
Bachelor Of Science In Nursing - Nursing
University Of Cincinnati
Cincinnati, OH2009
Associate Of Nursing - Nursing
Good Samaritan College Of Nursing And Health Science
Cincinnati, OH2006
High School Diploma - undefined
Fairfield High School
Fairfield, OH2000
Skills
- Microsoft Excel, Word, PowerPoint, Outlook, OneNote
- Process evaluations
- Process improvement
- Analytical reasoning
- Auditing methodology
- Cost Benefit Analysis (CBAs)
- Project management
- Flexible team player
- Team leadership
- Staff supervision
- Performance metrics
Accomplishments
- 2018 SuperHero Winner
- Supervised team of 22 staff members for leadership during audits
- 2020, 2019 & 2018 MAP exceeded expectations
- ECRS Nurse Coordinator
- Aquamarine recipient 2013
- Bravo recipient numerous times
- Nursing Inspire participant
Certification
Certified Case Manager
Timeline
Complex Case Manager
OptumHealth
05.2011 - Current
Team Lead Registered Nurse Operating Room
TriHealth
05.2006 - 03.2013
Master Of Health Administration - Health Administration
Ohio University
Bachelor Of Science In Nursing - Nursing
University Of Cincinnati
Associate Of Nursing - Nursing
Good Samaritan College Of Nursing And Health Science
High School Diploma - undefined
Fairfield High School