Kimberly Moravec
Waukesha,WI
Summary
Motivated, dedicated, and patient-focused Registered Nurse with extensive experience in Home Health Case Management, Utilization Management, Surgical Services, Care Coordination, Regulatory Compliance, and Healthcare Operations. Proven success managing complex patient populations, including ventilator-dependent, tracheostomy, enteral feeding, wound care, and chronic disease management patients across diverse care settings. Skilled in OASIS documentation, utilization review, medical necessity determinations, discharge planning, and interdisciplinary collaboration to improve clinical outcomes and reduce hospital readmissions. Experienced in coordinating care across the healthcare continuum, ensuring regulatory compliance, and advocating for patient-centered care. Recognized for strong leadership, clinical judgment, operational excellence, and a commitment to delivering high-quality, compassionate healthcare services.
Overview
29
29
years of professional experience
Work History
RN - Home Health Care/Case Manager - Per Diem
Maxim Healthcare Services
WI
07.2023 - Current
- Provided comprehensive nursing assessments and ongoing case management for home care patients, developing individualized care plans to meet medical and psychosocial needs.
- Coordinated care among physicians, therapists, caregivers, and community resources to ensure continuity of care and optimal patient outcomes.
- Monitored patient conditions, medication regimens, and treatment effectiveness, promptly reporting changes and implementing appropriate interventions.
- Educated patients and family members on disease management, medication administration, safety precautions, and self-care strategies to promote independence.
- Performed skilled nursing services including wound care, catheter care, injections, and chronic disease management in accordance with physician orders.
- Maintained accurate and timely clinical documentation, assessments, care plans, and progress notes while ensuring compliance with agency, state, and federal regulations.
- Managed a diverse caseload of patients, prioritizing visits, coordinating services, and advocating for patient needs to enhance quality of care and reduce hospital readmissions.
RN - Case Manager - Staff
ProMedica Home Healthcare and Hospice
Milwaukee, Wisconsin
12.2022 - 04.2023
- Conducted comprehensive patient assessments and OASIS-driven documentation throughout Waukesha and Milwaukee counties, developing and updating individualized plans of care for home health patients.
- Managed complex home care cases involving ventilator-dependent, tracheostomy, G-tube, enteral feeding, Foley catheter, and bowel/bladder management patients across diverse age groups and diagnoses.
- Coordinated interdisciplinary care with physicians, Physical Therapists, Occupational Therapists, Speech Therapists, home health aides, and community resources to ensure high-quality patient outcomes.
- Provided skilled nursing services including wound assessments, wound VAC therapy, catheter care, ostomy and colostomy management, medication management, and chronic disease education.
- Directed and supervised patient mobility and safety programs, including Hoyer lift transfers, repositioning schedules, pressure injury prevention, and range-of-motion exercises to improve patient function and comfort.
- Performed health aide supervisory visits, clinical observations, and competency assessments while ensuring compliance with agency policies, state regulations, and Medicare requirements.
- Educated patients, families, and caregivers on disease processes, ventilator and tracheostomy care, enteral feeding management, infection prevention, and safe home care practices to promote independence and reduce hospitalizations.
RN - Utilization Management & Case Manager - Staff
Wheaton Franciscan/Ascension Health Care
Milwaukee, Wisconsin
02.2013 - 05.2022
- Served in dual roles as Clinical Case Manager, Clinical Integration Specialist, and Utilization Management Nurse, facilitating coordinated patient care throughout the continuum of services.
- Collaborated with physicians, nursing staff, ancillary departments, payers, and community providers to improve communication, streamline care delivery, and optimize patient outcomes.
- Conducted concurrent and retrospective utilization reviews to determine medical necessity, regulatory compliance, and appropriate resource utilization in accordance with payer and reimbursement guidelines.
- Managed admissions, observation status reviews, and level-of-care determinations utilizing MCG and InterQual criteria to ensure accurate patient status and reimbursement compliance.
- Coordinated discharge planning and post-acute care placements, including skilled nursing facilities, inpatient rehabilitation, home health services, hospice, and community-based resources.
- Evaluated admission authorizations, payer approvals, denials, and appeals, collaborating with providers and insurance organizations to secure appropriate coverage and reduce revenue loss.
- Monitored patient progression throughout hospitalization, identifying barriers to discharge, facilitating interdisciplinary care conferences, and promoting safe, cost-effective transitions of care.
RN - Surgical Consultant & Coordinator - Staff
Hale Vision Center/WELC Wisconsin Eye Laser Center
Brookfield, Wisconsin
06.1997 - 06.2013
- Progressively advanced through multiple leadership and clinical roles including Ophthalmic RN Technician, RN Surgical Coordinator, Surgical Office Director, and Surgical Consultant, demonstrating expertise in ophthalmic and refractive surgery services.
- Coordinated all aspects of ophthalmic and cosmetic surgical procedures, ensuring seamless patient flow, regulatory compliance, and exceptional patient experiences throughout the surgical process.
- Served as a Certified VISX Laser and LASIK Surgery Trainer, traveling nationwide to educate physicians, nurses, and clinical teams on laser technology, surgical protocols, and best practices.
- Provided comprehensive pre-operative, intra-operative, and post-operative patient care, including assessments, patient preparation, recovery monitoring, and discharge education.
- Educated and counseled patients regarding LASIK, cataract, refractive, and elective cosmetic procedures, helping patients make informed treatment decisions and achieve realistic expectations.
- Managed surgical inventory, supplies, equipment maintenance, and vendor relationships for a multidisciplinary team of 12-15 surgeons, ensuring operational efficiency and cost-effective resource utilization.
- Developed and implemented clinical policies, procedures, quality assurance programs, operational standards, and documentation systems to support safe, compliant, and high-quality patient care.
Education
Bachelor of Science - Nursing
University of Wisconsin - Oshkosh
12-1995
Skills
- Comprehensive Patient Assessment
- Case Management
- Care Coordination
- Utilization Management
- OASIS Documentation
- EPIC Documentation
- Discharge Planning
- Chronic Disease Management
- Wound Care Management
- Tracheostomy Care
- Ventilator Management
- Enteral Feeding Management
- Foley Catheter Management
- Ostomy Care
- Medication Management
- Patient & Family Education
- Medical Necessity Review
- Prior Authorization Management
- Interdisciplinary Collaboration
- Clinical Leadership
Timeline
RN - Home Health Care/Case Manager - Per Diem
Maxim Healthcare Services
07.2023 - Current
RN - Case Manager - Staff
ProMedica Home Healthcare and Hospice
12.2022 - 04.2023
RN - Utilization Management & Case Manager - Staff
Wheaton Franciscan/Ascension Health Care
02.2013 - 05.2022
RN - Surgical Consultant & Coordinator - Staff
Hale Vision Center/WELC Wisconsin Eye Laser Center
06.1997 - 06.2013
Bachelor of Science - Nursing
University of Wisconsin - Oshkosh