Kristen Moore
Selma,NC
Summary
Experienced healthcare professional prepared for this role with strong emphasis on patient care and clinical skills. Proven ability to work collaboratively within multidisciplinary teams, adapting to changing situations with ease. Excels in communication, empathy, and problem-solving to achieve optimal patient outcomes. Reliable and results-driven, with focus on delivering high-quality care and maintaining positive, supportive environment.
Overview
20
20
years of professional experience
Work History
Population Health Nurse
Aledade
11.2024 - Current
- Manages Population Health initiatives to support our practice’s success in providing value-based care for patients in our Aledade ACO contracts.
- Quarterbacks core Population Health initiatives, including: Daily huddle workflows for pre-visit planning, care gap closure, and resolution of suggested diagnoses; conducting registered nurse components of Annual Wellness Visits and Transitional Care Management; managing outreach to prioritized patients on Aledade worklists (e.g., Wellness, Transitions of Care, Emergency Department follow-up, Care Gap closure, Uncontrolled Blood Pressure, Uncontrolled Diabetes).
- In clinic and telephonic patient care to promote wellness and disease management within the defined patient population (Annual Wellness Visits, Transitional Care Management and Chronic Disease Management, etc).
- Assists Aledade Product Team as a thought-partner for development of future iterations of the Aledade App to better engage CHCs
- Uses an evidence-based, data-driven approach to optimize Population Health outcomes.
- Mentors, coaches, and collaborates with key practice team members to execute Population Health strategies
- Assists in physician, advanced practice registered nurse (APRN, e.g., NP), physician assistant (PA), and office staff education regarding Population Health initiatives
- Identifies opportunities for continuous Population Health improvement, develops related plans of action, and implements process and documentation improvements
- Demonstrates commitment to providing outstanding customer service in a manner that is reflective of our mission, values, and customer service standards
- Maintains contact with the Aledade team and participates in collaborative learning opportunities.
- Performs related duties as assigned.
Nurse Case Manager I
Elevance Health
04.2021 - Current
- Perform care management for members with complex and chronic care needs by assessing, developing, implementing, coordinating, monitoring and evaluating care plans designed to optimize member health care across the continuum
- Perform duties telephonically
- Ensure member access to services appropriate to their health needs, conduct assessments and identify individual needs and a specific care management plan to address objectives and goals as identified during assessments
- Implement care plan by facilitating authorizations/referrals as appropriate within benefits structure or through extra-contractual arrangements
- Coordinate internal and external resources to meet identified needs
- Monitor and evaluate effectiveness of the care management and modify as necessary
- Interface with medical directors and physician advisors on the development of care management and treatment plans
- Assist in problem solving with providers, claims or service issues
- Talk and type at the same time
- Demonstrate critical thinking skills when interacting with members
- Work with Microsoft Office and other programs/systems/software
- Ability to learn new computer programs/systems/software quickly
- Manage, review and respond to emails/instant messages in a timely fashion
RN Case Manager
Johnston County Health Department
02.2020 - 01.2021
- RN Care Manager for Early Childhood Care Management Program
- Worked with at risk children ages 0-5
- Received referrals from DSS, WIC, Child Health, pediatricians, parents or other community providers
- Contacted parents to see what the child or family needed such as food, diapers, clothing, baby items, or help with doctor’s appointments, immunizations, child care, therapies, etc
- Used Virtual Health to document all interactions with parents or guardians and created care plans
- Educated parents and guardians about different resources available
- Worked with WIC, DSS, Child Health, Partnership for Children and other community providers to make sure needed resources were provided
- Worked with Crossroads, Epic, Cure MD, Virtual Health and NCIR to review records
- Made referrals to CDSA, Johnston County Pre-K, Head Start, Hope Services, Carolina Home Medical, About Speech, etc as needed
- Met families in WIC, Child Health or at their home and provided needed resources
- Followed up with family on weekly, biweekly or monthly basis and updated care plans as needed
- Graduated children from the program as they had reached their goals and needs had been met
RN Clinical Manager, Private Duty Nursing
Thrive Skilled Pediatric Care
03.2017 - 06.2019
- Managed private duty nursing cases, supervised RN's, LPN's and CNA's
- Trained nurses on electronic medical records documentation system called Kantime
- Completed patient assessments, created care plans in Kantime, performed supervisory visits in the clients home every 30 days, created medication and treatment records in Kantime
- Client admissions and discharges
- Entered data into NC Tracks for Private Duty Nursing approval
- Quality assurance of nurse documentation in Kantime
- Ordered medical supplies for patients through Medline
- In charge of monthly on call schedule with CMS
- Took clinical call on nights and weekends
- Wrote up incident reports
- Completed quarterly employee reviews
- Assisted with interviewing, scheduling and payroll
- Worked with PDN and CAP/C case managers to coordinate care for clients
- Met case managers, clients and families at hospitals to market our services and do opening paperwork
- Submitted orders to physicians for signatures
- Submitted new approvals to PDN for client services every 6 months
- Created new client POC and submitted to MD for signatures every 60 days
- Worked with E-Cap to verify authorizations and uploaded documents
Registered Nurse, Psychiatric
World-Wide Travel Staffing
12.2016 - 03.2017
- Psychiatric RN on adolescent unit at state hospital
- Completed assessments, created care plans, completed discharge paperwork, administered medications, etc
Director of Nursing, Home Care
Grace Healthcare Services, Inc
02.2013 - 11.2016
- Completed admission paperwork, completed assessments, created care plans, performed supervisory visits in client's homes every 90 days, completed discharge paperwork, trained and supervised PNA's, CNA's and PCA's, communicated with case managers from referring agencies for CAP-C and CAP-D cases
- Performed quarterly quality assurance chart reviews and employee reviews
- Ensured employees were in compliance with TB skin tests and CPR, approved time sheets, entered payroll into ADP
RN Clinical Manager, Home Care
Well Care Home Care
01.2015 - 01.2016
- Managed private duty nursing cases, supervised RN's, LPN's and CNA's
- Performed CNA orientations
- Completed assessments, created care plans, created medication and treatment records
- Completed admission and discharge paperwork
- Performed supervisory visits in client's homes every 60 days
- Ordered medical supplies for clients through McKesson
- Trained nurses on vent, trach and G-Tube care
- Worked with McKesson software program
Registered Nurse, Internal Medicine
Raleigh Medical Group
11.2011 - 01.2013
- Roomed patients, obtained vital signs, documented in electronic medical records
- Administered vaccines and triaged patient calls, educated patients, performed EKG's, lab tests and vision screenings
- Called prescriptions to pharmacies and sent refills electronically, assisted physicians, referrals and scheduled appointments
Registered Nurse, Pediatrics
Wake Forest/Knightdale Pediatrics
10.2008 - 09.2010
- Roomed patients, obtained vital signs, documented in charts, triaged calls, administered vaccines, educated patients and parents, administered breathing treatments and performed pulmonary function tests, urinary catheterizations, venipunctures, lab tests, vision and hearing screenings, called prescriptions to pharmacies and assisted physicians with procedures
Registered Nurse, Medical/Surgical
Franklin Regional Medical Center
08.2007 - 10.2008
- Performed charge nurse duties, admitted and discharged patients, assessed patients and documented in charts, administered medications, started IV's, applied and changed wound vacs, educated patients and assisted physicians
Registered Nurse, OB/Gyn
St Alphonsus Medical Group
09.2006 - 08.2007
- Roomed patients, obtained vital signs, documented in charts, administered injections, assisted with pap smears, colposcopies, ultrasounds, amniocentesis, endometrial biopsies, and placing IUD's
- Performed venipuncture's, lab tests
- Triaged patient calls, educated patients and called in prescriptions to pharmacies
Registered Nurse, Allergy
Virginia Adult and Pediatric Allergy and Asthma
05.2005 - 03.2006
- Roomed patients, obtained vital signs, documented in charts, administered allergy skin tests, educated patients, administered breathing treatments, performed pulmonary function tests, called in prescriptions to pharmacies, triaged patient calls and assisted physicians
Education
Associate Degree Nursing - RN
Vance-Granville Community College
Henderson, North CarolinaBachelor of Science - Health Information Management
Boise State University
Boise, IdahoAssociate of Science - Health Information Technology
Boise State University
Boise, IdahoLicense
Registered Nurse, North Carolina, Expires 11/30/25
Timeline
Population Health Nurse
Aledade
11.2024 - Current
Nurse Case Manager I
Elevance Health
04.2021 - Current
RN Case Manager
Johnston County Health Department
02.2020 - 01.2021
RN Clinical Manager, Private Duty Nursing
Thrive Skilled Pediatric Care
03.2017 - 06.2019
Registered Nurse, Psychiatric
World-Wide Travel Staffing
12.2016 - 03.2017
RN Clinical Manager, Home Care
Well Care Home Care
01.2015 - 01.2016
Director of Nursing, Home Care
Grace Healthcare Services, Inc
02.2013 - 11.2016
Registered Nurse, Internal Medicine
Raleigh Medical Group
11.2011 - 01.2013
Registered Nurse, Pediatrics
Wake Forest/Knightdale Pediatrics
10.2008 - 09.2010
Registered Nurse, Medical/Surgical
Franklin Regional Medical Center
08.2007 - 10.2008
Registered Nurse, OB/Gyn
St Alphonsus Medical Group
09.2006 - 08.2007
Registered Nurse, Allergy
Virginia Adult and Pediatric Allergy and Asthma
05.2005 - 03.2006
Bachelor of Science - Health Information Management
Boise State University
Associate of Science - Health Information Technology
Boise State University
Associate Degree Nursing - RN
Vance-Granville Community College