Laura Bagwell
Smyrna,TN
Summary
Accomplished and performance-driven healthcare professional with proven extensive background in top-quality healthcare service delivery, team leadership support, operations, compliance, utilization, and medical care management programs. Documented success and comprehensive experience in inpatient care, endoscopy, home health care, inpatient behavioral health, and choices program care coordination. Highly organized and forward-thinker; instrumental in producing high quality, patient-focused cost-effective, and responsive healthcare services within fast-paced inpatient and outpatient clinic setting to ensure patient and staff satisfaction in support of predefined mission and goals. Capable of managing and coordinating case management, utilization review, quality management, and community health service program. Specialized in scheduling staff assignments, supporting standardized healthcare plans, finding ways to improve efficiency, and collaborating with executives, physicians, and cross-functional teams to ensure high-quality healthcare service delivery.
Overview
16
16
years of professional experience
1
1
Certification
Work History
RN Care Manager
Belong Health ACO REACH
08.2024 - 03.2026
- Care Manager for Transitions of Care for patients discharged from Inpatient hospitalizations, ED visits or post acute rehab. Contact beneficiaries to review DC information, follow up care, medication review, barriers to care and care plan creation and provide follow up calls weekly to ensure a safe, stable DC with continued improvement. Participate in IDT meetings to discuss the course of treatment and ensure the patient is treated holistically. Work with providers via EMR for updates or needs.
- Developed comprehensive care plans to enhance patient outcomes and ensure continuity of care.
- Coordinated multidisciplinary team meetings to address complex patient needs and optimize treatment strategies.
- Implemented evidence-based practices to improve quality of care and reduce hospital readmissions.
- Advocated for patients' needs within healthcare systems, ensuring access to necessary resources and services.
RN
Elevance Health-Carelon
03.2023 - 08.2024
- Manage and critically review phone calls to ensure compliance with processes. Use attention to detail skills in tracking and analyzing audit reports and corrections after staff reviews or corrects errors. Coordinate with team to perform pre-auth clinical reviews for multiple health plans while ensuring pivoting between all health plans as required.
- Directed and motivated high-performing team of RNs and LPNs as Utilization Management Team Lead to review and navigate home health agency requests for producing exceptional home healthcare services.
- Delivered leadership and visionary approach to assess and monitor team productivity while conducting one on one reviews.
- Beginning in March of 2023 transitioned as TL to new STARS program (Carelon Medical Benefits Management) Trained new team members that included nurses and social workers on importance of Medicare STAR rating, process for contacting members identified by Anthem that were recently admitted to the hospital or had an ER visit. Participated in creating processes and workflows for the program as it evolved.
- Acted as subject matter expert while providing positive feedback, guidance, and support to healthcare team through orders verification, secondary reviews, or interpretation of home health frequencies.
RN Team Lead
Mynexus
Brentwood, TN
03.2017 - 03.2021
- Manage and critically review phone calls to ensure compliance with processes. Use attention to detail skills in tracking and analyzing audit reports and corrections after staff reviews or corrects errors. Coordinate with team to perform pre-auth clinical reviews for multiple health plans while ensuring pivoting between all health plans as required.
- Directed and motivated high-performing team of RNs and LPNs as Utilization Management Team Lead to review and navigate home health agency requests for producing exceptional home healthcare services.
- Delivered leadership and visionary approach to assess and monitor team productivity while conducting one on one reviews.
- Acted as subject matter expert while providing positive feedback, guidance, and support to healthcare team through orders verification, secondary reviews, or interpretation of home health frequencies.
- Credited with completing BSN certification.
Caregiver, Family, Natural Supports
ANTHEM (Amerigroup)
Nashville, TN
08.2014 - 03.2017
- Served as long-term service support care coordinator to a group of Medicaid members. Took full ownership to navigate overall management of member’s case. Partnered with members, caregivers, family, natural supports, and physicians to determine, plan, and set short-and long-term goals.
- Displayed big picture acumen in identifying members at high risk for complications while actively coordinating healthcare plan/case with member and healthcare team.
- Offered efficient utilization of health benefits and cost-effective healthcare solutions to members experiencing chronic illnesses, co-morbidities, or disabilities.
- Developed patient-centric individual care plan by collecting and documenting thorough patient history with precision.
- Known for consistently meeting/exceeding goals and expectations in compliance with institutional needs and job requirements.
Registered Nurse
Rolling Hills Hospital Franklin
RN
05.2014 - 08.2014
- Delivered expert-level mental, emotional, and behavioral support while serving as RN on general psychiatric and geriatric psychiatric floor. Developed and documented patient’s care chart while proactively reporting any changes or needs as assigned by MD or Psychiatrist.
- Specialized in assessing, providing prescribed treatments, and monitoring mental, emotional, and behavioral disorders of assigned patients.
- Employed multitasking, pressure handling, and time management skills in conducting assessment on assigned group of patients in each shift, administering medications, and monitoring care plan impact, effectiveness, or adverse effects.
Registered Nurse
Trustpoint Hospital Murfreesboro
TN
08.2013 - 05.2014
- Offered high-quality care to assigned patients at geriatric psychiatric floor with assessment, monitoring, and prescribed treatment. Coordinated various assignments, such as patient assessment, administered medications and supervised care plan effectiveness, or adverse effects.
Home Health RN
Home Healthcare of Middle Tennessee Murfreesboro
TN
03.2010 - 05.2013
- Acquired and deployed personal development skills in disease process education and monitoring, medications, wound care, IV administration, lab draws, and liaison with patient’s doctor as needed for updates. I pursued and received wound care certification.
- Executed comprehensive OASIS assessment for development and initiation of care plan, recertification, and discharge on patients admitted for home health.
- Actively contributed to high-quality healthcare service delivery by acquiring, documenting, and communicating patients’ medical histories to service providers.
Education
Bachelor of Science Nursing -
Western Governors University
01-2017
Associate Degree - Nursing
Motlow State Community College
01-2007
Skills
- Medical Services & Operations Management
- Healthcare & Patient Management
- Health Care Plans Implementation
- Training, Collaboration & Leadership
- High-Volume Workloads Management
- Process Improvement & Optimization
- Health & Safety Compliance
- Clinical preceptor
- Quality Assurance
- Care Management
- Compliance Management
- Relations Building
Accomplishments
April 2026 Passed CCM exam (pending certification)
Certification
RN Licensed in California, Connecticut, New York, Tennessee and Oregon
Timeline
RN Care Manager
Belong Health ACO REACH
08.2024 - 03.2026
RN
Elevance Health-Carelon
03.2023 - 08.2024
RN Team Lead
Mynexus
03.2017 - 03.2021
Caregiver, Family, Natural Supports
ANTHEM (Amerigroup)
08.2014 - 03.2017
Registered Nurse
Rolling Hills Hospital Franklin
05.2014 - 08.2014
Registered Nurse
Trustpoint Hospital Murfreesboro
08.2013 - 05.2014
Home Health RN
Home Healthcare of Middle Tennessee Murfreesboro
03.2010 - 05.2013
Associate Degree - Nursing
Motlow State Community College
Bachelor of Science Nursing -
Western Governors University
Additional Experience
- Med/Surge and Endoscopy at Stonecrest Medical Center, Smyrna, TN (08/2008 – 03/2010)
- Med/Surge and Diagnostic Lab at Middle Tennessee Medical Center, Murfreesboro, TN (05/2007 – 09/2008)