Lauren Madden
Fort Worth,TX
Summary
Accomplished Registered Nurse Case Manager with 10 years of experience dedicated to quality care of diverse patients. Skillfully blend hands-on skills with advanced background in acute care settings. Work effectively with all levels of healthcare providers, physicians and administrators to address patient needs.
Overview
11
11
years of professional experience
Work History
RN Case Manager PRN
Baylor Scott And White Medical Center
02.2021 - Current
- Participated in patient and family planning process, as well as provided instructions and addressed question and concerns.
- Discusses with physicians the appropriateness of resource utilization, consultations, treatment plan, estimated length of stay and discharge plan
- Develops comprehensive discharge plans to transition clients to appropriate service providers in community.
- Ensures the interdisciplinary care plan is consistent with the patient's clinical course, continuing care needs and covered services by monitoring diagnostic testing, treatments and procedures, data, and other aspects of patient care as appropriate for acute care.
- Coordinates with insurances, Skilled nursing facilities, acute rehab units, home health, and DME companies upon discharge.
- Partners with physicians, social workers, therapists, nutritionists, and case managers to develop and implement individualized care plans and documented patient interactions and interventions in electronic charting systems.
RN Travel Case Manager
Harmony Healthcare
10.2021 - 03.2023
- Collaborate with insurance companies and insurance case managers to obtain authorization for needed services for care inpatient and post acute.
- Advocated for patients by communicating care preferences to practitioners, verifying interventions met treatment goals and identifying insurance coverage limitations.
- Completed initial assessments of patients and family to determine and address individual home care needs. ·
- Worked with suppliers and vendors on provision of medical equipment, items and services.
- Ensure continuity of care through communication in rounds and written documentation.
- Communicated with healthcare team members to plan, implement and enhance treatment strategies.
- Obtained authorizations from multiple insurance carriers for various levels of care.
- Performed admission reviews based for medical necessity based upon Interqual specification.
- Offered exceptional care and support to individuals recovering from acute incidents and dealing with chronic conditions.
- Coordinate the transfer of patients to tertiary centers, including the transfer of patient information required for continuity of ongoing treatment services.
- Evaluate patients for appropriate utilization of services and diagnostic related group (DRG) maximization.
RN Case Manager
Parkland Hospital
10.2018 - 11.2021
- Created patient assessments and plans for individual home care needs.
- Examined patients and documented history of current and previous conditions, illnesses, injuries and current medications.
- Submitted cases for criteria failures and helped facilitate resolutions and approvals.
- Performed admission reviews based for medical necessity based upon Interqual specification.
- Performed prior authorization review of services requiring notification.
- Evaluated medical guidelines and benefit coverage to determine appropriateness of services.
- Offered exceptional care and support to individuals recovering from acute incidents and dealing with chronic conditions.
Psychiatric Intake Nurse
Sundance Behavioral Hospital
10.2017 - 12.2018
- Collaborated closely with mental health professionals with treatment plan implementation.
- Coordinated with medical and paramedical professionals to provide appropriate input and effectively formulate and implement treatment plans for patients.
- Recommended continuing care and medications to clients and communicated with family members on treatment and discharge plans.
- Supported patient confidentiality in accordance with HIPAA regulations.
- Monitored patient behavior and immediately reported changes to supervising physician.
RN Case Manager Home Health
Ally Home Health Care
07.2014 - 09.2017
- Monitored patient reactions after administering medications and IV therapies.
- Introduced changes to patient care plans based on regular evaluations and patient changes.
- Monitored vital signs, developed and implemented care plans, and documented patient progress.
- Managed patients recovering from medical or surgical procedures.
- Documented treatments delivered, medications and IVs administered, discharge instructions, and follow-up care.
- Advised and coached patients progressing from hospitals, rehab facilities, and other medical organizations to at-home treatment settings.
- Worked with multidisciplinary team to carry out successful treatment plans for diverse acute and chronic conditions.
- Determined and addresses individual home care needs by completing detailed assessments and reviewing documentation.
RN Charge Nurse
The Stayton At Museum Way
01.2012 - 05.2016
- Trained new nurses in proper techniques, care standards, operational procedures, and safety protocols.
- Supervised and managed daily scheduling, tasking, and administration.
- Coordinated nursing care on unit through staff assignments, assisting and rounding with physicians, monitoring patient orders, and communicating with ancillary departments.
- Monitored nursing care, patient assessment processes, and treatment implementations.
- Implemented medication and IV administration, catheter insertion, and airway management.
- Effectively prioritized assignments, executing care based on each patient's relative condition and delegating tasks to available personnel deliver safe and efficient care.
- Performed various nursing interventions such as wound dressing, vital sign monitoring, and specimen collection.
Education
Bachelor of Science - Nursing
The University of Texas At Arlington
Arlington, TX12.2018
Associate of Science - Nursing
Navarro College
Corsicana, TX05.2013
Skills
- EMR Systems (EPIC, Cerner, Midas, & Meditech)
- Determine Medical Necessity
- Benefits Guidelines
- InterQual Criteria
Licensure
Texas- RN
California- RN
Timeline
RN Travel Case Manager
Harmony Healthcare
10.2021 - 03.2023
RN Case Manager PRN
Baylor Scott And White Medical Center
02.2021 - Current
RN Case Manager
Parkland Hospital
10.2018 - 11.2021
Psychiatric Intake Nurse
Sundance Behavioral Hospital
10.2017 - 12.2018
RN Case Manager Home Health
Ally Home Health Care
07.2014 - 09.2017
RN Charge Nurse
The Stayton At Museum Way
01.2012 - 05.2016
Bachelor of Science - Nursing
The University of Texas At Arlington
Associate of Science - Nursing
Navarro College
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