LEAH ROMANO
Summary
Experienced with comprehensive client assessments, ensuring personalized care plans are in place. Utilizes strong communication and coordination skills to effectively manage client services. Track record of fostering positive client relationships and achieving measurable improvements in client well-being.
Results-driven case management professional with track record of effective client advocacy and support. Experienced in conducting thorough assessments and creating individualized care plans to meet client needs. Collaborates seamlessly with multidisciplinary teams and adapts to dynamic situations to ensure optimal client outcomes.
Overview
27
27
years of professional experience
1
1
Certification
Work History
Case Manager/Case Coordinator
Self-employed
05.2002 - Current
- Services Provided
- Legal nurse consulting services – malpractice, individual claims, personal injury, mass torts/class action
- Medical record review/abstraction, preparation of reports
- Cost projections
- Utilization management/utilization review/prior authorization – workers' compensation, health insurance plans, state Medicaid program, Medicare
- Inpatient concurrent review and discharge planning
- Case management (group health & liability claims)
- Disability claim reviews
- Workers' compensation case management (telephonic and field)
- Medical bill review
- Home health care/assessments/hospice triage
- Long-term care and geriatric assessments
- Telephone triage nurse
- Home Office Includes: Windows 11 and High-Speed Internet
- Maintained accurate documentation on all cases, ensuring compliance with regulations and confidentiality requirements.
- Conducted thorough assessments of clients'' situations, identifying issues, goals, and necessary interventions.
- Monitored ongoing cases closely, adjusting case management strategies as needed based on evolving circumstances or new information.
- Educated clients on available programs, benefits, and services, empowering them to make informed decisions about their care needs.
- Enhanced communication between clients and providers through consistent follow-ups and progress updates.
- Achieved positive client outcomes by developing and implementing comprehensive case management plans.
- Advocated for client rights when interacting with external agencies or institutions, ensuring fair treatment at all times.
Nurse Case Manager
Keystone Medical Resources
03.2002 - Current
- Educated patients and caregivers on healthcare protocols and processes.
- Served as a liaison between patients and various support services such as financial assistance programs, community resources, and mental health counseling to ensure holistic care was provided.
- Increased referral rates by providing excellent service and building meaningful relationships with patients and caregivers.
- Managed support services and fostered communication among social workers, therapists, hospital staff, and patients.
- Educated patients on disease management techniques, empowering them to take control of their health and reduce complications.
- Analyzed patient responses to medications, therapies and variances in plans of care.
Nurse Care Coordinator/Case Manager
Occudigm Health - Utah
05.2008 - 03.2024
- Provide telehealth services.
- Responsible for the initial contact and intake, seeking to identify the nature, severity, and acuity level of the employee's condition.
- Interviews the employee and the supervisor and assists them by providing recommendations for an appropriate course of action and follow-up procedures.
- Provided basic first aid recommendations to alleviate symptoms and prevent injury progression.
- Educating and advising employees, providing safe, effective, and appropriate dispositions.
- Complete documentation into the case record.
Supervisor: Medical Management-Workers' Comp
Keenan & Associates - Torrance
04.2000 - 05.2002
- Supervised Workers' Compensation Nurse Case Managers in their dealings with providers, employers, employees and attorneys regarding medical treatment and disability management. Assist Case Managers with difficult cases.
- Liaised with claims management in identifying and refining work process; ensure communication is maintained between the Case Managers, Examiners, and Management.
- Ensured Case Managers utilized established protocols, guidelines and resources.
- Ensure accurate documentation of decision, rationale and resources used in decision-making process in order to facilitate program evaluation and outcomes.
- Developed continuous quality improvement tools and protocols.
- Perform audits and identify quality problems and issues in support of the medical management continuous quality improvement program.
- Updated the training process of new case managers, developed a training/resource manual and developed a workshop/in-service program.
Senior Case Manager/Telephonic Case Manager
Workers' Compensation
07.1999 - 04.2000
- Provided telephonic case management and utilization review for worker's compensation providers, clients, attorneys and injured workers.
- Performed assessment, planning, implementation, coordination, monitoring, and evaluation of injured workers throughout their W/C claim process.
- Facilitated appropriate care, used contracted providers when possible, return to work of on modified duty/regular duty and vocational rehabilitation.
- Negotiated with clients and providers to obtain cost effective treatment plans. Managed caseloads from 60-90 injured workers.
- Trained new case manager; developing and implementing a quality improvement program; and supervising of other case managers in the day-to-day operations.
- (Initially provided this service through Blue Cross on site @ Keenan & Assoc. corporate office from 6/98-6/99-then Keenan & Assoc. took over the management of the medical management operations-was grand fathered in with Keenan & Assoc.)
Workers' Compensation- Telephonic Case Manager
Blue Cross/Wellpoint
06.1998 - 06.1999
- Provided telephonic case management and utilization review for workmen compensation providers, clients, attorneys and injured workers.
- Performed assessment, planning, implementation, coordination, monitoring, and evaluation of injured workers throughout their w/c claim process.
- Facilitated appropriate care, used contracted providers when possible, return to work of on modified duty/regular duty and vocational rehabilitation.
- Negotiated with clients and providers to obtain cost effective treatment plans. Managed caseloads from 60-90 injured workers.
- Previously employed as Case Manager with Prudential Insurance Company of America (10/97-6/98); Utilization Review Nurse with Prudential Insurance Company of America (5/96-10/97); Field Case Manager with Nations Healthcare (8/95-6/98); Floor Nursing with Little Company of Mary Hospital (10/94-8/95); Home Care RN/Liaison Nurse with Centinela Hospital (6/92-1/95); Emergency and Trauma Care Nurse with Daniel Freeman Marina Hospital (10/87-1/92); Staff Nurse with LAC-USC Medical Center (2/86-7/92).
Education
BSN -
University of Phoenix
01.1994
Certificate - Public Health Nurse
Diploma - Nursing
Los Angeles County School of Nursing
01.1986
Skills
- 37 years RN experience
- Medical record review/report preparation
- Case management
- Workers’ compensation
- Utilization review
- Proficient with using InterQual, MCG, ODG, ACOEM Guidelines, MDGuidelines
- Bill review
- Proficient in MS Office Suite and Windows OS
- Telephone triage
- Medical-surgical
- Emergency room
- Home healthcare/Hospice
- Orthopedics
- Cost Projections
- Project management
- Staff management
- Problem-solving
- Time management
- Case documentation
- Active listening
- Organization and multitasking
- Relationship building
- Positive attitude
- Email and telephone etiquette
- Client advocacy
- Care coordination
- Case planning
- Critical thinking
- MS office
- Resource management
- Patient support
- Interdisciplinary collaboration
- Patient assessment
Certification
- Certified Case Manager
- Medical Cost Projections
Affiliations
- The National MSP Network
- American Association of Legal Nurse Consultants
Timeline
Nurse Care Coordinator/Case Manager
Occudigm Health - Utah
05.2008 - 03.2024
Case Manager/Case Coordinator
Self-employed
05.2002 - Current
Nurse Case Manager
Keystone Medical Resources
03.2002 - Current
Supervisor: Medical Management-Workers' Comp
Keenan & Associates - Torrance
04.2000 - 05.2002
Senior Case Manager/Telephonic Case Manager
Workers' Compensation
07.1999 - 04.2000
Workers' Compensation- Telephonic Case Manager
Blue Cross/Wellpoint
06.1998 - 06.1999
Certificate - Public Health Nurse
BSN -
University of Phoenix
Diploma - Nursing
Los Angeles County School of Nursing
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