Linda Davidson
Bridgewater,MA
Summary
Committed and qualified nurse case manager seeking a full-time position that offers professional challenges utilizing interpersonal skills, excellent time management and problem-solving skills in order to plan, coordinate and transition a patient through the health care system where all their medical needs can be met at the appropriate level of care
Overview
30
30
years of professional experience
Work History
Utilization Case Manager
Tufts Medical Center
07.1998 - 04.2024
- Used InterQual and MCG Criteria in determining medical necessity for observation, admission and continued stays
- Worked within Medicare Guidelines to identify patients appropriate for the use of the Medicare 2 midnight benchmark, those in need of being issued a MOON or to have their clinical reviewed by the Medicare PA to determine if CODE 44 criteria is met
- Identified and discussed cases with attending physicians that do not meet criteria and/or have adequate documentation of medical necessity to warrant acute hospitalization
- Built a successful rapport with the case managers at the insurance companies
- Timely managed denials for in patient level of care by initiating peer to peer conversations between the attending physician and the payor's medical director
- Performed continued stay reviews with criteria to support the need for continued acute care treatment while providing updated clinical to payors in order to obtain maximum reimbursement with additional authorized days
- Attended biweekly multidisciplinary length of stay meetings which included discharge planners, social work, finance and leadership in order to identify and plan for the potential barriers a patient my encounter with regards to a to a safe and timely discharge to the next level of care
- Precepted and was a knowledgeable resource to new members to the Utilization team
Clinical Leader, Adult Endoscopy
Tufts Medical Center
02.2014 - 10.2019
- Assisted with day-to-day operations of a dynamic tertiary care endoscopy suite while working efficiently and productively with all team members.
- Worked effectively in fast-paced environments.
- Scheduled and assigned staff to meet patient care needs and address productivity standards, while adjusting for procedural census, skill mix and staffing .
- Cooperated and extensively communicated with care team including physicians, anesthesia providers, nursing and support staff to provide excellent and timely patient centered care
- Collaborated with Infection Control to diligently monitor the QA of materials and scope reprocessing to prevent patient infection
- Knowledgeable fo DPH and JCAHO standards while actively participated in hospital preparation for inspection
Endoscopy Staff Nurse
Tufts Medical Center
02.2005 - 02.2014
- Performed patient assessment, VS monitoring, IV insertion and other routine procedures and documented in electronic medical record to support interdisciplinary care.
- Monitored patient reactions after administering medications and IV therapies.
- Optimized patient recovery time by monitoring vital signs during post-procedure care and providing appropriate interventions as needed.
- Recovered patient from anesthesia to perform discharge teaching.
- Educated family members and caregivers on patient care instructions.
Staff Nurse, Medical Intensive Care Unit
Tufts Medical Center
07.1998 - 02.2005
- Exhibited strong critical thinking skills when assessing complex medical situations and determining appropriate interventions.
- Provided exceptional care to high-acute patients needing complex care such as ventilator management, extensive wound care and rehabilitation.
- Demonstrated excellent time management skills while juggling multiple priorities in a fast-paced environment.
- Developed strong rapport with patients and families, fostering trust and open communication during challenging times.
- Mentored new nursing staff, supporting their professional growth and development.
Staff Nurse
New England Sinai Hospital
08.1994 - 06.1998
- Collaborated with multidisciplinary healthcare professionals to create, implement and adapt individualized plans of care to restore a patient's health and drive recovery
- Voluntarily reassigned to Tufts Medical Center in Boston with the purpose to staff and support the establishment of the organization's satellite unit
Education
Bachelor of Science - Nursing
Curry College
Milton, MA06.1998
Associate of Science - Nursing
Brockton Hospital School of Nursing
Brockton, MA05.1994
Skills
- Case Management
- Utilization Management
- Proficient in EPIC
- Interdisciplinary Collaboration
- Organization and Time Management
- Multitasking Abilities
- Relationship Building
- Critical Thinking
- Positive Attitude
- Certified in CPR/AED
Timeline
Clinical Leader, Adult Endoscopy
Tufts Medical Center
02.2014 - 10.2019
Endoscopy Staff Nurse
Tufts Medical Center
02.2005 - 02.2014
Utilization Case Manager
Tufts Medical Center
07.1998 - 04.2024
Staff Nurse, Medical Intensive Care Unit
Tufts Medical Center
07.1998 - 02.2005
Staff Nurse
New England Sinai Hospital
08.1994 - 06.1998
Bachelor of Science - Nursing
Curry College
Associate of Science - Nursing
Brockton Hospital School of Nursing