MAHADEVI JADONATH
Winter Garden,FL
Summary
Proven history of success in optimizing patient care as well-qualified and experienced Case Manager. Minimize hospital stays through detailed focus on internal systems and individual patient needs. Focused on boosting utilization and department operational efficiency.
Overview
9
9
years of professional experience
Work History
Acute Case Manager
WellMed Medical Management - United Health Group
09.2024 - Current
- Contributed to cost savings through effective utilization review and negotiation of services such as SNF, LTACH, and ARU for patients.
- Prioritized caseload effectively, addressing urgent matters promptly while still managing ongoing responsibilities with a high degree of professionalism.
- Managed high-risk cases proactively, addressing potential complications before they escalated.
- Reduced hospital readmission rates by providing thorough discharge planning from hospital admission and follow-up care coordination 30 days post discharge.
- Maintained professional competence by staying current on industry trends, best practices, and regulatory requirements specific to utilization review nursing.
- Participated in weekly length of stay meetings to collaborate with peers on discharge planning barriers.
- Worked with MCG for utilization review to complete hospital continued stay reviews and initial reviews for LTACH and ARU.
Population Health Nurse Case Manager
WellMed Medical Management - United Health Group
11.2021 - 09.2024
- Educates patients and caregivers post discharge on healthcare protocols, medications, and processes.
- Develops and modifies patient care plans and assists interdisciplinary team in identifying client needs and goals to determine priorities of care.
- Collaborates with healthcare leaders and physicians to support and offer resources in performance of duties to maintain high-quality and efficient patient care.
- Gathers and records patient health information and data to assess, identify and manage characteristics that affect care outcome.
- Evaluates healthcare needs, goals for treatment and available resources of each patient and connected to optimal providers and care.
- Assesses and examines patients and documents history of current and previous conditions, diseases and injuries along with medications currently being taken.
- Takes an active role in patient and family planning process, detailing instructions and responding appropriately and effectively to questions and concerns.
RN Case Manager
Orlando Health South Lake Hospital
09.2018 - 11.2021
- Promotes and facilitates effective management of hospital resources from admission to discharge, collaborating with the assigned clinical team to identify patient most likely to benefit from care coordination services to include assessing patients' risk factors and the need for care coordination, clinical utilization management and the transition to the next appropriate level of care.
- Ensures compliance with all regulatory standards with review requirements for Managed contracts, Medicare, Medicaid, and Campus related to admission and continued stay approval.
- Communicates appropriately and timely with the interdisciplinary team and third party.
- Develops, collaborative relationships with patient business, nursing, physicians, and patient/family to facilitate efficient movement through continuum of care.
- Initially and concurrently assess all patients within assigned population to include but not limited to: Medical necessity training, assignment of initial DRG, leading/facilitating Complex Case review, identification/documentation of avoidable days, managing concurrent disputes, and making appropriate referrals.
- Completed initial utilization reviews in the emergency room using InterQual and Milliman programs.
Surgical Care Unit Registered Nurse
Orlando Health
07.2017 - 09.2018
- Assess patients of all ages, adolescent-late adult, admitted to the Surgical Care Unit, using interviewing, observation, and physical examination skills
- Provide nursing care based on identified nursing diagnoses and patient problems/needs
- Administer ordered treatments and medications
- Anticipate and initiates appropriate actions in an emergency
- Use and maintain medical equipment correctly and safely
- Provide patient education and emotional support regarding care/treatment/diagnostics
- Analyze vital signs, labs, and diagnostic results
- Seek professional growth via participation in relevant educational activities
Heart of Florida Regional Medical Center
08.2016 - 02.2017
- Functioned in the role of an RN under the supervision of an RN preceptor providing comprehensive care to patients and their families experiencing acute medical-surgical health alterations
Education
Associate of Science - Nursing
Concorde Career Institute
02.2017
Bachelor of Science - Nursing Education
Chamberlain University
Downers Grove, IL10.2020
Skills
- Supervision
- Strong clinical judgment
- Documentation proficiency
- Utilization Review
- Progress evaluations
- Regulatory compliance
- Charting and clinical documentation
- Treatment planning
- Interdisciplinary collaboration
- Chronic disease management
Additional Information
- ADDITIONAL INFORMATION, Registered Nurse in Florida, License number 9460811, 2017
Timeline
Acute Case Manager
WellMed Medical Management - United Health Group
09.2024 - Current
Population Health Nurse Case Manager
WellMed Medical Management - United Health Group
11.2021 - 09.2024
RN Case Manager
Orlando Health South Lake Hospital
09.2018 - 11.2021
Surgical Care Unit Registered Nurse
Orlando Health
07.2017 - 09.2018
Heart of Florida Regional Medical Center
08.2016 - 02.2017
Associate of Science - Nursing
Concorde Career Institute
Bachelor of Science - Nursing Education
Chamberlain University
Similar Profiles
ELIZABETH BALANELIZABETH BALAN
Registered Nurse Supervisor at WellMed Medical Management - United Health GroupRegistered Nurse Supervisor at WellMed Medical Management - United Health Group
Jean StephensJean Stephens
Regional Systems Consultant at WellMed Medical Management - United Health GroupRegional Systems Consultant at WellMed Medical Management - United Health Group
Lisa MorganLisa Morgan
Sr. Trainer at WellMed Medical Management - United Health GroupSr. Trainer at WellMed Medical Management - United Health Group