MARY E MYTON
Dundee
Summary
Detail-oriented Care Manager specializing in patient assessments and care coordination. Proven success in clinical documentation and regulatory compliance, enhancing patient outcomes. Strong communicator with a commitment to building relationships and implementing effective care plans.
Overview
18
18
years of professional experience
1
1
Certification
Work History
Independent Contractor
Home Health RN
06.2025 - Current
- Currently work as Home Health RN independent contractor with families to assist with home health needs.
- Doctor appointment's, medication management administration and other healthcare networking as needed to facilitate quality of life care needs for patients and their families.
RN UM/SR Care Manager
Legacy Health
Portland
11.2018 - 10.2023
- Audited charts and reviewed clinical documents to verify accuracy.
- Reviewed patient admissions for inpatient versus outpatient level of care thru ED admissions.
- Evaluated EMR for legacy and other outside facilities regarding medical determination for hospital bed status based on legacy and/OR CMS policy.
- Maintained certifications/education as needed for Care management including CPR and continuing education per hosp mandates.
- Current vaccination records including COVID.
- Reviewed and monitor hosp patients via remote access for admission and continued stay.
- Also Reviewed hosp surgical pre admit requests for IP vs OBS bed status.
- Conducted accurate chart updates in computer system.
- Worked closely with physicians, surgeons and nursing staff as part of unit team.
- Maintained accurate records and charted consistently in EHR system.
- (EPIC,CORTEX) Delivered evidence-based, cost-effective care following facility policies.
- Legacy Health is a healthcare organization providing a range of medical services.
RN Case Manager II
Healthnet of Oregon
Tigard
04.2012 - 06.2018
- I began working as a Temp fill position at Healthnet, this position became full time permanent in March 2013, in Concurrent review case management for Medicare patients.
- I had previously worked as a Resident care manager in skilled nursing facilities doing care management as well as CMS MDS assessments and submissions.
- While in this position I was tasked to work CA members as well as Oregon and Washington.
- My job set included doing all reviews for current and continued stay for both in state and out of state of admissions.
- Repatriation when applicable and coordinating emergent transportation auths for acute care patients.
- I regularly Coordinated care conversations with Case managers at all facilities and participated in Regular medical level of care rounds with medical director.
- My Duties also included sending to medical director for secondary review when failing to meet criteria for continue stay and Processing denial process when directed to by Medical Director.
- I have been working remotely and am familiar with epic other electronic media formats currently in use.
- Healthnet uses IQ as a Review criteria which I used daily.
- I was responsible to maintain familiarity with and follow all state and federal guidelines as mandated for Members rights in regard to their healthcare benefit.
- Healthnet of Oregon provides health insurance and care management services.
RN Case Manager
Kelly Healthcare
04.2012 - 03.2013
- Working for Healthcare insurance company as care manager II providing Prior auth and concurrent review for member involved in medicare advantage program.
- Duties include patient information review and clinical assessment to determine Mbr eligibility.
- Mbr review is based on review using established CMS and company guidelines.
- Referral to medical director for review when appropriate for secondary review.
Agency RN
Star Nursing
08.2011 - 01.2012
- As an agency relief RN I was hired to fill vacancies for the Oregon State Hospital for the mentally ill.
- I floated to fill daily vacancies on the forensic locked units in moderate and maximum security.
- These patients were ORS 370 patients pending trial with evaluation for competency and PRSB(psyche review and revocation board) revocation patients.
- The patients in this facility were within intensive care and treatment for acute psychiatric conditions and were under 24 hour care and observation.
- This facility operated under state and federal guidelines for care.
Resident Care Manager RN
French Prairie Care Center
03.2010 - 07.2011
- My responsibilities at FPCC as Resident Care Manager included coordinating all aspects of patient care from admission thru discharge, MDS planning and scheduling, coordinating completion times with other IDT members and managing MDS to optimize patient goal outcomes with Rehab.
- My duties also include evaluating and assessing Residents for changes in condition and effectiveness of treatment outcomes.
- I am also responsible for planning and producing monthly MDS schedules and updating weekly timelines for completion.
- As RCM at FPCC my duties were also responsible for coordinating, originating, coding and completion of MDS for federal and state compliance.
- Networking with and frequent contact with Clinical nurse manager and MDS coordinator at corporate level to ensure optimal timeliness and compliance with MDS process.
- My duties included completing in timely fashion all reports associated with patient care including incident investigations and consultant reports.
- I attended regularly meetings associated with compliance for patient care including care conferences, psychotropic review, Nutrition at risk, Medicare case management and rehab, also as part of the IDT attendance at QI review of facility goals and compliance.
- My duties also included networking extensively with other professional services providing care to our patients in facility-i.e.
- Hospice As RCM, I was responsible for completing assessments, creating and monitoring care plans, coordinating care needs with MD appts., specialist and other Medical procedures.
- Managing and educating staff to specific resident needs and family specific requests.
- My duties required that I think outside the box much of the time to ensure that the complete resident needs were being addressed and that possible problems were monitored for prior to coming to fruition.
- Weekend rotations on call were required as well as frequent after hour or weekend work to ensure timely completion of MDS and assuring continuity of planned care through all shifts in the absence of DNS I was asked at times to act as ADON on call.
RN Resident Care Manager
Life Care of McMinnville
01.2008 - 03.2010
- As a Registered Nurse/ Resident Care Manager my duties in this long term skilled nursing facility included all aspects of patient care.
- My duties included working shifts as necessary to provide skilled nursing care for patients that were receiving rehab services post discharge from the hospital.
- As a nurse manager I was responsible for implementing programs to ensure compliance with state and federal guidelines in nursing home care.
- I supervised CNA'S, Medication Aides and other licensed staff to ensure program compliance and that patient safety was maintained.
- I developed training protocols for staff to enhance patient care and participated in staff in-services.
- As an RCM, managing patient and family needs to ensure optimal quality of life occupied the majority of my working hours.
- I wrote and implemented care plans as well as documentation to ensure accurate MDS recording.
- My position included assessing and completing all documentation for the MDS as well as updating care plans as necessary to reflect changes in patient condition.
Registered Nurse
Roselinn Care Center
08.2008 - 03.2009
- While at Rose Linn Care I worked as weekend shift charge working double shifts Sat Sun.
- This is a locked gero-psyche facility that had a capacity of 72 residents.
- As Shift charge on the weekend my duties included providing all aspects of patient care and monitoring to ensure safety.
- I was responsible for all documentation over the course of both of these shifts to maintain compliance with state/federal guidelines for nursing home care as well as facility documentation criteria.
- I supervised over the course of each day 20-22 CNA's, 1 CMA and 1 Licensed Nurse who worked a split shift doing treatments.
- My duties also included treatment care prior to and after the LN left for the day.
- If no Treatment Nurse was available it was my responsibility to ensure that all treatments were completed in addition to my other duties.
- This position required that I monitor the status of 70 patients daily to ensure that any changes were quickly identified and that the appropriate healthcare providers were contacted.
- I was responsible for identifying change, notifying MD's, getting orders, documenting and then implementing those order to ensure that any emergent issues were treated quickly.
Education
Associate Degree - Nursing: Medicine
Apollo College-Phoenix Inc
Phoenix, Arizona11-2007
Skills
- Medication management
- Patient assessments
- Care coordination
- Clinical documentation
- Patient advocacy
- Care management
- Regulatory compliance
- Problem solving
- Physician collaboration
- Fall prevention
- Direct patient care
Certification
- OSBN RN License, 12/2027
- AZBN RN License, Inactive
Languages
English
Timeline
Independent Contractor
Home Health RN
06.2025 - Current
RN UM/SR Care Manager
Legacy Health
11.2018 - 10.2023
RN Case Manager II
Healthnet of Oregon
04.2012 - 06.2018
RN Case Manager
Kelly Healthcare
04.2012 - 03.2013
Agency RN
Star Nursing
08.2011 - 01.2012
Resident Care Manager RN
French Prairie Care Center
03.2010 - 07.2011
Registered Nurse
Roselinn Care Center
08.2008 - 03.2009
RN Resident Care Manager
Life Care of McMinnville
01.2008 - 03.2010
Associate Degree - Nursing: Medicine
Apollo College-Phoenix Inc