MARY E. MATTIOLI
Stokesdale,NC
Summary
RN case management professional with a strong background in utilization review, discharge assessments, and care coordination across complex cases. Brings critical thinking, clear communication, and experience working with health plan members, providers, and care teams to support informed decisions and continuity of care.
Overview
16
16
years of professional experience
Work History
RN Case Manager-Fully Insured
UHG
Minneapolis, Minnesota
2023.09 - 2025.05
- Coordinated telephonic case management for UHG health plan members.
- Reviewed medical records for utilization and care planning.
- Collaborated with physicians, social workers, and case management teams.
- Documented assessments, interventions, and care plans in electronic records.
- Educated members on treatment options, medications, and self-care.
- Participated in team meetings to discuss treatment options for complex cases.
- Provided education and counseling on health promotion, risk reduction strategies, disease prevention and self-care techniques to patients and their families.
- Utilized critical thinking skills when assessing new information or changes in a patient's condition.
- Evaluated effectiveness of treatments provided by consulting specialists or other providers involved in a patient's care plan.
RN-Case Manager
Enhanced TCM Program UHG
2021.04 - 2023.09
- Supported launch of advanced TCM program by making outbound calls to members before hospital discharge and within 30 days after discharge.
- Provided discharge teaching, including questions to ask at discharge, contact details for PT, OT, DME, transportation home, and medication pickup.
- Coordinated care through submission of referrals to Behavioral Health, Life Solutions, Pharmacy, Social Worker, and Medical Director to ensure comprehensive support.
- Delivered at-home education on complex medical conditions and conducted post-discharge and disease management assessments, along with Milliman and InterQual guideline reviews, to empower patients in their recovery.
- Conducted post-discharge assessments to evaluate patient recovery and identify management needs, enhancing continuity of care.
- Applied Milliman and InterQual guidelines to assess patient eligibility for services.
- Manager Ashley Marshall
RN Case Manager
Engagement Team UHG
2018.02 - 2021.04
- Working in the dialer for inbound calls for members in need, assessing members' needs, making referrals as needed and transferring member to a separate queue within ICUE to be assigned to a permanent Case Manager to follow their needs.
- Also working outbound calling members who had previously called in for assistance and there was not an RN able to take the call, assessing members' needs, making referrals as needed and transferring member to a separate queue within ICUE to be assigned to a permanent Case Manager to follow their needs.
- Manager Beth Lopez
RN-Case Manager
Optum Medicare
2015.01 - 2018.02
- Case Management for selected members with AARP Ship Medicare
- Conducted assessments to evaluate member needs, teaching requirements, and referral options, facilitating collaboration with pharmacists, medical directors, and social workers.
- Proactively assessed member needs to secure assistance before situations worsened, enhancing preventative care.
- Identified gaps and barriers in treatment plans, implementing strategies to address and close those gaps.
- Performed medication reconciliation to identify discrepancies and improve patient safety.
- Making outbound calls to providers as needed.
- Collaborate with Medical Directors, Pharmacists and Social Workers
- Manager Megan Takashige
Registered Nurse
Novant Health Medical Center
Forsyth
2009.07 - 2015.01
- Admission and discharge planning for new mothers and babies to floor and home
- Administered prescribed medications, closely monitoring for side effects and adverse reactions to ensure patient safety.
- Assessed mothers for bleeding and pain, supported infant feeding with both breast and bottle to promote maternal and infant wellbeing.
- Evaluated patient Plan of Care to ensure adherence to comprehensive treatment guidelines, enhancing patient outcomes.
- Administered influenza and tetanus with routine vaccinations.
Education
Certified Case Management -
Certified Case Manager
2018-09
Associate of Science - Registered Nurse
Guilford Technical Community College
Jamestown, NC2009-05
Skills
- Utilization Management experience
- Managed Care Experience
- Knowledge of Medicare and Medicaid
- Familiar with Milliman Care Guidelines
- Familiar with InterQual
- Clinical information collection
- Medication Management
- Proficient in Microsoft Office
- Telephone communication with providers
- Written and verbal communication
- Strong organizational skills
- Ability to work independently at a high pace
- Ability to work independently and collaborate with others
- Collaboration with Medical Directors
- Critical thinking skills
Personal Information
Title: Registered Nurse Case Manager
Timeline
RN Case Manager-Fully Insured
UHG
2023.09 - 2025.05
RN-Case Manager
Enhanced TCM Program UHG
2021.04 - 2023.09
RN Case Manager
Engagement Team UHG
2018.02 - 2021.04
RN-Case Manager
Optum Medicare
2015.01 - 2018.02
Registered Nurse
Novant Health Medical Center
2009.07 - 2015.01
Certified Case Management -
Certified Case Manager
Associate of Science - Registered Nurse
Guilford Technical Community College