Melody Clements
Rexford,NY
Summary
Experienced Case Manager adept at handling high caseloads without sacrificing quality of care. Operates in high-pressure environments while recommending and educating on best resources and courses of action to benefit patient needs and return each to optimal quality of life.
Overview
19
19
years of professional experience
1
1
Certification
Work History
Pediatric Care Manager
Healthfirst
03.2021 - Current
- Ensured continuity of care for patients transitioning between healthcare settings by coordinating handoffs among medical professionals.
- Improved patient outcomes by developing and implementing comprehensive care plans for pediatric patients.
- Evaluated the effectiveness of existing care plans and adjusted strategies as needed based on individual patient needs and feedback from healthcare providers.
- Streamlined case management processes by maintaining accurate and up-to-date documentation of patient information.
- Implemented evidence-based practices for optimal patient care, leading to improved clinical outcomes.
- Provided education to family members on various health topics, empowering them to make informed decisions regarding their child''s care.
- Coordinated interdisciplinary team meetings to discuss treatment plans, address concerns, and optimize patient care.
- Reduced hospital readmission rates through diligent monitoring of high-risk pediatric patients and providing ongoing eduucation.
- Partnered with physicians, social workers, activity therapists, nutritionists, and case managers to develop and implement individualized care plans and documented patient interactions and interventions in electronic charting systems.
RN III
Albany Medical Center Hospital
06.2015 - 02.2021
- Administered medications accurately and safely, reducing medication errors and adverse reactions.
- Enhanced patient satisfaction through effective communication, empathy, and timely response to their needs.
- Collaborated with interdisciplinary teams for comprehensive patient care plans, resulting in better health outcomes.
- Administered medications via oral, IV, and intramuscular injections and monitored responses.
- Collaborated with physicians to quickly assess patients and deliver appropriate treatment while managing rapidly changing conditions.
- Educated patients, families and caregivers on diagnosis and prognosis, treatment options, disease process, and management and lifestyle options.
- Developed strong relationships with patients'' families, providing emotional support while addressing concerns or questions about care plans.
- Improved patient outcomes by providing high-quality nursing care and implementing evidence-based practices.
Administrative Assistant II/Customer Service Support Associate
CDPHP
03.2008 - 06.2012
- Answered multi-line phone system, routing calls, delivering messages to staff and greeting visitors.
- Maintained confidentiality of sensitive information by adhering to strict privacy policies and implementing secure filing systems.
- Delivered excellent customer service through prompt responses to client inquiries, addressing concerns effectively, and building strong relationships.
- Ensured accurate record-keeping with diligent data entry and database management for vital company information.
- Received and sorted incoming mail and packages to record, dispatch, or distribute to correct recipient.
- Scheduled office meetings and client appointments for staff teams.
- Created and maintained databases to track and record customer data.
- Executed record filing system to improve document organization and management.
- Improved document organization with thorough file maintenance, archiving outdated records as necessary for efficient retrieval when needed.
Eligibility Associate II/ Marketing Support Assoc.
Fidelis Care New York
06.2005 - 03.2008
- Reduced application processing times by streamlining workflows and optimizing document management systems.
- Facilitated smooth transitions between departments during case escalations by providing comprehensive summaries of case details as needed.
- Utilized advanced software tools to efficiently manage applicant records, enhancing organization and accessibility of data.
- Resolved discrepancies in application materials by coordinating with clients and gathering necessary information for accurate evaluations.
- Provided excellent customer service, addressing client concerns and answering questions about program eligibility requirements.
- Leveraged strong attention to detail when verifying income, employment history, and other critical factors impacting client eligibility determination processes.
- Collaborated with team members to ensure accurate and timely completion of eligibility determinations.
- Maintained up-to-date knowledge of relevant federal, state, and local statutes governing public assistance programs, ensuring accurate eligibility determinations.
- Maintained strict adherence to confidentiality guidelines, protecting sensitive client information throughout the eligibility process.
Education
Master of Science - Pediatric Nurse Practitioner
Stony Brook University
Stony Brook, NY05.2020
Bachelor of Science - Nursing
Russell Sage College
Troy05.2015
Associate of Science - Science
Hudson Valley Community College
Troy, NY05.2013
Skills
- Family-centered care
- Healthcare Navigation
- HIPAA Compliance
- Child Welfare Knowledge
- Care Coordination
- Progress Monitoring
- Child development expertise
- Medical terminology knowledge
- Individualized care planning
- Documentation proficiency
- Educational Advocacy
- Case Documentation
- Decision-Making
Certification
- Board Certified Pediatric Nurse Practitioner- PNCB
Timeline
Pediatric Care Manager
Healthfirst
03.2021 - Current
RN III
Albany Medical Center Hospital
06.2015 - 02.2021
Administrative Assistant II/Customer Service Support Associate
CDPHP
03.2008 - 06.2012
Eligibility Associate II/ Marketing Support Assoc.
Fidelis Care New York
06.2005 - 03.2008
Master of Science - Pediatric Nurse Practitioner
Stony Brook University
Bachelor of Science - Nursing
Russell Sage College
Associate of Science - Science
Hudson Valley Community College