Michelle L. Cochran
Milton,Ky
Summary
Self-driven nursing professional equipped with clinical and managerial expertise leading in and outpatient care. This gives me the opportunity to benefit members and the company in a broad manner.
Overview
17
17
years of professional experience
Work History
Episodic Care Manager
Blue Cross Blue Shield North
03.2023 - Current
- Evaluate the process of each patient in the acute setting and request updates to facilitate the approval process
- Perform utilization reviews in accordance with state and federal regulations
- Responded to emails and calls from acute facilities
- Exceptional interpersonal and written communication skills
- Strong Clinical judgement
Care Manager
RIDE-Home Solutions
09.2012 - 03.2023
- Flexible assignment between the RIDE team and UM Home solutions
- Serving as RIDE Care Team Manager
- (Response to Infectious Disease Exposure Team)
- Serving as Utilization Manager for Home Solutions: Value-Based/Innovative Home Care
- SME for Quality Improvement Organizational Appeals
- Serve as educator for QIO Appeals
- Process Approvals, Denials, QIO's and Change of condition request
- Participate and lead On Call services
- Received Nurse 2 Nurse Peer Recognition
Nurse
Medicare Health Services HGB
09.2012 - 03.2023
- Evaluate the process of each patient in the acute setting and request updates to facilitate the approval process
- Perform utilization reviews in accordance with state and federal regulations
- Responded to emails and calls from acute facilities
- Exceptional interpersonal and written communication skills
- Strong Clinical judgement
- Earned MCG certification.
Case Manager
Telephonic Nurse 2 HGB
09.2012 - 03.2023
- Selected for 2021Nurse Leadership Career Rotation Program
- Gaining valuable leadership skills
- In this Rotation, Currently the project manager, implementing business learning opportunities for IT
- Successfully meets and exceeds all metric targets including quality audit scores at 96.5-100% (target is 95%) and member engagement is 210 Members (Goal is 181 members)
- Continually succeeds as a top enroller averaging 25-40 enrollments a month (Goal 20 enrollments)
- Awarded the 2020 Star Award for introducing a tool that improved efficiency and increased collaboration
- Serve as SME in time management, Motivational Interviewing, and renal dialysis education
- Serve as a mentor for the Nurse Ambassador Program
- Serve as a Nurse Nightingale, mentoring onboarding nurses through their first 90 days
- Served as education and contact person for members in the Covid 19 Outreach project
- Assisted in roll out and troubleshooting of new applications
- Designed and implement an assignment sheet, simplifying the assignment process
- Manage a diverse population case load involving a disease specific diagnosis
- Coordinate services and care as well as assisting members to best utilize their health care benefits
- Navigate through social determinants of health to ensure quality care and outcomes
- Team coverage when leader was participating in PTO or work events.
Care Manager
Humana Inc
09.2012 - 03.2023
- Served as a Nurse Preceptor
- Three-time recipient of the Treasure Chest Peer Award for creating a positive work and facilitating collaboration
- Managed a case load involving disease- specific Diagnosis
- Served as subject matter expert for renal members involved in Village Health
- Served as SharePoint Leader, managing and updating SharePoint Site
- Coordinated services and care as well as assisting members to best utilize their health care benefits.
Family Social Worker
RN
12.2011 - 09.2012
- Facilitated the education of families on pregnancy, birth and child development to 3 years old
- Formulated educational assignments weekly
- Supervised care assistance in oversight of documentation, outcome metrics continuing education and time management.
Dialysis Nurse
Fresenius Medical Care
01.2010 - 12.2011
- Implemented and managed the dialysis patient in the acute setting, servicing six hospitals, including one Children’s Hospital
- Assessed patient health problems, needs, and maintained medical records
- Advised patients on health maintenance and disease prevention
- Performed fistula, graft and catheter care
- Supervised Patient Care Technicians overseeing their job performance, interactions with patients, completion of documentation and continuing education.
Nurse
Renal, Clarian Health Care
05.2008 - 05.2009
- Served as a charge nurse for the Liver, kidneys, multi visceral, small bowel and pancreas, transplant patient
- Assessed patient health problems, needs, developed, implemented nursing care plans, and maintained medical records
- Implemented patient education on health maintenance and disease prevention
Education
Bachelor Of Science -
Walden University
08.2021
06.2002
Seminary - <ul><li>Nursing</li><li>Christian Psychology</li></ul>
Excelsior College
002,.2002
MA - Christian Psychology
Jacksonville Theological Seminary
06.2002
ASN - Nursing
Excelsior College
06.2002
LPN - Nursing
Spencerian College
12.1994
Skills
- Medical chart documentation
- Case assessments
- Team Building
- Multidisciplinary team collaboration
- Training and mentoring
- Relationship building and retention
- Patient education and counseling
- Wellness services
Timeline
Episodic Care Manager
Blue Cross Blue Shield North
03.2023 - Current
Care Manager
RIDE-Home Solutions
09.2012 - 03.2023
Nurse
Medicare Health Services HGB
09.2012 - 03.2023
Case Manager
Telephonic Nurse 2 HGB
09.2012 - 03.2023
Care Manager
Humana Inc
09.2012 - 03.2023
Family Social Worker
RN
12.2011 - 09.2012
Dialysis Nurse
Fresenius Medical Care
01.2010 - 12.2011
Nurse
Renal, Clarian Health Care
05.2008 - 05.2009
Bachelor Of Science -
Walden University
Seminary - <ul><li>Nursing</li><li>Christian Psychology</li></ul>
Excelsior College
MA - Christian Psychology
Jacksonville Theological Seminary
ASN - Nursing
Excelsior College
LPN - Nursing
Spencerian College
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