MMANCEL PARIKIAN
RN
CA
Summary
Dedicated healthcare professional with extensive experience in patient care and clinical skills, committed to enhancing patient outcomes through compassionate service. Proven ability to collaborate effectively within multidisciplinary teams while adapting seamlessly to dynamic situations. Strong communication, empathy, and problem-solving skills contribute to a reliable, results-driven approach that ensures the delivery of high-quality care in a positive and supportive environment. Passionate about fostering a culture of excellence in healthcare delivery while prioritizing patient needs.
Overview
15
15
years of professional experience
Work History
Patient Access Nurse
Guidehouse/MLKCH
09.2017 - Current
- Delivered high level of quality care to diverse populations while overseeing patient admission and triaging based on acuity and appropriate department admission.
- Performed accurate documentation of patient assessments, interventions, and outcomes in compliance with regulatory standards using Milliman Guidelines to determine medical necessity.
- Utilized strong clinical judgment in prioritizing patient needs during high-stress situations, ensuring optimal outcomes.
- Collaborated with interdisciplinary teams for optimized patient treatment plans and outcomes.
- Mentored new nursing staff members, fostering teamwork and improving unit efficiency.
CASE COORDINATOR
Methodist Hospital Of Southern California
01.2013 - 01.2017
- Involved with patients/families and the treatment team to discuss and develop plans for discharge. This included assessing benefits, patient/family support systems and ensuring that patients were accessing the full benefits/services available to them.
- Worked with identifying coverage gaps in order to attempt to identify community resources that could assist or take suggestions back to the team to adjust the treatment plan.
- Coordinated with pharmacists to identify alternate cost-effective medications (medications on formulary, obtaining prior authorizations for coverage of non-formulary meds etc.).
- Completed arrangements for post discharge needs such as coordinating home-health, home IV antibiotics and post discharge needs such as follow-up appointments (Anticoagulation clinic, follow up appointments through OPAT clinic, Acute response clinic)
- Performed utilization reviews utilizing InterQual. Participated in daily IDT (Interdisciplinary Team) meeting.
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- Collaborated with physicians and staff to arrange resources needed for patient to prevent an admission to hospital and to utilize hospital resources appropriately.
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CASE MANAGER
San Gabriel Medical Center
01.2009 - 01.2013
- Served as liaison between contractors, third party insurance pay sources, physicians and patients by clarifying information and resolving barriers to healthcare.
- Monitored ongoing cases closely, adjusting case management strategies as needed based on evolving circumstances or new information.
- Conducted thorough assessments of clients'' situations, identifying issues, goals, and necessary interventions. Used InterQual guidelines to help payers and providers determine medical necessity of healthcare services.
- Contributed to team discussions and case conferences actively, sharing insights and expertise with colleagues to optimize client support strategies.
- Maintained accurate documentation on all cases, ensuring compliance with regulations and confidentiality requirements.
- Coordinated services with other agencies, community-based organizations, and healthcare professionals to provide useful benefits to clients.
CASE MANAGER
Monrovia Memorial Hospital
01.2006 - 01.2009
- Triaged patients for acuity needs to effectively manage disease symptoms/pain levels.
- Received/reviewed, verified appropriate criteria of patients for admission to program.
- Coordinated care w/Physicians/Clinical staff members/patients/families for effective holistic approach.
- Formulated care plans/ participated in meetings as applicable.
- Conducted thorough assessments of clients'' situations, identifying issues, goals, and necessary interventions.
- Educated clients on available programs, benefits, and services, empowering them to make informed decisions about their care needs.
License:
RN: 95427976
LVN: 168380
Timeline
Patient Access Nurse
Guidehouse/MLKCH
09.2017 - Current
CASE COORDINATOR
Methodist Hospital Of Southern California
01.2013 - 01.2017
CASE MANAGER
San Gabriel Medical Center
01.2009 - 01.2013
CASE MANAGER
Monrovia Memorial Hospital
01.2006 - 01.2009
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