Monica Smith
Las Vegas,NV
Summary
Multi-talented Case Manager with expertise in Acute care environments. Hardworking and dedicated to top outcomes. Excellent time manager, communicator and problem solver. Accomplished travel Case Manager adept at handling high caseloads without sacrificing quality of care. Operate in high-pressure environments while recommending best resources and courses of action to benefit patient needs and return each to optimal quality of life.
Overview
22
22
years of professional experience
Work History
Care Coordination
Dignity. Health - Dignity Health
Las Vegas, NV
04.2022 - Current
- Collaborated with other departments within the organization to ensure timely completion of tasks related to patient care coordination
- Implemented patient care coordination programs aimed at improving patient health outcomes
- Participated in performance improvement activities related to improving clinical outcomes associated with patient care coordination
- Actively sought out continuing education opportunities related to direct care coordination practices
- Monitored patient admissions and discharges to optimize care coordination and resource utilization
- Identified, assessed, and managed high-risk cases in need of intensive care coordination
- Actively participated in educational sessions focused on best practices related to transitional care coordination
- Collaborated with physicians, nurses, pharmacists, case managers, and other stakeholders to develop strategies for improving care coordination for sepsis patients
- Actively participated in staff meetings discussing best practices in patient care coordination
- Collaborated with other departments within the health system to ensure comprehensive patient care coordination
- Led care coordination efforts, ensuring effective communication among all parties involved in a client's care.
RN Case Manager
AMN/AdventHealth
Flagler Beach, FL
04.2021 - Current
- Helped patients navigate healthcare system and care options by educating on relevant subject areas and answering questions throughout treatment process
- Collaborated with physicians during medical rounds, updated treatment plans, and provided plan of care to patients and families
- Coordinated home care, home infusion, and durable medical equipment
- Supervised nurse administration of oral, intramuscular and IV medications to patients as prescribed, monitoring responses for adverse reactions
- Arranged placement of admissions and transfers in accordance with clinical standards and guidelines
- Developed patient care plans, including overall patient health assessments and evaluations
- Coordinated with vendors and suppliers and negotiated medical equipment and supply prices
- Liaised between injured workers and hospital staff to organize treatment and after-care services
- Determined and coordinated appropriate level of care to meet individual patient needs
- Collaborated in consults, patient care plans development, patient monitoring and evaluations
- Assessed and reviewed patients for discharge and planning, including integrating services for patients requiring home care, home infusion and durable medical equipment (DME)
- Conducted evaluations to address changes in patient needs, conditions and medications
- Actively participated in family and patient planning processes
- Secured insurance authorizations to rehabilitation facilities or long-term care placement
- Advocated for patients by identifying insurance coverage, communicating care preferences to practitioners and verifying interventions met patients' treatment goals
- Collaborated with physicians on patient medications, medical needs and performance
- Administered medications and treatment plans in accordance with physician orders
- Trained, guided and mentored home healthcare providers to ensure all objectives were met
- Updated and maintained discharge plan of care with physician, members of healthcare team, patients, and families
- Obtained recommendations for inpatient or outpatient level of care by discussing cases with physician advisor.
Registered Nurse Case Manager
GreenKey/UCI
Anahiem California, CA
01.2021 - 04.2021
- Helped patients navigate healthcare system and care options by educating on relevant subject areas and answering questions throughout treatment process
- Arranged placement of admissions and transfers in accordance with clinical standards and guidelines
- Participated in on-call rotations, delivering daily continuous quality care to patients
- Developed patient care plans, including overall patient health assessments and evaluations
- Assessed and reviewed patients for discharge and planning, including integrating services for patients requiring home care, home infusion and durable medical equipment (DME)
- Obtained recommendations for inpatient or outpatient level of care by discussing cases with physician advisor
- Collaborated in consults, patient care plans development, patient monitoring and evaluations
- Determined and coordinated appropriate level of care to meet individual patient needs
- Actively participated in family and patient planning processes
- Updated and maintained discharge plan of care with physician, members of healthcare team, patients, and families
- Coordinated home care, home infusion, and durable medical equipment.
Emergency Department Care Coordination
Piedmont Atlanta Hospital
Atlanta, GA
02.2020 - 01.2021
- Resolved conflicts promptly among physicians, nurses and other healthcare employees to keep workflows on task
- Created and maintained facility documents and records, maintaining accuracy while managing sensitive data
- Drove process, efficiency and quality improvements, resulting in increase in patient discharge times
- Participated in weekly meetings with department heads to discuss census information, admissions and discharges for residents
- Solicited medical history information from patients to provide the best and most effective medical advice
- Communicated with patients with compassion while keeping medical information private
- Coordinated delivery of exceptional patient care by evaluating workflows and facilitating positive changes
- Collaborated with multi-disciplinary staff to improve overall patient care and response times
- Delivered outstanding patient care based on physical, psychological, educational and related criteria
- Assisted with patient admissions, discharges and transfers.
Discharge Planner
Dignity Health
Las Vegas, NV
10.2019 - 02.2020
- Developed safe discharge plans for adults
- Coordinated support services and optimized communication between healthcare workers and patients
- Utilized business customer service and relationship building skills to consistently increase referrals
- Communicated with legal services providers, social services agencies and local judicial systems regarding cases
- Managed all logistics for abuse and neglect cases from start to finish
- Evaluated nursing notes to confirm completeness and accuracy of descriptions outlining nursing care provided and corresponding patient responses
- Charted daily progress notes
- Monitored diet, physical activity, behaviors and other patient factors to assess conditions and adjust treatment plans
- Participated in continuing education programs and workshops to enhance training and nursing knowledge
- Consistently maintained core measures, patient satisfaction and HCAPs
- Monitored and recorded patient condition, vital signs, recovery progress and medication side effects.
ED Case Manager With House Coverage After Hours
Wilmington Hospital
Wilmington, DE
03.2019 - 06.2019
- Applied medical criteria and clinical judgement to researched cases to evaluate and establish determinations
- Kept detailed documentation on all utilization reviews by using
- Assisted patients with multiple chronic diagnoses, including COPD and asthma
- Referred cases to secondary review for failure to meet criteria
- Reviewed patient admissions to determine medical necessity as directed by the criteria
- Oversaw implementation of patient management processes pertaining to denials and potential denials as outlined by insurance carriers.
Utilization Review Nurse
EvergreenHealth Medical Center
Kirkland, WA
10.2018 - 03.2019
- Referred cases to secondary review when they did not meet certain criteria such as
- Contacted insurance carriers to obtain authorizations for services delivered to patients
- Kept detailed documentation on all utilization review
- Reviewed patient admissions to determine medical necessity as directed by the criteria
- Monitored the nursing and operation of support departments to ensure that resident needs were met and facility was properly maintained
- Observed strict confidentiality and safeguarded all patient-related information
- Provided treatment within scope of practice as defined by state law.
Discharge Planner
St. JosephsCandler
Savannah, GA
04.2018 - 09.2018
- Collaborated with multidisciplinary healthcare teams to develop and adapt individualized plans of care to achieve patient care and recovery goals
- Completed comprehensive patient assessments to determine individual needs, formulating plans of care in collaboration with multidisciplinary healthcare professionals, including physicians, case managers and social workers
- Evaluated patient care needs, prioritized treatment and maintained patient flow
- Worked with members of the community to determine needs
- Controlled hospital costs through review of options and standards of care
- Communicated with legal services and local judicial systems regarding [patient] cases
- Collaborated with different disciplines to provide cohesive care to patients
- Provided on-call care at all times of day and night.
Case Manager
Virginia Commonwealth University
Richmond, VA
10.2017 - 01.2018
- RN case manager on orthopedics floor
- Worked closely with social worker for safe discharge planning
- Average case loads between 20-40 patients
- Controlled hospital costs through review of options and standards of care
- Collaborated with different disciplines to provide cohesive care to patients
- Assisted patients in receiving high-quality, appropriate care with reasonable results
- Delivered high-quality and compassionate treatment to indigent and low-income patient community
- Actively participated in unit-based Quality Assurance Program
- Coordinated with doctors and registered nurses to develop care plans for patients
- Disciplined, energetic employee who quickly establishes rapport with patients and colleagues
- Provided education to patients on detox and withdrawal, medications, addiction, recovery, coping skills and community resources
- Assisted patients with multiple chronic diagnoses including COPD and asthma
- Supported patients with customized patient teaching tools
- Evaluated patient care needs, prioritized treatment and maintained patient flow.
Case Manager
Northwest Medical Center
Tucson, AZ
07.2017 - 10.2017
- Controlled hospital costs through review of options and standards of care
- Collaborated with different disciplines to provide cohesive care to patients
- Reviewed treatment plans against individual goals and healthcare standards
- Assisted patients in receiving high-quality, appropriate care with reasonable results
- Delivered high-quality and compassionate treatment to indigent and low-income patient community
- Actively participated in unit-based Quality Assurance Program
- Coordinated with doctors and registered nurses to develop care plans for patients
- Sound, ethical and independent decision-making ability consistent with medical protocols
- Assisted patients with healing and recovery after surgery
- Provided education to patients on detox and withdrawal, medications, addiction, recovery, coping skills and community resources
- Supported patients with customized patient teaching tools
- Provided necessary health education training for patients
- Evaluated patient care needs, prioritized treatment and maintained patient flow
- Utilized strong assessment skills to determine necessary patient care
- Often commended for maintaining the safety, respect and dignity of residents
- Maintained patient charts and confidential files.
Travel Acute Care Case Manager
St Joseph's Medical Center
Houston, TX
05.2017 - 08.2017
- Documented plans, findings and results and submitted to employers and insurance carriers
- Controlled hospital costs through review of options and standards of care
- Collaborated with different disciplines to provide cohesive care to patients
- Reviewed treatment plans against individual goals and healthcare standards
- Delivered high-quality and compassionate treatment to indigent and low-income patient community
- Sound, ethical and independent decision-making ability consistent with medical protocols
- Provided education to patients on detox and withdrawal, medications, addiction, recovery, coping skills and community resources
- Assisted patients with multiple chronic diagnoses including COPD and asthma
- Evaluated patient care needs, prioritized treatment and maintained patient flow
- Utilized strong assessment skills to determine necessary patient care
- Partnered with team of Registered Nurses to ensure over all well-being of all patients
- Often commended for maintaining the safety, respect and dignity of residents
- Referrals for Home Health/SNF/LTAC/Home IV abx therapy
Case Manager
Tidelands Waccamaw Community Hospital
Murrells Inlet, SC
01.2014 - 05.2017
- Controlled hospital costs through review of options and standards of care
- Collaborated with different disciplines to provide cohesive care to patients
- Reviewed treatment plans against individual goals and healthcare standards
- Delivered high-quality and compassionate treatment to indigent and low-income patient community
- Actively participated in unit-based Quality Assurance Program
- Coordinated with doctors and registered nurses to develop care plans for patients
- Sound, ethical and independent decision-making ability consistent with medical protocols
- Disciplined, energetic employee who quickly establishes rapport with patients and colleagues
- Referrals for Home Health/SNF/LTAC/Home IV abx therapy
Hospice Registered Nurse Case Manager
Traditional Hospice
Dunmore, PA
08.2008 - 11.2014
- Created and applied tailored care plans that would meet each patient's individualized needs
- Guided patients' loved ones and caregivers in such tasks as pain management, wound care, and medication dosing
- Ensured that each patient and his or her family received a superior level of compassionate nursing and palliative care
- Listened to patients and loved ones, offering emotional support and kindness to help with the end-of-life transition
- Utilized effective interpersonal, writing and active listening skills to build and cultivate positive relationships with patients, caregivers and physicians
- Planned hospice care for elderly and disabled patients
- Interviewed patients to obtain medical information and measure vital signs, weight and height
- Worked as part of team to ensure proper care of body mechanics and safety of patient
- Assisted patients with multiple chronic diagnoses, including COPD and asthma
- Developed and implemented successful patient care plans
- Supervised and evaluated the activities of medical, nursing, technical, clerical, service, maintenance and other personnel
- Ensured smooth transition of residents into new environment
- Assessed patients in active drug and alcohol withdrawal and provided interventions to manage physical and psychological withdrawal symptoms
- Ensured the accuracy of public information and materials
- Established and maintained positive relationships with government regulators, residents, families, other area health care providers, physicians and community at large
- Maintained all confidential personnel files, licensing and CPR compliance records
- Assisted patients with multiple chronic diagnoses including COPD and asthma.
Detox nurse
Clearbrook Treatment Centers
Wilkes Barre, PA
04.2003 - 11.2013
- Counseled clients, patients and families and provided emotional and psychosocial support
- Collected and documented vital signs to track current patient conditions
- Answered patient and family questions to educate on optimal treatment procedures
- Worked with healthcare team, including social workers, physical therapists, and speech therapists, to assess patient needs, plan and adjust plans of care and actualize nursing interventions to promote and restore patient health
- Protected patients, families and staff from infection by cleaning and sanitizing rooms and equipment
- Cleaned and sterilized instruments and equipment to protect staff and patients from infection risk
- Delivered high-quality care by administering treatments using specialized equipment
- Promoted patient satisfaction by assisting with daily living needs such as bathing, dressing, toileting and exercising
- Documented patient intake information, including medical histories, current symptoms and vitals such as height and weight
- Followed rehabilitation and treatment care plans to accelerate patient recovery, minimize pain and optimize patient outcomes
- Researched and studied client diagnoses to identify care needs, effectively contributed to nursing plan developments and facilitated patient education
- Assessed patients by measuring and recording vital signs and collecting specimens for lab analysis
- Educated clients, patients, and caregivers on medical diagnoses, treatment options, chronic disease self-management and wound management
- Administered medications and therapies in accordance with physicians orders.
Licensed Practical Nurse
Allied Services Skilled Nursing Facility
Scranton, PA
03.2003 - 04.2004
- Guaranteed exceptional care quality by correctly administering medication, inserting and caring for catheters, dressing and changing wounds and assisting with personal hygiene
- Observed, charted and reported developments in patient health condition
- Evaluated patient status and re-assessed clients' nursing needs every
- Administered patient care to patients by initiating preventative and rehabilitative interventions, assisting patients with activities of daily living (ADL), positioning, mobilization and personal hygiene support
- Provided pre- and post-operative nursing care
- Responded to patient alarms and requests to assess needs and obtain necessary care for medical and personal concerns
- Assessed patients to identify lacerations, contusions and other physical symptoms in need of further attention
- Protected patients, families and staff from infection by cleaning and sanitizing rooms and equipment
- Delivered high-quality care by administering treatments using specialized equipment
- Monitored patient's respiration activity, blood pressure and blood glucose levels in response to medical administration
- Assessed patients by measuring and recording vital signs and collecting specimens for lab analysis
- Researched and studied client diagnoses to identify care needs, effectively contributed to nursing plan developments and facilitated patient education
- Collected and documented vital signs to track current patient conditions
- Documented patient intake information, including medical histories, current symptoms and vitals such as height and weight
- Communicated concerns regarding clients' status, care and environment to nursing supervisors, clinical care supervisors and case managers
- Answered patient and family questions to educate on optimal treatment procedures
- Took blood, tissue and fluid samples to perform laboratory tests
- Started, monitored and managed intravenous medication to stabilize patient heart and blood pressure
- Assisted physicians with conducting examinations and patient scans during diagnostic processes
- Administered medication and IV therapies.
Education
Bachelor of Science Nursing -
The University of Scranton
Scranton, PA01.2013
Associate of Science Licensed Practical nurse -
Career Technology Center
Scranton, PA01.2000
Skills
- Orthopedics
- Oncology
- Telemetry
- Neurology
- ICU
- Utilization review
- Curaspan
- Meditek
- Cerner
- Physicians portal
- Plink
- Interqual
- Milliman-mcg
- Verbal and written communication
- Patient transfers and transitions
- Continuous assessments
- Patient and family focused
- Clinical issues understanding
- BAC screening/drug screen collection
- Basic Life Support Certification
- Problem resolution ability
- HIPAA Compliance
- Insurance knowledge
- Documentation
- Case Management
- Needs Assessment
- Care Coordination
- Teamwork and Collaboration
References
References available upon request.
Timeline
Care Coordination
Dignity. Health - Dignity Health
04.2022 - Current
RN Case Manager
AMN/AdventHealth
04.2021 - Current
Registered Nurse Case Manager
GreenKey/UCI
01.2021 - 04.2021
Emergency Department Care Coordination
Piedmont Atlanta Hospital
02.2020 - 01.2021
Discharge Planner
Dignity Health
10.2019 - 02.2020
ED Case Manager With House Coverage After Hours
Wilmington Hospital
03.2019 - 06.2019
Utilization Review Nurse
EvergreenHealth Medical Center
10.2018 - 03.2019
Discharge Planner
St. JosephsCandler
04.2018 - 09.2018
Case Manager
Virginia Commonwealth University
10.2017 - 01.2018
Case Manager
Northwest Medical Center
07.2017 - 10.2017
Travel Acute Care Case Manager
St Joseph's Medical Center
05.2017 - 08.2017
Case Manager
Tidelands Waccamaw Community Hospital
01.2014 - 05.2017
Hospice Registered Nurse Case Manager
Traditional Hospice
08.2008 - 11.2014
Detox nurse
Clearbrook Treatment Centers
04.2003 - 11.2013
Licensed Practical Nurse
Allied Services Skilled Nursing Facility
03.2003 - 04.2004
Bachelor of Science Nursing -
The University of Scranton
Associate of Science Licensed Practical nurse -
Career Technology Center
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