Nancy Aguh

• Utilized targeted chronic conditions, level of care, and member's disease-specific and preventive measures to identify members suitable for care management
• Perform on-site or telephonic assessments to ascertain member's ongoing needs and develop personalized care plans during their facility stays.
• Ensured seamless integration of social services/case management functions throughout patient care, discharge, and home planning processes by coordinating efforts with various hospital departments, external service organizations, agencies, and healthcare facilities.
• Worked closely with healthcare professionals to ensure successful implementation of care plans and goal attainment.
• Implemented strategic measures to enhance utilization, quality, and compliance monitoring
• Enhanced member engagement by making outbound calls to complete telephonic assessments, deliver interventions, and educate them on health management.
• Monitored and analyzed variances in barriers pertaining to access of care, providing recommendations and implementing action plans for process improvement.
• Delivered educational support to patients for managing their medical conditions or diseases.
• Supported in the management of performance improvement initiatives
• Demonstrated initiatives in enhancing quality improvement strategies for the case management department

Telehealth Triage Nurse April 2020 to 2022

Effectively triaged client calls based on symptoms

Assessed patient needs and offered suitable clinical advice in accordance with guidelines.

Provided appropriate referrals to primary providers, specialists, healthcare facilities and community resources

Collaborated with healthcare providers, team members, and supervisors to achieve common goals.

Educated patients on health information, home care advice, and prevention concepts.

• Evaluated patient progress updates to determine necessary home care support
• Monitored and maintained compliance with Medicare/third party payor requirements for assigned cases
• Executed visits and oversaw the seamless flow of care coordination procedures including comprehensive assessments, admissions, recertifications, and discharges
• Provided clear and concise communication on the plan of care to patients and their families
• Collaborated with healthcare professionals to analyze patient information using SBAR methodology for enhanced communication in treatment decisions.
• Conducted precise Oasis collection and made necessary updates to the medication profile.

• Provided exceptional care to a varied caseload of 5+ patients with different medical conditions, employing keen assessment abilities to identify appropriate treatment measures.
• Delivered exceptional nursing care by adhering to resident care policies, procedures, and medical protocols while exercising sound judgment
• Educated and informed patients on health promotion, disease management, medication usage, recovery techniques...
• Facilitated coordination between doctors and a nursing team to devise optimal care plans for individuals
• Ensured precise documentation of nursing assessments, treatment procedures, medication records, discharge guidelines and post-treatment follow-up care
• Proficiently handled medication dispensing and Intravenous fluid administration.