NICHOLE WALKER-COTTON
Registered Nurse
Merrillville,IN
Summary
Registered nurse with over 30 years of diverse healthcare experience, including ICU, ER, and dialysis. Proven leadership as clinical manager and director, enhancing patient care through effective discharge planning and utilization review. Successfully managed a team of 30 case managers, achieving a 50% increase in productivity and maintaining a 10% attrition rate. Experienced in Medicare/Medicaid program startups, implementing processes to ensure compliance with federal and state guidelines.
Overview
30
30
years of professional experience
Work History
Manager of Care Coordination
Humana
Indianapolis, Indiana
01.2024 - 09.2025
- Developed strategic initiatives to improve patient care and service delivery.
- Facilitated training sessions for staff to promote skill development and compliance.
- Oversaw the implementation of new technology systems to improve patient management processes.
- Monitored staff performance and addressed issues.
- Enforced customer service standards and resolved customer problems to uphold quality service.
- Coached, mentored and trained team members in order to improve their job performance.
- Trained employees on additional job positions to maintain coverage of roles.
- Assigned tasks to associates to fit skill levels and maximize team performance.
- Maintained up-to-date records of employee attendance, payroll information, vacation requests.
- Ensured compliance with all applicable laws, regulations, industry standards.
- Recruited and hired qualified candidates to fill open positions.
- Conducted regular meetings with staff to discuss progress and identify areas of improvement.
Travel Nurse Case Manager
RN Network
Boca Raton, FL
03.2022 - 01.2024
- Administered patient care in diverse clinical settings across multiple states.
- Provided comprehensive case management services, including assessments, crisis interventions, and referrals.
- Collaborated with healthcare teams to develop and implement patient care plans.
- Linked clients with social services, healthcare providers, and government agencies to enhance autonomy.
- Fostered trusting relationships with service providers to facilitate client support.
- Assisted individuals with determining eligibility for available benefits.
- Adhered to ethical standards to protect client confidentiality throughout all processes.
- Coordinated support services while optimizing communication between healthcare teams and patients.
- Provided direct nursing care to patients with acute, chronic, and complex conditions.
- Utilized electronic health records to document patient information accurately.
Director of Case Management
Regency Hospital
East Chicago, IN
01.2018 - 03.2022
- Developed and implemented patient-specific discharge plans to ensure safety and timeliness.
- Verified insurance benefits and submitted reviews for Medicare, Medicaid, and commercial plans.
- Built relationships with insurance providers to promote proper reimbursement and cost-effective care.
- Coordinated interdepartmental activities to expedite workflows and enhance overall performance.
- Generated reports analyzing data to implement corrective actions for continuous improvement.
- Ensured compliance with facility-wide utilization management policies and procedures.
- Managed fiscal responsibilities while adhering to business plans and maintaining key performance indicators.
- Facilitated multi-disciplinary team meetings to enhance collaboration among healthcare professionals.
Registered Nurse Case Manager
Cigna Health Spring
Chicago, IL
01.2014 - 01.2018
- Utilized strong assessment skills for identifying obstacles to care.
- Accurately documented nursing assessments, treatments, medications, discharge instructions, and follow-up care.
- Developed coordinated care plans in collaboration with healthcare team members.
- Established policies and procedures ensuring adherence to CMS guidelines.
- Worked with internal and external vendors to resolve gaps in patient care.
- Enabled patient access to community resources for necessary support services.
Dialysis Registered Nurse
Fresenius Dialysis, Acute/Chronic Care
Merrillville, IN
01.2012 - 01.2016
- Evaluated patient medical history and monitored vitals to assess treatment tolerance.
- Performed hemodialysis in acute and chronic care environments.
- Modified treatment plans based on patient responses and conditions.
- Demonstrated proficiency in venipuncture and central line maintenance.
- Utilized computerized resource and patient management systems for efficient operations.
- Responded to emergencies with expertise and composure, ensuring optimal care.
- Made independent decisions aligned with medical protocols and standards of care.
Critical Care Registered Nurse ICU
Community Hospital
01.2008 - 01.2014
- Implement critical thinking skills to determine necessary patient care & evaluate treatment modalities
- Provide excellent quality care to patients in Intensive Care Unit and E.R
- Facilitate discussions with patients & families regarding end-of-life
- Augment the review and revision of Operational Policies within ICU
- Adherence to HIPPA and other ethical standards of nursing practice
- Managed PA catheters and arterials, vasoactive drug administration and titration, thrombolytic therapy, dysrhythmia interpretation and chest tube management.
- Prioritized patient care assignments based on patient conditions to achieve optimal outcomes.
- Treated patients with broad range of acute, life-threatening diagnoses
- Supervised cardiac monitors, mechanical ventilators and alarms and oxygen delivery devices.
Registered Nurse OR/PACU
Mobile Anesthesia LLC
Chicago, IL
01.2003 - 01.2010
- Evaluate children & adults prior to surgical procedures
- Assist anesthesiologist with intubation & airway management
- Recognize & treat post-operative complications
- Coordinated discharge plan & follow-up care post-operatively
- Educated patients & family members on post-operative care
- Interpret & implement quality assurance standards
- Administered medications and treatments, monitoring patients for reactions and side effects.
- Recorded patient condition, vital signs, recovery progress and medication side effects.
- Assessed and prepared patients for procedures, performing initial and ongoing patient assessments.
- Oversaw patient admission and discharge processes to coordinate related paperwork.
- Monitored patients after surgery, answered questions and provided home care strategies.
Education
Bachelor of Science - Nursing
Saint Xavier University
01.1998
Skills
- Medicare and Medicaid criteria expertise
- Understanding of CMS and ACA regulations
- Application of NCQA HEDIS and STAR measures
- Creation of assessment tools
- Engagement in monthly compliance audits
- Leadership meetings with MCOs and state representatives involvement
- Participation in IDT/Outlier/QAPI meetings
- Utilization management applying Milliman criteria
- Dashboard analytics with Power BI proficiency
- Microsoft Office skills, including Excel expertise
- Cost control within Medicare LOS management
- Manual for community resources development
Timeline
Manager of Care Coordination
Humana
01.2024 - 09.2025
Travel Nurse Case Manager
RN Network
03.2022 - 01.2024
Director of Case Management
Regency Hospital
01.2018 - 03.2022
Registered Nurse Case Manager
Cigna Health Spring
01.2014 - 01.2018
Dialysis Registered Nurse
Fresenius Dialysis, Acute/Chronic Care
01.2012 - 01.2016
Critical Care Registered Nurse ICU
Community Hospital
01.2008 - 01.2014
Registered Nurse OR/PACU
Mobile Anesthesia LLC
01.2003 - 01.2010
Bachelor of Science - Nursing
Saint Xavier University