NICOLE CROZIER
Carlsbad,CA
Summary
As a Registered Nurse with over two decades of professional experience, I have consistently provided quality care in accordance with the nursing process and evidence-based practices. I began my career in nursing by working as an inpatient nurse in med-surg/telemetry units, but due to my deep passion for home health, I transitioned into that field shortly after. During my tenure, I had the opportunity to acquire valuable experience in managing patients with complex medical conditions, which helped me to develop my nursing skills and knowledge. I work as a complex case manager for a large health plan, where I establish person-centered care goals, identify barriers, and implement interventions to help patients achieve their goals.
My ability to independently assess and interpret clinical information enables me to develop individualized care plans with patients while promoting self-management. I monitor and coordinate patient care to ensure the delivery of medically appropriate and cost-effective care. Additionally, I am committed to patient education and advocacy, recognizing the importance of working collaboratively with providers and healthcare teams to address patient needs.
Through my extensive experience and dedication to my profession, I have acquired a wealth of knowledge and expertise in providing exceptional patient care. Additionally, I have consistently demonstrated my ability to work collaboratively with providers and healthcare teams to address patient needs. My extensive experience and expertise make me a valuable asset to any healthcare organization.
Overview
16
16
years of professional experience
1
1
Certification
Work History
RN Case Manager
Blue Shield of CA
San Diego, CA
02.2019 - Current
- Researched and designed treatment/care plans to promote quality of care, cost-effective health care services based on individuals' medical needs with a caseload of over 300 members
- Collaborated with the interdisciplinary healthcare team to help reduce hospital readmissions and ensure members receive timely preventive care and screening tests
- Complete transition of Care follow-up to maintain continuity of care
- Participate in ICT on all members with Medical director and interdisciplinary healthcare team
- Coordinated care for specific high-risk patient populations, including referrals to community resources, social services, and specialists
- Designed individualized plan of care with targeted interventions that enhance quality, access and cost-effective outcomes
- Initiated and implemented appropriate modifications in the plan of care to adapt to changes occurring over time and through various settings especially transitions of care
- Possessed strong written and verbal communication skills with the ability to advocate on behalf of the member and family
- Utilized strong clinical documentation skills, independent problem identification, and resolution skills
- Work with minimal supervision and demonstrate professional judgment and critical thinking when advocating for the medical necessity that promotes quality, cost-effective care
- Assist Members to make medical decisions while demonstrating cultural competence and respecting members values
- Demonstrated clinical judgment and independent analysis to identify and navigate barriers that may prevent Members from achieving their healthcare goals
- Work with medical groups and individual providers to ensure continuity of care and implement effective discharge planning activities appropriate for the member's needs.
HOME HEALTH RN CASE MANAGER
Scripps
San Diego, CA
10.2008 - 01.2019
- Organized and coordinated nursing care in order to meet the needs of individuals and families within their homes and communities
- Developed and initiated an individualized plan of care for home healthcare patients with a caseload of 20-30 patients
- Provided direct patient care ordered by providers as indicated in the plan of care
- Responsible for the ongoing interdisciplinary assessment and development of the individualized plan of care using CMS Oasis guidelines
- Provided patient and caregiver education using teach back method and utilizing cultural awareness
- Identifies discharge planning needs as part of the care plan development/transition of care and implements them prior to discharge of the patient
- Ensures that arrangements for equipment and other necessary items and services are available in the home
- Supervised and delegated to Licensed Vocational Nurses (LVNs) and/or Home Health Aids (HHAs) as directed
- Presented home health patient for weekly Interdisciplinary rounds
- Assessed patient conditions and updated physicians with status changes
- Provided direct patient care in the home setting such as collected vitals, wound/ostomy care, medication management,blood draws, catheter care, Lvad/Heart failure management
- Completed initial assessments of patients and family to determine and address individual home care needs
- Conducted regular re-evaluations to address changes in needs and conditions, and introduced revisions to care plans such as referrals
- Advocated for patient needs with interdisciplinary team and implemented outlined treatment plans
- Collaborated with health groups to plan or implement programs designed to improve overall health of communities.
Education
Bachelor of Science -
University of Arizona Global Campus
12.2022
Associate of Science - Nursing
Bristol Community College
06.2003
Skills
- Case Management
- Utilization Management
- Population Health Medicare and Medi-Cal/Managed Care
- Strong teamwork and interpersonal skills
- Motivational Interviewing
- Community Resource Referrals
- Care Coordination
- Medication Management
- Cultural Awareness
- Autonomous problem solving
- independent thinking,decision making, and prioritizing
- Chronic Disease Management
- Proficient in Microsoft Office (excel,outlook,word,power point, MS Teams)
- Interdisciplinary Collaboration
- Patient Care and Education
- Care Planning
- Quality Improvement
- Right fax, Zoom
- Experience with Epic, Salesforce, CTD, Auth Accel, Facets and other computer programs
- HIPAA Compliance
- Insurance knowledge
- Medical Groups and Independent Physician Associations
- Discharge Planning
- Healthcare regulations
- CMS and NCQA regulatory requirements
- Health Risk Assessment
Certification
RN License in California current/active), Basic Life Support (BLS) Certification Certified Case Manager (CCM) current/active . Six Sigma Health Greenbelt Certificate, Pending Holistic Nurse Certificate, Pending Public Health Nurse Certificate
Additional Information
- Registered Nurse in the State of California License (current/active) Scripps Nurse of the year 2012, Deans list Spring 2021
References
References available upon request.
Timeline
RN Case Manager
Blue Shield of CA
02.2019 - Current
HOME HEALTH RN CASE MANAGER
Scripps
10.2008 - 01.2019
Bachelor of Science -
University of Arizona Global Campus
Associate of Science - Nursing
Bristol Community College
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