Patricia Duke

• Monitored patients prescribed psychotropic medications to assess medications' effectiveness and side effects.
• Recorded comprehensive patient histories and coordinated treatment plans with multi-disciplinary team members.
• Handled vital sign monitoring, medication administration and patient behavior assessments.
• Collaborated with prescribing professionals to get patients necessary medications.
• Assessed patient conditions, monitored behaviors and updated supervising physicians with observations and concerns.
• Responded to emergency situations with speed, expertise and level-headed approaches to provide optimal care, support and life-saving interventions.

• Determined medical necessity and cost-effectiveness of services through utilization review processes.
• Applied medical criteria and clinical judgement to researched cases to evaluate and establish determinations.
• Referred cases to secondary review for failure to meet InterQual Criteria.
• Maintained strict patient data procedures to comply with HIPAA laws and prevent information breaches.
• Utilized computerized Resource and Patient Management System (RPMS) and Electronic Health Record (EHR) system.

Ensure member access to services appropriate to member's health needs
Conducts assessments to identify individual needs and a specific care management plan to address objectives and goals as identified during assessment.

Coordinate internal and external resources to meet identified needs.
Monitor and evaluates effectiveness of the care management plan and modifies as necessary.

Responsible for presentation of complex cases in interdisciplinary rounds.
Implement care plan by facilitating referrals as appropriate within benefits structure.

• Provided case management services including intake, assessment, crisis intervention, advocacy, referral and monitoring of families.
• Linked clients with social services, health care providers and governmental agencies to help claim or reclaim individual autonomy.
• Assisted individuals with eligibility for available benefits.
• Advocated for clients by obtaining information regarding treatment options and clinical status.
• Participated in regular team meetings and in-house training sessions to boost group effectiveness.

• Assessed ICU patients each shift to ascertain vitals and key information.
• Evaluated patient vital signs and laboratory data to assess needs and provide emergency interventions.
• Supervised cardiac monitors, mechanical ventilators and alarms and oxygen delivery devices.
• Detected emerging problems by monitoring patients' behavior, vital signs and fluid intake and output.
• Helped patients and families feel comfortable during challenging and stressful situations, promoting recovery and reducing compliance issues.