Dynamic RN Case Manager at Cigna with a proven track record in care coordination and patient advocacy. Expert in developing individualized care plans and fostering team collaboration to enhance patient outcomes. Adept at utilizing electronic health records and providing emotional support, ensuring compliance with regulatory standards while driving quality improvement initiatives.
Overview
13
13
years of professional experience
1
1
Certification
Work History
RN Case Manager
Cigna
07.2021 - Current
Collaborated with health groups to plan or implement programs designed to improve overall health of communities.
Facilitated transitions between levels of care through effective coordination of resources within a managed care environment.
Monitored diet, physical activity, behaviors and other patient factors to assess conditions and adjust treatment plans.
Ensured compliance with regulatory standards concerning utilization review, ethical decision making and legal aspects of case management practice.
Provided emotional support to patients and their families during difficult times.
Maintained accurate documentation of patient progress in the electronic health record.
Educated patients on disease prevention strategies, wellness promotion techniques and lifestyle modifications.
Assessed patient's physical, mental, and psychosocial health status to develop individualized care plans.
Provided emotional support and counseling to patients dealing with chronic illness or end-of-life issues.
Collaborated with physicians, nurses, and other healthcare professionals to ensure optimal patient outcomes.
Participated in quality improvement initiatives related to case management processes.
Provided support and guidance to colleagues to maintain a collaborative work environment.
Managed time effectively to ensure tasks were completed on schedule and deadlines were met.
Assisted with customer requests and answered questions to improve satisfaction.
Demonstrated strong problem-solving skills, resolving issues efficiently and effectively.
Resident Services Director
Atria Cranberry Woods
Cranberry, PA
08.2020 - 07.2021
Monitored the progress of residents in achieving goals outlined in individual service plans.
Maintained accurate records of clients' progress and updated case notes regularly.
Interfaced with residents to address and resolve complaints or grievances.
Developed and implemented comprehensive resident services program.
Evaluated existing programs and services offered by the organization and identified areas where improvements could be made.
Attended conferences and seminars related to resident services and kept abreast of changes in regulations affecting the field.
Provided training opportunities for staff on topics related to resident services.
Demonstrated strong problem-solving skills, resolving issues efficiently and effectively.
Provided support and guidance to colleagues to maintain a collaborative work environment.
Resident Services Director
Franciscan Manor
Beaver Falls, PA
07.2019 - 08.2020
Administered, coordinated or recommended disciplinary and corrective actions.
Monitored the progress of residents in achieving goals outlined in individual service plans.
Maintained accurate records of clients' progress and updated case notes regularly.
Interfaced with residents to address and resolve complaints or grievances.
Developed and implemented comprehensive resident services program.
Evaluated existing programs and services offered by the organization and identified areas where improvements could be made.
Attended conferences and seminars related to resident services and kept abreast of changes in regulations affecting the field.
Conducted regular rounds to keep residents and areas safe and secure.
Conferred with medical personnel to understand backgrounds and needs of residents.
Conducted assessments to identify residents' needs and develop plans of action for their care.
Actively participated in weekly team meetings to discuss caseloads and best practices for serving clients.
Supervised staff members responsible for providing direct services to residents.
Coordinated with other departments to ensure that all services are provided in a timely manner.
Ensured compliance with all applicable laws, regulations, policies, procedures, standards.
Director of Nursing Administration
Beaver Valley Health and Rehab
Beaver Falls, PA
09.2012 - 07.2019
Conducted recruitment and retention activities to develop highly skilled nursing team.
Maintained communication and transparency with governing boards, department heads and medical staff.
Monitored performance of nursing staff through observation, review of documentation and feedback from other team members.
Evaluated staff performance and prepared accurate reports detailing findings.
Conducted regular meetings with department managers and staff to discuss operational issues.
Communicated with patients with compassion while keeping medical information private.
Assessed need for additional staff, equipment and services based on historical data and seasonal trends.
Developed and maintained staffing schedule in accordance with contract terms, budget mandates and accreditation standards for nursing coverage.
Ensured compliance with all applicable laws, regulations and accreditation standards related to healthcare services.
Participated in hiring decisions for new nursing personnel.
Developed medical programs that promoted community health and research.
Recruited, hired and trained new medical and facility staff.
Maintained a safe environment for patients, visitors and employees by adhering to established safety standards.
Education
Bachelor of Science - Register Nurse
Robert Morris University
Coraopolis, PA
08-2016
Skills
Care coordination
Patient assessment
Electronic health record
Disease prevention
Quality improvement
Team collaboration
Time management
Emotional support
Staff training
Creative problem solving
Patient advocacy
Case evaluation
Documentation
Goal setting
Adaptability
Strong clinical judgment
Physical assessment
Electronic health records
Organizational skills
Healthcare personnel supervision
Heartsaver first aid CPR AED
Preventive healthcare
Self motivation
Multitasking capacity
Healthcare program planning
Nursing performance assessment
Patient care oversight
Community program referrals
Safety protocols
Infection control
Accomplishments
I was recently a recipient of the Cigna Pinnacle award for customer service.