Summary
Overview
Work History
Education
Skills
Certification
Gardening, Playing the piano, thrifting at vintage antique stores and vacations in the mountains.
Languages
Timeline
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Rebecca Moulden, RN, CCM

Rebecca Moulden, RN, CCM

Suffolk,VA

Summary

Dynamic leader and forward-thinking problem-solver with a proven track record at Elevance, InforMed Medical Management and Hines & Associates as a successful Team Leader of Nurse Case Managers, known for strategic thinking and a hands-on approach, fostering a collaborative and inclusive environment. Specialize in staff training and analytical thinking, significantly improving project outcomes. Demonstrates professionalism and adaptability, achieving high-quality standards and developing strategies to improve efficiency and productivity. Pursuing full-time role that presents professional challenges and leverages interpersonal skills, effective time management, and problem-solving expertise.

Overview

32
32
years of professional experience
1
1
Certification
50
50

RN Licensed in nearly all 50 states

1
1

Virginia Compact Nursing License - State of Residence

Work History

Team Leader

Elevance
01.2021 - 09.2024
  • Set performance expectations for the team, monitoring progress towards goals and providing constructive feedback as needed for team of approximately 25 nurses.
  • Empowered team members by delegating responsibilities according to individual strengths and areas of expertise.
  • Managed conflict resolution among team members, fostering a positive and collaborative work environment.
  • Maintained an inclusive and diverse team culture, promoting respect and understanding among all members.
  • Provided technology troubleshooting to team that utilized telephonic dialer technology, Electronic Medical Records, Microsoft Outlook and VPN.
  • Facilitated quality chart reviews following NCQA guidelines and telephonic recording reviews to ensure quality and procedural adherence. Provided coaching, training as needed and escalated issues to manager as identified.
  • Organized, led and provided documentation of interdisciplinary rounds with Medical Director, manager and case managers

Telephonic Nurse Case Manager

Elevance
01.2015 - 01.2021
  • Collected and inputted case data in managed care system and timely and accurately generated required correspondence and review notification for management.
  • Supported patients in developing effective coping strategies for managing the emotional impact of living with a chronic illness, promoting resilience and psychological wellbeing.
  • Provided resources and referrals for patients seeking additional support services, such as mental health counseling or nutrition counseling.
  • Maintained meticulous documentation of case management activities, facilitating accurate billing and compliance with regulatory requirements.
  • Educated patients on self-management techniques to promote independence and improve quality of life.
  • Managed caseloads of approximately 30-50 patients efficiently while prioritizing urgent cases requiring immediate intervention.
  • Completed psychosocial evaluations and needs assessments.

Team Leader

InforMed Medical Management Services
01.2007 - 12.2014
  • Organized "start-up" case management with interviewing and hiring nurses, implementing orientation and on-going training of approximately 20-30 nurses
  • Developed team members skills through targeted coaching sessions, resulting in improved individual performance.
  • Collaborated with other department leaders to establish shared goals and ensure alignment across teams.
  • Established open and professional relationships with team members to achieve quick resolutions for various issues.
  • Enhanced team productivity by implementing efficient work processes and regularly reviewing performance metrics.
  • Assisted in recruitment to build team of top performers.
  • Built and maintained strong client relationships, leading to repeat business and referrals.
  • Evaluated staff performance and provided coaching to address inefficiencies.
  • Evaluated customer needs and feedback to drive product and service improvements.
  • Generated reports detailing findings and recommendations.

Telephonic Nurse Case Manager

Medical Management and Rehab Services (MMARS)
01.2006 - 12.2006
  • InforMed Medical Management Services acquired a portion of MMARS nursing staff as a "start-up" to their new company 1/2007.
  • Assessed current treatment plan to identify barriers, clarify or determine realistic goals and objectives and seek potential alternatives.
  • Collaborated with other health care professionals regarding plan of care and variances in plan implementation to achieve outcomes.
  • Utilized evidence-based practices to inform decision-making in the development and implementation of targeted interventions for each patient's unique needs.
  • Educated patients on self-management techniques to promote independence and improve quality of life.
  • Completed psychosocial evaluations and needs assessments.
  • Provided patient and family education on available resources and self-care strategies.

Team Leader

Hines & Associates Case Management
01.2003 - 12.2005
  • Evaluated team member performance against established objectives during regular reviews, offering praise for achievements or identifying areas requiring further development.
  • Mentored junior staff members, helping them develop their leadership potential and advance in their careers.
  • Increased customer satisfaction ratings by closely monitoring service quality standards and addressing any issues promptly.
  • Provided ongoing support to direct reports, addressing concerns or questions promptly so they could remain focused on their tasks.
  • Set performance expectations for the team of approximately 5 case managers, utilizing productivity analytics and monitoring progress towards goals and providing constructive feedback as needed.
  • Assisted in recruitment to build team of top performers by facilitating interviews and and hiring of new staff.
  • Oversaw quality control measures by performing quality chart reviews on staff, maintaining high standards for all project outputs.

Telephonic Nurse Case Manager

Hines & Associates Case Management
12.2001 - 01.2003
  • Helped patients navigate complex insurance processes, easing their financial burden while ensuring access to necessary treatments.
  • Managed caseloads of approximately 30-50 patients efficiently while prioritizing urgent cases requiring immediate intervention.
  • Collaborated with interdisciplinary teams to optimize patient-centered interventions and ensure continuity of care.
  • Provided empathetic emotional support for patients facing challenging health concerns, fostering trust and open communication.
  • Supported patients in developing effective coping strategies for managing the emotional impact of living with a chronic illness, promoting resilience and psychological wellbeing.
  • Educated patients on self-management techniques to promote independence and improve quality of life.
  • Assisted patients in setting achievable health goals and monitoring progress to enhance motivation and adherence to care plans.
  • Enhanced patient care by providing telephonic support and guidance to individuals with chronic illnesses.

Home Health RN Case Manager

Obici Hospital - Acquired by Sentara Hospital
01.1995 - 12.2001
  • Managed complex caseloads of approximately 20-30 patients efficiently by prioritizing tasks, delegating responsibilities to support staff, and maintaining detailed records.
  • Expedited wound healing using advanced wound care techniques such as negative pressure therapy or hydrocolloid dressings when appropriate.
  • Reduced hospital readmissions through diligent monitoring of patients progress, open communication with physicians and timely interventions within the home settings.
  • Improved medication adherence through education on drug administration, interactions, and potential side effects.
  • Prevented complications from chronic illnesses like diabetes or heart failure through targeted patient education initiatives tailored to individual needs.
  • Administered medications and treatments as prescribed by physicians including IV therapy, chemotherapy, TPN and nutrition via PEG tube within the home setting.
  • Implemented care plans for patient treatment after assessing physician medical regimens.
  • Observed and documented patient factors such as diets, physical activity levels, and behaviors to understand conditions and effectively modify treatment plans.
  • Managed patients recovering from medical or surgical procedures.
  • Facilitated therapeutic communication, conflict resolution and crisis intervention by redirecting negative behaviors and helping patients regain or improve coping abilities.
  • Provided care to diverse patient populations/patient acuity including med-surg, chronic care/illness, pediatric, newborn and hospice care.

Home Health RN Case Manager

Interim Home Health
01.1994 - 01.1995
  • Promoted a safe living environment for patients by conducting thorough home safety evaluations and recommending necessary modifications or equipment upgrades.
  • Managed complex caseloads of approximately 25-35 patients efficiently by prioritizing tasks, delegating responsibilities to support staff, and maintaining detailed records.
  • Increased patient satisfaction by providing compassionate care, addressing concerns, and advocating for their needs.
  • Empowered patients and their families to take an active role in care decisions, fostering a sense of self-efficacy and improving long-term health outcomes.
  • Streamlined communication with physicians, ensuring accurate documentation and prompt updates on patient conditions.
  • Improved medication adherence through thorough education on drug administration, interactions, and potential side effects.
  • Administered medications and treatments as prescribed by physicians, including IV therapy, chemotherapy and TPN.
  • Coordinated with other healthcare team members to support patient needs.
  • Monitored vital signs, developed and implemented care plans, and documented patient progress.

Hospital Staff RN

Children's Hospital of the King's Daughters
01.1993 - 06.1994
  • Utilized critical thinking skills to make quick decisions in high-pressure situations, prioritizing patient needs and addressing emergent issues promptly.
  • Enhanced patient care by implementing evidence-based practices and individualized care plans on Transitional Care Unit - Long Term Care Unit for Ventilator Dependent infants, children and adolescents (up to age 18) with congenital anomalies, neuro-muscular diseases or pulmonary complications that render them ventilator dependent with tracheotomies.
  • Monitored vital signs, lab results, and other indicators to detect changes in patients'' conditions promptly.
  • Served as a preceptor for new nurses, sharing knowledge, expertise, and best practices to improve their skills and confidence.
  • Participated in unit-based quality improvement initiatives focused on enhancing patient outcomes through process improvements.
  • Promoted patient safety by adhering to infection control protocols and conducting regular health assessments.
  • Administered medications accurately and safely, ensuring proper dosages were given per physician orders.
  • Monitored patients' conditions and reported changes in physical presentation, appearance, and behavior to discuss treatment with physicians.
  • Performed various nursing interventions such as wound dressing, vital sign monitoring, and specimen collection and chest physiotherapy.
  • Assessed physical, psychological, physiologic, and cognitive status of patients.
  • Educated patients, families and caregivers on diagnosis and prognosis, treatment options, disease process, and management and lifestyle options.
  • Performed frequent checks on life support equipment and made necessary adjustments to preserve optimal patient conditions.

Education

Diploma - Nursing

DePaul Hospital Professional School of Nursing
Norfolk, VA

Skills

  • Teamwork and Collaboration
  • Coaching and Mentoring
  • Overseeing Daily Activities
  • Quality Improvement
  • Leading Team Meetings
  • Organizational Skills
  • Process Improvement
  • Effective Communication

Certification

  • Certified Case Manager, Commission for Case Management Certification, #00054671 issued 12/01 2002 and expires on 11/30/2027

Gardening, Playing the piano, thrifting at vintage antique stores and vacations in the mountains.

I am a dedicated antique thrifter! I love to go into old stores that sell old things that are long-forgotten. Sometimes I buy nothing, sometimes I find something that reminds me of my childhood and brings back great memories. A really great time is when I can find one of these antique stores in the mountains on one of our vacations that my husband and I go on either during the early Spring or Fall. The mountains have great finds! Sometimes we even come upon a winery and take part in a wine tasting - which is a real treat because the mountain views are spectacular and its a great place to take it all in.

I have played the piano since a child. My mother "made" us all take lessons (I am the youngest daughter of seven) growing up. I have enjoyed playing and it is very relaxing and peaceful. Personally, I think everyone should learn how to play an instrument just for the relaxation and down-time.

Plants. I have a love-hate relationship with plants...or maybe its them with me. I did not really start up my hobby with plants until my mother passed away in 2022. She had a green thumb and could make anything grow anywhere. So when she passed away, I inherited her plants and I have been striving to keep them alive. So far, its been a challenge. I have bought the plant lights, the special additives you put in the soil and if they were humans they would probably be on the ICU step-down unit. I'm getting better at it and I continue to Pinterest my way through it!

Languages

English
Full Professional

Timeline

Team Leader

Elevance
01.2021 - 09.2024

Telephonic Nurse Case Manager

Elevance
01.2015 - 01.2021

Team Leader

InforMed Medical Management Services
01.2007 - 12.2014

Telephonic Nurse Case Manager

Medical Management and Rehab Services (MMARS)
01.2006 - 12.2006

Team Leader

Hines & Associates Case Management
01.2003 - 12.2005

Telephonic Nurse Case Manager

Hines & Associates Case Management
12.2001 - 01.2003

Home Health RN Case Manager

Obici Hospital - Acquired by Sentara Hospital
01.1995 - 12.2001

Home Health RN Case Manager

Interim Home Health
01.1994 - 01.1995

Hospital Staff RN

Children's Hospital of the King's Daughters
01.1993 - 06.1994

Diploma - Nursing

DePaul Hospital Professional School of Nursing

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Rebecca Moulden, RN, CCM