Rene Lewton
Phoenix,AZ
Summary
Dynamic Case Management Team Lead with a decade of experience in Emergency Department and Intensive Care Unit settings, complemented by seven years in case management and two years in leadership roles. Recognized for fostering empathetic engagement and designing innovative programs that drive measurable outcomes. Proven track record in developing health initiatives and championing staff development, ready to leverage strategic vision and operational expertise to enhance population health initiatives. Committed to delivering impactful solutions that improve patient care and optimize team performance.
Overview
16
16
years of professional experience
1
1
Certification
Work History
Team Lead on the FEP Team
Blue Cross Blue Shield of Arizona
07.2023 - Current
- Team Lead for FEP care management, overseeing multiple programs and leading/mentoring care managers
- Designed and launched the Rare Condition Management Program for FEP: developed high-volume referral processes, data-collection workflows, clinical assessments, and staffing/training protocols
- Revamped the ED Care Coordination Program by pinpointing inefficiencies, creating job aids and tracking tools for complex research and outreach, and training both clinical and non-clinical teams under pressure
- Collaborated across multiple debartments to troubleshoot escalations and deliver targeted services to members
- Participated in procedure review, audits and reeducation initiatives to ensure compliance and reinforce best practices
- Provided interim coverage for care managers to maintain uninterrupted member support
- Actively advocated for staff needs, driving engagement and professional development
Nurse Care Manager on the FEP Team
Blue Cross Blue Shield of Arizona
11.2020 - 07.2023
- Managed care for FEP members, overcoming barriers to deliver efficient, compassionate advocacy
- Served as FEP subject-matter expert on the policy review team
- Mentored colleagues on FEP and IU65 care management teams
- Designed and facilitated staff training in motivational interviewing
- Contributed to PCH and Genesis outreach initiatives during contract negotiations
- Partnered with Field Services to deliver educational presentations to the FEP population
CVICU RN
Banner Thunderbird Medical Center
04.2020 - 11.2020
- Provided invasive hemodynamic monitoring and ventilator management for critically ill patients using Vigileo, Impella, IABP, SLED, and Swan-Ganz catheters
- Managed diverse cardiothoracic, medical, neurologic, and trauma cases, delivering tailored critical-care interventions
- Served as patient advocate, bridging communication between families, multidisciplinary teams, and providers in high-stress situations
RN Case Manager for Chronic Complex Case Management
Steward Health Choice
08.2019 - 03.2020
- Managed diverse insurance portfolios—including Health Choice, Health Choice Generations, UHC Community/SNP, Cigna Medicare Advantage, and traditional Medicare—ensuring compliance and cost-effective care delivery
- Leveraged CareRadius, Cerner, and proprietary plan systems to streamline case management processes and maintain data accuracy
- Conducted community needs assessments and delivered targeted education and resources to reduce ED visits and hospital admissions while increasing primary care engagement
- Executed rapid interventions to address care barriers and nonadherance, boosting patient follow-up and health plan participation
- Educated members on active plan involvement, self-advocacy, and lifestyle modifications to enhance quality of life
- Orchestrated end-to-end care coordination among payers, PCPs, discharge planners, and pharmacies for patients with complex needs
RN Case Manager
Banner Thunderbird Medical Center
07.2018 - 08.2019
- Evaluated medical necessity and appropriateness of care using MCG admission and continued-stay criteria, identifying discharge barriers and driving timely resolutions
- Partnered with interdisciplinary teams to design and manage safe, patient-centric discharge plans, ensuring seamless handoffs across the care continuum
- Educated clinical staff on case management and managed care principles, embedding best practices into daily workflows
- Oversaw individual patient journeys from admission through post-acute care, optimizing clinical, financial, operational, and satisfaction metrics
- Led process improvement projects and provided mentorship to new team members, enhancing department performance and staff confidence
ICU Specialty RN
Banner Staffing Services
10.2017 - 07.2018
- Floated across multiple specialty units within the Banner Health network, leveraging comprehensive nursing assessments and care planning to support diverse patient populations
- Collaborated with interdisciplinary teams to coordinate care and optimize patient outcomes through effective communication
CVICU RN
Banner Thunderbird Medical Center
07.2015 - 10.2017
- Administered advanced hemodynamic monitoring and ventilatory support to critically ill patients using Vigileo, Impella, IABP, SLED, and Swan-Ganz catheters
- Managed comprehensive care for cardiothoracic, medical, neurologic, and trauma patient populations
- Acted as patient advocate, facilitating clear communication between families, staff, and providers in high-stress scenarios
- Precepted and mentored new nursing staff, accelerating clinical proficiency and unit integration
Adult ICU RN
St Joseph Mercy Oakland
04.2012 - 07.2015
- Utilized advanced monitoring and support technologies (Vigileo, IABP, CRRT, Swan-Ganz catheters, EVD systems) to care for critically ill patients
- Delivered specialized treatment across cardiothoracic, medical, neurologic, and trauma units
- Advocated for patients and mediated communication among families, staff, and multidisciplinary teams in high-stress scenarios
- Served as charge nurse—coordinating patient flow, enforcing safety protocols, and mentoring nursing staff
- Precepted and developed new nurses, accelerating their clinical proficiency and unit integration
Emergency Department, Level II Trauma Center RN
St Joseph Mercy Oakland
04.2011 - 04.2012
- Applied the nursing process to deliver targeted emergent care for adult and pediatric patients
- Co-developed and launched an ED-based urgent care unit, streamlining patient flow
- Triaged and prioritized treatment for a consistently high-volume patient census
- Precepted and mentored new nursing staff, accelerating clinical competency and confidence
Emergency Department, Level I Trauma Center RN
Detroit Receiving Hospital
08.2009 - 04.2011
- Delivered emergent care to a high volume of critically ill adult patients in a Level I trauma setting
- Managed non-critical caseloads while coordinating multiple ICU admissions and holds
- Partnered with residents and escalated complex cases to attending physicians
- Adapted workflows during staffing shortages to uphold patient safety and quality of care
- Educated patients on appropriate ED utilization, reducing non-urgent visits
- Innovated supply solutions by repurposing existing materials amid chain shortages
- Participated in community outreach and vaccination initiatives in a culturally diverse urban environment
Education
RN to Bachelor of Science in Nursing -
Western governernor’s university
12.2020
Associated Degree in Nursing - undefined
oakland community college
12.2009
Skills
- Attention to detail
- Conflict resolution
- Coaching and mentoring
- Performance improvement
- Process improvement
- Schedule management
- Employee evaluation
- Diversity and inclusion
- Regulatory compliance
- Workflow management
Certification
- Arizona State Licensure, 2027-01-01
- CCM, 2027-01-01
Timeline
Team Lead on the FEP Team
Blue Cross Blue Shield of Arizona
07.2023 - Current
Nurse Care Manager on the FEP Team
Blue Cross Blue Shield of Arizona
11.2020 - 07.2023
CVICU RN
Banner Thunderbird Medical Center
04.2020 - 11.2020
RN Case Manager for Chronic Complex Case Management
Steward Health Choice
08.2019 - 03.2020
RN Case Manager
Banner Thunderbird Medical Center
07.2018 - 08.2019
ICU Specialty RN
Banner Staffing Services
10.2017 - 07.2018
CVICU RN
Banner Thunderbird Medical Center
07.2015 - 10.2017
Adult ICU RN
St Joseph Mercy Oakland
04.2012 - 07.2015
Emergency Department, Level II Trauma Center RN
St Joseph Mercy Oakland
04.2011 - 04.2012
Emergency Department, Level I Trauma Center RN
Detroit Receiving Hospital
08.2009 - 04.2011
Associated Degree in Nursing - undefined
oakland community college
RN to Bachelor of Science in Nursing -
Western governernor’s university
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