Renee Jenkins
Commerce City,CO
Summary
Compassionate healthcare professional with extensive expertise in patient management and coordination. Recognized for effectively navigating complex healthcare systems and driving patient-centered care initiatives. Collaborates with diverse teams and adapts seamlessly to changing healthcare environments while maintaining focus on achieving optimal patient outcomes.
Overview
24
24
years of professional experience
Work History
Nurse Case Manager
Pinnacol Assurance
2014.05 - 2026.05
- Provided on-going assessments of injured workers medical care, identified obstacles to recovery, and developed an action plan to get the injured worker to the point of Maximum Medical Improvement (MMI).
- Focused on facilitating a return to work for the employee at the earliest medically feasible opportunity.
- Generate written authorizations, denials and informational letters to providers for requested services and procedures in compliance with the Colorado Division of Workers' Compensation Rules of Procedure.
- Prepared injured workers medical histories, nursing options and questions about medical reports and legal documentation as preparation for peer review, hearings and other staffing conferences with internal and external customers.
- Scheduled appointments, managed referrals, and ensured injured worker followed established medical treatment plan.
- Worked with employers and providers to outline physical work restrictions and explore transitional or modified duties.
- Provided regular updates to adjuster regarding injured worker's recovery progress and prognosis.
- Multitasking managing approximately 30-40 incoming calls, emails and faxes per day from injured workers, adjusters, internal and external customers.
- Ensured open communication with injured workers at all times.
- Served as a resource for medical issues and questions from injured workers, adjusters and other internal and external customers.
RN Nurse Case Manager
CNIC Health Solutions
2012.02 - 2014.05
- Patient advocate coordinating care and bridging gap between patients and care team members, and community resources to ensure continuous care.
- Organizing safe, appropriate follow-up and resources for patients leaving the hospital.
- Help individuals and families understand diagnoses, treatment options, and insurance benefits.
- Aligning patient needs with community support systems and long-term care services.
- Utilized electronic health record systems for accurate documentation and data management.
UR Medical Management Specialist
MSA / EBMS
2002.05 - 2012.02
- Performed medical reviews to determine medical necessity through the use InterQual.
- Developed a knowledgeable working relationship with patients and healthcare team members to assist in identifying providers to be utilized for additional services upon patient's discharge from the hospital setting.
- Research, review and facilitate resolution of claims concerns.
- Educate patients on maximizing health insurance benefits.
- Monitor all activities related to Quality Assurance to help identify processing concerns.
- Developed and maintained department policy and procedures manual.
Education
Bachelor of Science - Nursing
CU School of Nursing
Denver, CO05.1989
Skills
- Clinical assessment
- Care coordination
- Electronic recordkeeping
- Discharge planning
- Teamwork and collaboration
- Attention to detail
- Time management
- Problem-solving abilities
- Multitasking
- Compassionate and caring
- Effective communication
- Patient advocacy
Languages
Spanish
Elementary
Timeline
Nurse Case Manager
Pinnacol Assurance
2014.05 - 2026.05
RN Nurse Case Manager
CNIC Health Solutions
2012.02 - 2014.05
UR Medical Management Specialist
MSA / EBMS
2002.05 - 2012.02
Bachelor of Science - Nursing
CU School of Nursing