Renee Sheffield
Southside,AL
Summary
Energetic leader promotes 29 years of industry experience with superior record of accomplishment. Ambitious and highly motivated RN Case Manager surpasses demanding objectives and achieves or exceeds set goals.
Overview
26
26
years of professional experience
1
1
Certification
Work History
RN Case Manager
Brundage Group/UAB Hospital
02.2024 - Current
- Managed complex cases involving multiple comorbidities, requiring close monitoring and coordination of various healthcare services.
- Provided emotional support to patients coping with chronic illness or end-of-life decisions, fostering resilience during difficult times.
- Collaborated closely with physicians to develop individualized treatment plans, supporting optimal patient outcomes.
- Educated patients and families on available community resources, facilitating access to necessary support services.
- Reduced hospital readmission rates through effective case management and patient education on self-care techniques.
- Enhanced patient care by developing comprehensive care plans and coordinating with interdisciplinary healthcare teams.
- Coordinated care conferences with interdisciplinary team members, ensuring all perspectives were considered in the development of comprehensive treatment plans.
- Managed support services and fostered communication among social workers, therapists, hospital staff, and patients.
- Streamlined discharge planning processes, ensuring a smoother transition for patients back to their homes or other facilities.
- Advocated for patients'' rights and preferences, working diligently to align care with individual values and goals.
- Navigated regulatory requirements effectively, ensuring proper documentation and compliance with relevant laws and guidelines.
- Monitored patient progress closely, adjusting care plans as necessary to meet evolving health requirements.
- Ensured compliance with healthcare regulations and standards, conducting regular reviews of patient care activities.
- Streamlined discharge planning, ensuring patients received necessary resources and support for recovery at home.
RN Case Manager
GHR/Memorial Hermann Hospital
09.2023 - 12.2023
- Provided emotional support to patients coping with chronic illness or end-of-life decisions, fostering resilience during difficult times.
- Managed complex cases involving multiple comorbidities, requiring close monitoring and coordination of various healthcare services.
- Collaborated closely with physicians to develop individualized treatment plans, supporting optimal patient outcomes.
- Educated patients and families on available community resources, facilitating access to necessary support services.
Travel RN Case Manager
GHR Healthcare/Houston Methodist Hospital
02.2023 - 09.2023
- Advocated for patients by communicating care preferences to practitioners, verifying interventions met treatment goals and identifying insurance coverage limitations.
- Effectively communicated with physicians regarding patient needs, performance, medications and changes.
- Evaluated healthcare needs, goals for treatment, and available resources of each patient and connected to optimal providers and care.
- Responded promptly and professionally to patient questions and concerns.
- Participated in patient and family planning process, as well as provided instructions and addressed question and concerns.
- Performed evaluations on consistent basis to address changes in patient needs, conditions and medications, altering care plans when required.
- Liaised with physicians regarding patient needs, performance and changes.
- Coordinated with interdisciplinary professionals to develop plans of care, administer tests and monitor patient status.
- Completed initial assessments of patients and family to determine and address individual home care needs. ·
- Conducted regular re-evaluations to address changes in needs and conditions, introducing revisions to care plans.
- Authored initial assessments of patients and family to develop plans for individual home care needs.
- Worked with suppliers and vendors on provision of medical equipment, items and services.
- Managed and streamlined referral queues by efficiently prioritizing patients and clearing insurance obstacles.
- Initiated appropriate preventive and rehabilitative nursing procedures.
Travel RN Case Manager
GHR Healthcare/Ochsner Medical Center
11.2022 - 02.2023
- Advocated for patients by communicating care preferences to practitioners, verifying interventions met treatment goals and identifying insurance coverage limitations.
- Effectively communicated with physicians regarding patient needs, performance, medications and changes.
- Evaluated healthcare needs, goals for treatment, and available resources of each patient and connected to optimal providers and care.
- Responded promptly and professionally to patient questions and concerns.
- Performed evaluations on consistent basis to address changes in patient needs, conditions and medications, altering care plans when required.
- Coordinated with interdisciplinary professionals to develop plans of care, administer tests and monitor patient status.
- Completed initial assessments of patients and family to determine and address individual home care needs. ·
- Conducted regular re-evaluations to address changes in needs and conditions, introducing revisions to care plans.
- Examined patients and documented history of current and previous conditions, illnesses, injuries and current medications.
- Created patient assessments and plans for individual home care needs.
- Authored initial assessments of patients and family to develop plans for individual home care needs.
- Worked with suppliers and vendors on provision of medical equipment, items and services.
- Coordinated rehabilitative and preventive nursing processes and procedures.
- Managed and streamlined referral queues by efficiently prioritizing patients and clearing insurance obstacles.
RN Case Manager
Riverview Regional Medical Center
01.2016 - 06.2022
- Effectively was responsibly for the activities of utilization management, and care coordination in the development and implementation of a discharge plan for an assigned group of patients.
- Served as resource for other members of the healthcare team and provided education to team members on issues related to the continuum of care, reimbursement, regulatory agency guidelines and resource use
- Through collaborative team work, assured that the treatment plan was implemented accurately, in a cost-effective and efficient manner in order to promote customer satisfaction and prevent delays in care and discharge
- Responsible for reviewing medical necessity indicators to assure that appropriateness of care criteria was met
- Documented reviews and discharge planning in the medical record/computer system as appropriate
- Actively participated and contributed to multidisciplinary rounds
- Documented avoidable days to support process improvement activities and support other quality improvement programs/projects as needed
- Reviewed reasons for Readmissions, concurrently appealed managed care denials
- Completed initial assessments of patients and family to determine and address individual home care needs. ·
- Advocated for patients by communicating care preferences to practitioners, verifying interventions met treatment goals and identifying insurance coverage limitations.
Clinical Marketing Liaison
Noland Hospital LTACH
02.2012 - 08.2015
- Responsible for developing and implementing census growth strategies in order to develop and maintain referral relationships
- Developed a referral base to include hospital discharge planners, physicians, nursing homes, home health agencies, outpatient clinics, and healthcare providers as appropriate
- Performed speaking engagements, cold calls, and facilitated networking activities
- Responsible for performing thorough pre-admission patient assessments and clinical information to commercial insurances and Medicare HMO's for LTACH admission authorization
- Served as a resource and provided patient screens toward necessity to determine appropriate level of patient care
- Responsible for educating patients and families regarding Noland LTACH's mission and goals
- Communicated and established a LTACH discharge plan with patients' and families prior to admission
- Communicated patient history, current status, and patient's needs to Attending LTACH prior to LTACH admission
- Continually maintained and improved company's reputation and positive image in markets served
Community Relations/Admissions Coordinator
Oasis Healthcare
08.2010 - 02.2012
- Developed and implemented a marketing plan for Etowah, Calhoun, And St. Clair Counties
- Built a referral base to include physicians, hospital discharge planners, nursing home, home, health agencies, social workers, and nurses to increase the growth of census and admissions for the agency
- Performed cold calls, relationship building, and speaking engagements
- Performed assessments and data collection through history and physicals and hospital discharge plans
- Responsible for ensuring admissions were appropriate in regard to Hospice Medicare, Hospice Medicaid, and commercial insurance
- Responsible for planning nursing interventions to meet identified patient's physical, psychological , social, and environmental needs
- educating families on palliative care
- Responsible for educating families on palliative care
- Responsible for communicating with physicians tp attain admission orders
- Responsible for coordinating all aspects of the admission process from point of referral to completion of admission in accordance with policy and procedures
Administrator
Southern Care
06.1998 - 08.2010
- Managed staff for the following positions: Clinical Director, Community Relations Staff, Volunteer Coordinator, Team Secretary,
- Responsible for ensuring that all state and federal guidelines were being followed at a local level
- Management of the hospice program in matters of overall operations at the local level
- Responsible for identification, selection, and management of employees, oversight of organization and direction of patient care
- Responsible for oversight of orientation and in-service training programs for all employees
- Oversight of the Community Relations and Admissions functions, monitor and facilitate the active status of contractual agreements, communication protocols and the education of staff on all contractual agreements
- Serve as a Liaison for all Community Relations Staff in regards to Physician or Family complaints
- Maintained bimonthly meetings with Medical Director to discuss the overall operations, goals, and performance improvenet
- Responsible for ensuring that overall profits and losses were within proposed budget at the local level
Education
Associate of Science - Nursing
Gadsden State Community College
Gadsden, AL05.1993
Skills
- Teambuilding
- Decision-Making
- Flexible and Adaptable
- Active Listening
- Multitasking Abilities
- Analytical and Critical Thinking
- Written Communication
- Planning and Coordination
- Organization and Time Management
- Self-Motivated
- Attention to Detail
- Problem-Solving
- Good Telephone Etiquette
- Excellent Communication
- PPE Compliance
- Interpersonal Communication
- Data Entry
- First Aid/CPR
Certification
Alabama Board of Nursing 1-070367
AHA BLS Certified
Additional Information
References available upon request
Timeline
RN Case Manager
Brundage Group/UAB Hospital
02.2024 - Current
RN Case Manager
GHR/Memorial Hermann Hospital
09.2023 - 12.2023
Travel RN Case Manager
GHR Healthcare/Houston Methodist Hospital
02.2023 - 09.2023
Travel RN Case Manager
GHR Healthcare/Ochsner Medical Center
11.2022 - 02.2023
RN Case Manager
Riverview Regional Medical Center
01.2016 - 06.2022
Clinical Marketing Liaison
Noland Hospital LTACH
02.2012 - 08.2015
Community Relations/Admissions Coordinator
Oasis Healthcare
08.2010 - 02.2012
Administrator
Southern Care
06.1998 - 08.2010
Associate of Science - Nursing
Gadsden State Community College
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