RHONDA SKJERVA
New Rockford,ND
Summary
Obtained and upheld compact licensure in conjunction with Minnesota nursing license and CCM certification, underscoring dedication to exceptional patient care and proficient case management.
Assisted healthcare teams in creating patient care plans. Supported coordination of care to achieve positive patient outcomes. Facilitated communication between patients and medical professionals to improve care delivery.
Overview
12
12
years of professional experience
Work History
RN CASE MANAGER
BCBSND
03.2018 - Current
- As a nurse case manager, I help members of BCBSND facilitate and navigate the healthcare system. Individuals are identified through high costs and complex medical conditions. Assessments are conducted to identify member's needs and to coordinate appropriate interventions by utilizing motivation interviewing and collaborating with interdisciplinary teams, educating, monitoring, and evaluating the options and services required to meet the member’s health needs and member centered goals. Outreach is made telephonically to members, family, providers and caregivers. I assist members with transitions of care, and I provide education and resource management within the community to help facilitate members with the tools to be able to advocate for themselves and navigate their health care. Communication among different departments within BCBSND is key in assisting BCBS members including pharmacy, UM, Member advocacy, and the customer contact center. A high view knowledge about networks, eligibility and benefits is needed to elevate member experience. Documentation according to protocol and regulatory standards is completed with each interaction. I have experience with different focus groups. This has included managing the Medicaid expansion population which is a complex population that has various SDOH concerns, complex medical conditions, and behavioral health components. Challenges that may be encountered include addressing pre-authorization challenges including referrals and keeping care in state when able. I have managed disease management hypertension and diabetes that included educating members and family on self-care practices and promoting health literacy. I received my CCM in December 2019. During my time at BCBSND, I have transferred to 3 different case management documentation platforms including Pega, Aerial and Predictal. I work regularly with excel spreadsheets, Teams meetings, Outlook, and Microsoft word documents. I have been part of stretch assignments including URAC accreditation workgroup and CM assignment/work prioritization workgroup developing workflows and SOPs. As one of the senior team members, I help with mentoring new team members and work with them to enhance team performance by knowledge sharing through case study reviews.
MDS COORDINATOR-RN, RAC-CT
EVENTIDE FARGO
03.2016 - 03.2018
- As an MDS coordinator, I was responsible for completing all required MDS assessment for CMS and the stated of ND. With these assessments, I would complete a pain assessment, mobility assessment, vision/hearing assessment, oral/dental assessment, and assess for shortness of breath. After completion of these assessments, I would follow up with skilled nursing staff with the findings and ensure that there was appropriate follow up. I put out communication for nursing staff to complete required assessment, needed diagnoses, and care plan updates. I managed the Medicare case load with as many as 30 residents at a time. With Medicare management it was my responsibility to have communication with skilled therapy, set guidelines for Medicare charting, giving notice of Medicare ending, and knowledge of RUG levels. Family communication was very important as many family members had questions on room rates and therapy discontinuation. I was part of the management team and took part in education of staff, QI, audits, State survey prep, and daily IDT meeting. I was required to be on call on rotating shifts during evenings and weekends. ICD-10 knowledge was also required for this position and I attended classes specific to this.
RESIDENT CARE MANAGER-RN
EVENTIDE HEARTLAND
07.2015 - 02.2016
- As resident care manager, I oversaw ensuring documentation was reviewed daily and ensuring that appropriate follow up was done. I participated in a daily IDT meeting, QI, staff education, and coaching plans. I initiated care plans and reviewed them. I participated in care conferences and psych rounds (including pre-appointment preparation, orders and family communication)
MDS COORDINATOR-RN
EVENTIDE HEARTLAND
08.2014 - 07.2015
- As an MDS coordinator, I was responsible for completing all required MDS assessment for CMS and the stated of ND. With these assessments, I would complete a pain assessment, mobility assessment, vision/hearing assessment, oral/dental assessment, and assess for shortness of breath. After completion of these assessments, I would follow up with skilled nursing staff with the findings and ensure that there was appropriate follow up. I put out communication for nursing staff to complete required assessment, needed diagnoses, and care plan updates. I managed the Medicare case load with as many as 30 residents at a time. With Medicare management it was my responsibility to have communication with skilled therapy, set guidelines for Medicare charting, giving notice of Medicare ending, and knowledge of RUG levels. Family communication was very important as many family members had questions on room rates and therapy discontinuation. I was part of the management team and took part in education of staff, QI, audits, State survey prep, and daily IDT meeting. I was required to be on call on rotating shifts during evenings and weekends. At this facility, I was also in charge of restorative nursing program and setting up bowel and bladder programs.
RN-ACUTE CARE/ER
TURTLE LAKE COMMUNITY MEMORIAL HOSPITAL
02.2014 - 08.2014
- I worked as charge nurse which included diabetic care, IV care and maintenance, doctor orders/rounds, daily and weekly assessments, admissions/discharges/transfers. I provided patient education and communication with family and medical staff. I oversaw swing bed patients, acute care patients, assisted with IV placement for outpatient procedures and ER duties. The RN charge nurse was responsible for the ER on all shifts. I received my PALs and ACLs certification while I worked here.
CHARGE NURSE-RN
EVENTIDE HEARTLAND
11.2013 - 01.2014
- I assessed and monitored residents, completed daily assessments, received doctor orders, communicated with other medical staff, administered medications and treatments, completed weekly skin assessments, wound assessments, IV care, diabetic care, TPN, colostomy care, catheterization, peritoneal dialysis, and care of the dying. Communication with department managers, communication and education for family members and residents. This facility had an Alzheimer’s unit that I also oversaw. As charge nurse it was also my duty to take staff call ins and ensure adequate staff. I needed to be able to manage, delegate and prioritize. This unit had 40 residents plus staff.
Education
Associates of Arts and Science-RN -
Lake Region State College
05.2007
Skills
- Certified case manager since January 2020
- Experience in multiple healthcare settings
- Adaptable to change
- Proficient in CM documentation platforms
- Compliance-focused documentation skills
- Work organization based on priorities
- HIPAA regulations adherence
- CMS regulatory understanding
- Integrated problem-solving
- Patient discharge coordination
- MDS coordination expertise
ACTIVITIES
My passion is people and being able to help them in any way I can. I love to volunteer and have participated in Day of Caring, School Supply Drive, and Meals for Kids. Along with my daily work, I participate in stretch assignments.
Timeline
RN CASE MANAGER
BCBSND
03.2018 - Current
MDS COORDINATOR-RN, RAC-CT
EVENTIDE FARGO
03.2016 - 03.2018
RESIDENT CARE MANAGER-RN
EVENTIDE HEARTLAND
07.2015 - 02.2016
MDS COORDINATOR-RN
EVENTIDE HEARTLAND
08.2014 - 07.2015
RN-ACUTE CARE/ER
TURTLE LAKE COMMUNITY MEMORIAL HOSPITAL
02.2014 - 08.2014
CHARGE NURSE-RN
EVENTIDE HEARTLAND
11.2013 - 01.2014
Associates of Arts and Science-RN -
Lake Region State College