∙ 20+ years of Case Management experience: includes 5+ years of Remote/Telephonic Case Management
∙ 5+ years of experience working with Special Needs Populations (SNP) including both high risk physical and psychological needs patients
Case Management, Utilization Review, Discharge Planning
Telephonic/Remote CM including Telehealth CM/Nurse Triage (Work at Home)
Managed Care (Medicare & Medicaid); SNP (Special Needs Populations)
complex Physical & Behavioral health needs patient populations
ICU/Critical Care, Palliative Care, Oncology, Medical/Surgical
Clinical Nurse Auditor
Director of Case Management
Educator: Faculty/Clinical Instructor
Overview
6
6
years of professional experience
Work History
House Supervisor
Fundamental Healthcare
Saint George, SC
11.2018 - 11.2019
Managed nursing staff schedules to ensure optimal coverage during peak hours and reduced overtime costs.
Streamlined communication between departments for improved patient flow and satisfaction.
Reviewed clinical documentation to asses standards and quality of care.
Monitored patient acuity levels closely, adjusting staffing assignments as needed for optimal care delivery.
Telehealth Case Manager
AMC Health
New York, NY
12.2016 - 07.2017
Maintained accurate documentation on all cases, ensuring compliance with regulations and confidentiality requirements.
Conducted thorough assessments of clients'' situations, identifying issues, goals, and necessary interventions.
Monitored ongoing cases closely, adjusting case management strategies as needed based on evolving circumstances or new information.
Educated clients on available programs, benefits, and services, empowering them to make informed decisions about their care needs.
Telephonic Case Manager
Humana
Louisville, KY
05.2016 - 12.2016
Conducted ongoing evaluations of patients'' medical conditions and needs, advocating for appropriate resources when required.
Enhanced patient care by conducting thorough telephonic assessments and developing comprehensive case management plans.
Exceeded performance metrics consistently by managing caseloads effectively while prioritizing high-risk cases that required immediate attention.
Provided education on disease processes, medications, and self-care techniques for patients and their families, empowering them to take charge of their health.
Amerihealth Caritas
Clinical Nurse Auditor/Telephonic Case Manager
Remote/Charleston South Carolina
10.2013 - 10.2016
Self-motivated, with a strong sense of personal responsibility.
Worked effectively in fast-paced environments.
Skilled at working independently and collaboratively in a team environment.
Proven ability to learn quickly and adapt to new situations.