Samantha Claxton
Cone Health System
Greensboro,NC
11
years of professional experience
Innovative Nurse Case Manager Leader with expertise in managing high-risk patient populations in value-based care models. Specializes in utilization management, care coordination, and discharge planning to minimize avoidable admissions. Collaborates effectively with interdisciplinary teams to enhance care transitions and patient outcomes while integrating Social Determinants of Health into comprehensive care plans.
Work History
Transition of Care Nurse
6 Months- Conducted post-discharge follow-up, assessing patient needs to tailor care plans and enhance recovery.
- Collaborated with healthcare providers to prevent complications and reduce readmissions through effective communication and care coordination.
- Educated patients and families on treatment plans, discharge instructions, and self-care routines.
- Optimized time management skills to prioritize tasks effectively and provide consistent attention to multiple patients simultaneously.
Manager of Nursing Community Care NC Market
3 Years 5 Months- Supervised NC market Nurse Case Managers to support care coordination, complex case management, and SDOH intervention delivery.
- Managed staffing schedules, tracked productivity, evaluated performance, and validated competencies.
- Managed quality, safety, and performance improvement initiatives focused on CMS, HEDIS, and value-based benchmarks.
- Directed daily operations, aligning team priorities with business objectives and service standards.
- Managed staffing scheduling, productivity tracking, performance evaluations, and competency validation.
- Designed and implemented workflow process improvements to standardize execution and reduce operational delays.
- Coordinated cross-functional communication to resolve issues and maintain project momentum.
- Established policy and procedure compliance practices across teams to support consistent execution.
- Reviewed performance data and operational reports to guide informed management decisions.
- Directed member safety investigations and performed root cause analysis (RCA) to support complaint resolution.
Care Team Lead
1 Year 5 Months- Overseen multidisciplinary team of registered nurse care managers, community health partners, behavioral health specialists, and providers serving high-risk, complex patients across inpatient and community settings.
- Led Complex interdisciplinary team in Care Case Conference integrating medical, behavioral, and community-based interventions to address barriers impacting outcomes and care transitions.
- Monitored care quality, patient safety, and outcomes metrics, implementing process improvements that enhanced compliance and streamlined service delivery.
- Coordinated cross-functional communication between clinical, operations, and support teams to resolve member issues.
RN Case Manager
5 Years 3 Months- Managed acute and complex inpatient cases, including utilization review, reduction of LOA and discharge planning.
- Coordinated patient transitions across skilled nursing facilities, dialysis centers, home health agencies, and community resources, ensuring seamless access to DME and home support services.
- Oversaw COVID-19 patient placement, inter-facility coordination, and reporting to ensure safe and timely care delivery.
- Assessed patient needs, barriers, and care goals to develop individualized case management plans.
- Collaborated with physicians, social workers, and care teams to align treatment plans and utilization needs.
- Reviewed medical records and clinical updates to ensure accurate documentation and timely care coordination.
Education
Bachelor of Science - Nursing
Bachelor of Science - Business Administration And Management
Skills
Clinical Leadership & Operations
Staff Supervision & Performance Management Interdisciplinary Team Leadership
Workforce Planning Quality Improvement
KPI Monitoring
Regulatory Compliance
Patient Experience
Cost Reduction
Complex Case Management
Utilization Management
Care Coordination
Population Health
SDOH Integration
Value-Based Care
Policy developmentt
Patient advocacy
Chronic disease management
Time management
Critical thinking
Strong clinical judgment
Clinical Audit
Hiring/Firing
EARLIER EXPERIENCE
Registered Nurse – Cone Health System (2013–2016)
Project Delivery Leader – Procter & Gamble (1997–2011)
LICENSURE & CERTIFICATIONS
Registered Nurse (RN), North Carolina
BLS – American Heart Association
CCM (Commission for Case Manager Certification) – In Progress
EDUCATION
Bachelor of Science, Nursing – North Carolina A&T State University
Bachelor of Science, Money & Finance – Guilford College
Timeline
Transition of Care Nurse
Cone Health System
04.2026 - CurrentRead More
Manager of Nursing Community Care NC Market
Cityblock
11.2022 - 04.2026Read More
Care Team Lead
Cityblock Health
06.2021 - 11.2022Read More
RN Case Manager
Cone Health System
03.2016 - 06.2021Read More
North Carolina A&T State University
Bachelor of Science from Nursing
Read More
Guilford College
Bachelor of Science from Business Administration And Management
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