Samantha Lay
Knoxville,TN
Summary
Bachelor level RN with management experience Accomplished Registered Nurse Case Manager with 10+ years of experience dedicated to quality care of diverse patients. Skillfully blend hands-on skills with advanced background in case management, long term care and hospital/clinic settings. Work effectively with all levels of healthcare providers, physicians and administrators to address patient needs.
Overview
16
16
years of professional experience
1
1
Certification
Work History
RN BSN CASE MANAGER
Amerigroup
10.2014 - Current
- Coordinating physical, mental, and long-term care needs of elderly and physically disabled population
- Initiating and updating member's PCSP to ensure that services were initiated and continued to meet ever-changing needs of membership
- Managing members with chronic illnesses and co-morbidities to ensure cost effective and appropriate utilization of choices services
- Improving patient outcomes by assisting patients with resources available in the community to assist with healthcare needs
- Facilitating authorizations and referrals for utilization of services within benefit structure
- Performing telephonic and face to face clinical assessments for identification, evaluation, and coordination of member's needs, including physical health, behavioral health, social services, and long-term care support
- Identify members for high-risk complication and coordinate with member and healthcare team
- Collaborated with physicians to quickly assess patients and deliver appropriate treatment while managing rapidly changing conditions
- Evaluated healthcare needs, goals for treatment, and available resources of each patient and connected to optimal providers and care
- Liaised with other healthcare professionals to develop comprehensive patient care plans and provide highest quality of care
Charge Nurse/ Manager
Summit View of Farragut
01.2011 - 01.2014
- Provide supervision of ancillary staff (RNs, LPNs, CNAs) to provide holistic approach to care which includes educating and advocating for client's individual needs
- Create care plans for patients and ensure patients goals are met
- Functions as main point of communication between clients/families and nursing facility
- Implemented new floor assignments based on evaluation of staffing requirements
- Discharge planning/case management in Skilled Nursing Facility Setting
- Collaborated with medical staff, patients, community resources and providers to arrange extended care in home setting prior to discharge from nursing facility based upon individual needs of patient
- Monitored current Medicare regulations, standards and reimbursement requirements related to quality improvement, case management and managed care of individuals
- Designed and implanted processes, procedures, and standards to improve clinical practices, services, and operations
- Provided nursing care to medical/surgical patients, administered medications/IV fluids, operated and inserted Foley catheters, nasogastric feeding tubes, monitored intake and output
- Led staff meetings to keep team informed of departmental changes and provide opportunities for nurses to share ideas and concerns
- Investigated and independently resolved complaints from staff, physicians, and patients by leveraging clinical judgment and unit management expertise
- Developed and implemented quality improvement initiatives to provide best possible patient care and identify and address areas of concern
- Trained new nurses in proper techniques, care standards, operational procedures, and safety protocols
- Implemented medication and IV administration, catheter insertion, and airway management
- Educated patients, families and caregivers on diagnosis and prognosis, treatment options, disease process, and management and lifestyle options
Licensed Practical Nurse
Stat Care Pulmonary
01.2010 - 01.2011
- Collaborated with medical staff, patients, community resources and providers to arrange home health services in community
- Obtaining prior authorizations
- Vaccine administration
- Documented accurate and complete patient information to address patient problems and expected outcomes
- Educated patients and caregivers on medical diagnoses, treatment options, chronic disease self-management and wound management
- Comforted and counseled patients and families throughout care process.
- Assessed patients' temperature, pulse, and blood pressure and recorded in electronic medical records
- Tracked findings of procedures such as EKGs using manual and automated recording devices
Patient Care Assistant
East Tennessee Children's Hospital
01.2008 - 01.2010
- Recorded temperature, blood pressure, pulse, or respiration rate as directed by medical or nursing staff
- Attended to patient and family's immediate needs and concerns by acknowledging and providing required attention
- Answered call lights and supported patient comfort and safety by adjusting bed rails and equipment
- Supported patient mobility needs with correct assistive devices and proper body mechanics to prevent injuries
- Gathered medical information, weight and height measurements and vital signs
- Assisted with feeding and monitored intake to help patients achieve nutritional objectives
- Assisted in transferring patients, beds and patient care equipment to other rooms adhering to necessary safety precautions
Education
Bachelor of Science in Nursing -
King University
Knoxville, TN05.2015
Associate of Science in Nursing -
Lincoln Memorial University
Knoxville, TN12.2013
Licensed Practical Nurse -
Tennessee College of Applied Science
Knoxville, TN12.2009
Skills
- Case Management
- Interdisciplinary Collaboration
- Effective Communication Skills
- Health Insurance
- Client Education
- Client Relationship Management
- Excel, Word and Powerpoint Expert
- Managed Care Experience
- Referral Coordination
- Chronic Disease Management
- Staff education and training
- Patient and family advocacy
Certification
- Registered Nurse, 198285
- CPR certified through American Heart Association
References
References available upon request
Timeline
RN BSN CASE MANAGER
Amerigroup
10.2014 - Current
Charge Nurse/ Manager
Summit View of Farragut
01.2011 - 01.2014
Licensed Practical Nurse
Stat Care Pulmonary
01.2010 - 01.2011
Patient Care Assistant
East Tennessee Children's Hospital
01.2008 - 01.2010
Bachelor of Science in Nursing -
King University
Associate of Science in Nursing -
Lincoln Memorial University
Licensed Practical Nurse -
Tennessee College of Applied Science
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