Experienced healthcare professional with strong focus on team collaboration and achieving results. Prepared to provide comprehensive care management, ensuring optimal patient outcomes. Demonstrates adaptability to changing needs and offers reliable support. Skilled in patient advocacy, care coordination, and resource management, with compassionate approach that fosters trust and respect.
Overview
15
15
years of professional experience
1
1
Certification
Work History
Pediatric Care Manager RN
Centene, Sunshine Health Children’s Medical Services Health Plan (CMS)
06.2022 - Current
Perform care management services to assess, plan, and coordinate the various aspects of physical, behavioral, and social needs for medically complex children, ages ranging from newborn to 21 years old.
Maintain a caseload of over 150 pediatric members with low to medium acuity, requiring monthly and quarterly outreaches.
Coordinate services between primary care providers, specialists, and medical and nonmedical providers, such as home health, durable medical equipment, speech therapy, occupational therapy, and physical therapy, as needed.
Facilitate and participate in productive interdisciplinary team meetings to enhance communication and streamline patient care processes.
Complete initial and annual assessments, along with developing personalized care plans for each member to reflect specific goals, objectives, and interventions designed to meet each member’s individual needs.
Continuously assessed patient progress and modified individualized care plans to promote improved health and recovery.
Complete follow-up assessments, including medication reconciliation after hospitalizations and emergency room visits, to ensure accurate documentation and clear discharge instructions.
Establish and participate in productive interdisciplinary team meetings with members and providers to ensure alignment of health care goals and plans of care.
Monitor referrals made for medical services, behavioral health services, and community services to support members' overall care management plan.
Document case management observations, assessments, and care plans using various medical records management systems.
Provide guidance, training, and performance feedback as a preceptor for new employees to ensure compliance with health plan policies and procedures, standards of care, and regulatory requirements.
Mother Baby Unit Staff RN/Fill In Charge RN
Lakeland Regional Health
03.2011 - 05.2022
Oversee a 32-bed mother/baby unit with an average of 20 couplets per shift by managing 5-7 clinical and support staff in patient care while maintaining a high level of staff morale and professionalism.
Manage care for postpartum mothers and their newborn infants from admission through discharge.
Ensure quality patient care, safety, and satisfaction by rounding on patients on floor during shift.
Delegate staff nurse and Patient Care Tech duties.
Strong leader for nursing staff assigned to the unit/shift.
Took patients and provide nursing care to allow for any overflow of postpartum couplets from Labor and Delivery to transfer to Mother Baby in a timely manner.
Provide breastfeeding assessment, support, and counseling to inpatient mothers.
Ensure effective collaboration and communication between physicians and clinical staff.
Collaborate in the successful implementation of “Quiet Time” and family centered care to allow families uninterrupted to bond with their newborn.
Provide professional nursing care to 3-4 mother/baby couplets in the Mother Baby Unit.
Initiate and implement the plan of care based on patient-specific needs through direct patient care and coordination with other members of the healthcare team.
Provide education on breastfeeding, infant care, pain management, postpartum care, Skin to Skin, SIDS and educational resources for Mother/Baby prior to discharge.
Evaluated and monitored patients care through consultation and direct hourly rounding.
Administered intravenous fluids and medications to mothers and babies as required.
Precept new employees and cross-train staff from other departments in compliance with department and hospital policies and procedures, standards of care, and regulatory requirements.
Determine patient care assignments in accordance with patient’s requirements as fill in charge nurse.
Floated to various units within the Women and Children Specialties including NICU, Labor and Delivery, and Pediatrics.
4W Trauma Unit
Lakeland Regional Medical Center
06.2010 - 03.2011
Provide professional nursing care to 4-5 assigned patients in the Trauma Unit.
Responsible for planning, assessing, implementing and evaluating patient care.
Update trauma surgeons and doctors about patients’ conditions and monitor vital information of patient.
Applied and maintained the principles of infection control in caring for IV site/lines, catheters, and surgical/trauma wounds.
Provided patient education in various areas including the disease processes, medical-surgical procedures, and pain management techniques.
Provide assistance to floor staff with all aspects of care to the trauma patient.
Education
B.S. - Nursing
Lewis University
Romeoville, IL
12.2009
B.S. - Accountancy
University of Illinois
Chicago, IL
07.2000
Skills
Care planning
Case assessments
Clinical documentation
Service coordination
Workflow coordination
Patient education
Quality improvement
Resource utilization
Referral management
Technology proficiency
Care quality assessments
Discharge planning
Patient & family support
Long-term care coordination
Critical thinking
HIPAA guidelines
Records management
Performance metrics
Problem identification
Process improvement
Accomplishments
Dedicated Registered Nurse with over over 10 years of hospital healthcare experience and nurse care manager with 3 years experience.
Consistently achieved metrics by completing charting with accuracy and efficiency.
Maintain strict adherence to professional ethics and confidentiality guidelines, safeguarding sensitive information and promoting trust.
Certification
Registered Nurse
Florida Board of Nursing
May 2010
License # RN9307150
Timeline
Pediatric Care Manager RN
Centene, Sunshine Health Children’s Medical Services Health Plan (CMS)
Provider Engagement Administrator II at Centene Corporation (Sunshine Health Plan)Provider Engagement Administrator II at Centene Corporation (Sunshine Health Plan)
Pediatric Care Manager at Centene, Sunshine Health Children's Medical ServicesPediatric Care Manager at Centene, Sunshine Health Children's Medical Services