Shelley Jones
Concord,CA
Summary
To seek and maintain full-time position that offers professional challenges utilizing interpersonal skills, excellent time management and problem-solving skills. Seasoned nursing professional offering proven clinical knowledge, natural interpersonal strengths and technical abilities. Knowledge about medication administration and interdisciplinary collaboration focused on optimizing patient care and support. Quality-focused and efficiency-driven leader.
Overview
25
25
years of professional experience
1
1
Certification
Work History
Catastrophic Nurse Case Manager Workers Comp.
Gateway Health Management
09.2019 - Current
- Communicated with healthcare team members, attorney's and adjuster's to plan, implement and enhance treatment strategies that encourage progress toward return to health and return to work.
- Collaborated with medical providers and employee's to support , educate, and participated in patient and family planning process, as well as provided instructions and addressed question and concerns.
- Effectively communicated with physicians regarding patient needs, treatment recommendations, medications and progress.
- Used first-hand knowledge and clinical expertise to advocate for patients under care and enacted prescribed treatment strategies
Telephonic Nurse Case Manager
Allied Managed Care
10.2010 - 04.2019
- Maintained detailed records of patient progress, documentation of services and case notes.
- Interfaced with third-party payers, insurance companies and providers for utilization review activities and submitted timely reports to clients and providers.
- Assessed current treatment plan to identify barriers, clarify or determine realistic goals and objectives and seek potential alternatives.
- Provided patient and family education on available resources and self-care strategies
Telephonic Nurse Case Manager
Wellcomp Managed Care
03.2009 - 10.2010
- Evaluated patients referred for case management to determine physical, mental, financial and psychosocial status by utilizing comprehensive, standardized criteria to identify existing and potential needs.
- Assessed current treatment plan to identify barriers, clarify or determine realistic goals and objectives and seek potential alternatives.
- Maintained detailed records of patient progress, documentation of services and case notes
Worker's Compensation Case Manager
Professional Dynamics
06.2008 - 03.2009
- Developed and implemented comprehensive case management plans to address client needs and goals.
- Interfaced with third-party payers, insurance companies and providers for utilization review activities and submitted timely reports to clients and providers.
- Collaborated with other health care professionals regarding plan of care and variances in plan implementation to achieve outcomes.
Nurse
John Muir Medical Center
08.1998 - 01.2007
- Provided direct patient care, stabilized patients, and determined next course of action.
- Assessed patients to determine individual needs and develop care plans in coordination with multidisciplinary healthcare professionals.
- Collaborated with physicians to quickly assess patients and deliver appropriate treatment while managing rapidly changing conditions.
- Remained calm during high-stress, critical situations, demonstrating sustained focus and problem-solving in real-time.
- Oversaw delivery of care for patients on medical-surgical unit, providing direct care, delegating nursing assignments and supervising team comprised of nurses, LPNs, technicians, and unit clerks.
Education
Bachelor of Science - Nursing
University of Portland
Portland, OR05.1998
Skills
- Regulatory Compliance
- Interdisciplinary Collaboration
- Utilization Review
- Accurate Documentation
- Compassionate and Caring
- Determine Medical Necessity
- Clear Patient Communication
- Electronic Recordkeeping
- RN Case Management
Certification
- Certified Case Manager - { Since 2020}
Timeline
Catastrophic Nurse Case Manager Workers Comp.
Gateway Health Management
09.2019 - Current
Telephonic Nurse Case Manager
Allied Managed Care
10.2010 - 04.2019
Telephonic Nurse Case Manager
Wellcomp Managed Care
03.2009 - 10.2010
Worker's Compensation Case Manager
Professional Dynamics
06.2008 - 03.2009
Nurse
John Muir Medical Center
08.1998 - 01.2007
Bachelor of Science - Nursing
University of Portland
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