Sonita Jacobs
Registered Nurse
Auburn,GA
Summary
Analytical and strategic registered professional nurse with excellent problem-solving and time management skills. Organized, efficient and always willing to go extra mile to meet expectations. Extensive work history. Past work experience includes clinical roles in critical care & acute care nursing within a hospital setting, management, and acute rehab nursing. Transition to working as worker Compensation Disability Field Case Manager & Catastrophic Nurse Case manager. Substantial worker compensation and insurance background, with a focus on customer service. Goal-oriented and driven for success.
Overview
23
23
years of professional experience
1
1
Certification
Work History
Disability Sr. Clinical Nurse Case Manager
Alight Solutions LLc. (Goldman Sac)
07.2023 - 12.2023
- Enhanced care coordination for 35 -45 patients with complex medical needs through effective communication and collaboration with multidisciplinary teams.
- Increased patient satisfaction by establishing strong rapport, actively listening to concerns, and addressing issues efficiently.
- Streamlined healthcare delivery by efficiently managing caseloads, prioritizing tasks, and maintaining accurate documentation.
- Supported individuals with mental health disorders by developing personalized treatment plans and connecting them to appropriate community resources.
- Promoted interdisciplinary collaboration among healthcare professionals by organizing team meetings to share best practices and improve patient care processes.
- Assessed individual barriers to optimal health outcomes, such as socioeconomic factors or access limitations, and worked diligently to address these challenges through tailored interventions.
- Maintained up-to-date knowledge of relevant policies, procedures, regulations, and guidelines related to clinical case management practice, ensuring compliance across all professional activities.
- Provided crisis intervention services, responding quickly and appropriately to urgent situations to protect patient safety and well-being.
- Participated in an multidisciplinary team providing ongoing case management services to adults with severe and persistent mental illnesses.
- Provided crisis intervention and risk assessments.
- Partnered with physicians, social workers, activity therapists, nutritionists, and case managers to develop and implement individualized care plans and documented patient interactions and interventions in electronic charting systems.
Disability Clinical Sr. Nurse Case Manager
Anthem BCBS
12.2019 - 06.2023
- Responsible for collaborating with healthcare providers and members to promote quality member outcomes and optimize member benefits
- Responsible for promoting effective use of resources for more complex medical issues
- Ensures medically appropriate, high-quality, cost-effective care by assessing medical necessity of inpatient admissions and outpatient services
- Responsible for ensuring appropriateness of medical, surgical, and diagnostic procedures by utilizing applicable medical policy and industry standards
- Responsible for accurately interpreting benefits and managed care products and steering members to appropriate providers, programs, or community resources
- Works with medical directors to interpret appropriateness of care and accurate claims payment
- Manage appeals for services denied and conduct precertification, continued stay review, care coordination, & discharge planning.
- Responsible for processing claims, customer services, claims appeal, Updating COB, and benefits administrator.
- Enhanced patient care by implementing evidence-based nursing practices and protocols.
- Reduced medication errors through thorough double-checking of prescriptions and dosages.
Disability Clinical Sr. Nurse Case Manager
GENEX services, LLC
01.2010 - 04.2020
- Provide onsite medical care coordination, vocational counseling, and job analysis while collaborating with providers to ensure safe return to work.
- Responsible for coordinating medical, surgical, and rehabilitation needs of injuries workers who suffered Catastrophic injuries such as TBI (traumatic Brain Injury), Spinal cord injuries, burns, and multiple trauma injury cases
- Work directly with multiple employers, as well as worker compensation and disability insurance, to ensure injured employees receive treatment for work-related injuries.
- Review and analyze medical Records for treatment compliance within Official Disability Guidelines (ODG) and Medical Treatment Guidelines.
- Facilitate communication between Carrier, physicians, and injured worker, keeping all parties abreast of treatment recommendations, prescriptions, and prognoses for recovery and anticipated return to work timeframes.
- Provide education to providers, employers , regarding medical treatment guidelines, state worker compensation laws
- Collaborated with physicians, therapists, and other healthcare professionals to develop comprehensive care plans that addressed patients' medical, emotional, and social needs.
- Improved patient outcomes by developing and implementing comprehensive care plans tailored to individual needs.
- Enhanced interdisciplinary team communication, ensuring timely and accurate updates on patient progress.
- Initiated and created 50-patient referral system, successfully boosting profits.
- Utilized professional networking to increase direct referrals from 25 monthly to 45.
Telephonic/Triage Nurse, Nurse Case Management
United Healthcare group (Optum Health Care Solution)
01.2008 - 01.2010
- Improved patient outcomes by conducting thorough telephonic assessments and promptly addressing medical concerns.
- Supported physicians in managing patient caseloads, ensuring accurate symptom assessment and seamless care coordination.
- Maintained compliance with regulatory standards by adhering to established protocols for telephonic nurse triage services.
- Demonstrated adaptability during periods of high call volume or staffing shortages while maintaining consistent quality of care.
- Supported quality improvement initiatives by participating in regular case review meetings and providing constructive feedback to colleagues.
- Counseled patients via telephone according to established guidelines and protocols, advising on provider-established plans of care.
- Assisted in management of patient utilization of health care system and provided patient education relative to health care needs, use of community resources and responsibilities of membership in managed care.
- Reported findings to quality departments after conducting routine restraint audits and worked with team to devise corrective actions for deficiencies.
Charge Nurse, Emergency Department
Piedmont Hospital
01.2007 - 01.2009
- Improved patient care by implementing evidence-based nursing practices in the emergency department.
- Enhanced team performance by providing ongoing mentoring and coaching to nursing staff.
- Streamlined workflow processes for increased efficiency and reduced patient wait times.
- Collaborated with interdisciplinary teams to develop comprehensive care plans for patients in crisis situations.
- Led successful quality improvement initiatives, resulting in improved patient satisfaction scores and outcomes.
- Ensured regulatory compliance with hospital policies, procedures, and protocols, maintaining a safe environment for patients and staff.
- Managed staffing assignments to optimize resources, ensuring appropriate nurse-to-patient ratios during peak times.
- Participated in hospital-wide committees focused on process improvements, contributing valuable insights from the Emergency Department perspective.
- Served as a liaison between patients, families, and physicians, promoting effective communication and timely resolution of concerns or issues.
- Facilitated seamless transitions of care between the Emergency Department and other healthcare units by optimizing communication channels among medical professionals.
- Developed strong relationships with community partners for streamlined referral processes and improved resource availability for patients upon discharge from the Emergency Department.
- Provided leadership during critical incidents or mass casualty events, coordinating resources effectively to manage the influx of patients requiring urgent care.
- Promoted a culture of accountability within nursing staff members by conducting regular performance evaluations and identifying areas for improvement.
Nurse Manger High Risk Pregnancy Unit
Gwinnett Medical Center
01.2008 - 12.2008
- Responsible for Supervision and management of Unit and staff that provide direct health services; insuring goals objectives and work performance are consistent with standards and quality of care
- Develop budgets estimates or other financial information ensuring compliance with budgets guidelines and effective delivery of services
- Evaluate staff, tracking quality indicators and other information to ensure resources are available to provide quality and on time services and performance are consistent with standard
- Collaborate and provide consultation for development of long-range growth of hospital
- Develop and implement policies, established area of responsibility through assignment.
Registered Professional Nurse/ Charge Nurse (Emergency Room/ Surgical Intensive Care)
Dept Of Veterans Medical Center
01.2001 - 04.2007
- Assessed and identified actual or potential health problems using nursing processing in various roles as Cardiac/telemetry nurse, Emergency Room nurse, Medical surgical nurse, and Permanent charge nurse
- Participated in pharmacy and skin care nurse committee
- Responsible for unit performance initiatives and discharge planning
- Assess and treat patients with multiple medical and health concerns, providing care in collaborative and fast-paced setting
- Demonstrate effective team leadership skills as charge nurse and Preceptor
- Provide expert input on computer software and programs for computerized charting and barcode medication programs
- Monitor patient for lethal arrhythmia
- Cardiac arrest code team
- Design and implement clinical pathway for congestive heart failure
- Parental Feeding
- Knowledge of Ventilation.
Education
Master of Science - Nursing Administration
Mercy College
Dobbs Ferry05.2007
Bachelor of Science - Nursing
Mercy College
Dobbs Ferry, NY05.2002
Associate of Applied Science - Nursing
Borough of Manhattan Community College
New York, NY12.2000
Skills
- Extensive multiple-disciplinary medical background and education (Critical care, orthopedics, medical surgery, Acute Rehab)
- Excellent written and verbal communication skills
- Presentation/ Preceptor/ training
- Leadership Supervisory & Management
- Expert with multiple Microsoft & Mac computer software, medical documentation software &
- Expert Computerized Charting
- Case Management
- Quality Improvement
- Disease Prevention &Health Promotion
- Concurrent & retrospective Chart review
- Healthcare billing &coding
- Chronic Disease Management
- Emergency Response
Certification
- CCM
- ACLS
- BCLS
- PALS
- EKG
- IV Insertion
- Phlebotomy
- Telemetry
- Medical Surgical & Emergency Nurse certification
- New York – 30316
- New Jersey
- RI
- Georgia Rehabilitation supplier
- California-748672
- Georgia-RN187349
- Pennsylvania-RN6093397
Research Nursing
True
Phone
718-318-1659, 917-864-3971
Personal Information
Title: R N, BSN, MSN, CCM
Accomplishments
- Supervised team of 45 staff members.
- Used Microsoft Excel to develop inventory tracking spreadsheets.
- Documented and resolved Readmission for CHF failure patients which led to decrease readmission.
- Achieved patient safety by introducing Barcode for Medication Administration tasks.
- Collaborated with team of 20 in the development of wellness program.
- Patient Care - Delivered compassionate care that exceeded hospital requirements. Successfully provided quality care to 25 patients in critical care environment.
- Training - Trained team of staff nurses in medical office procedures to ensure consistent quality of care.
- Quality Assurance - Ensured and enforced medical office compliance with HIPAA, OSHA and CLIA regulations for maximum quality and control.
Work Availability
monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
swipe to browse
Timeline
Disability Sr. Clinical Nurse Case Manager
Alight Solutions LLc. (Goldman Sac)
07.2023 - 12.2023
Disability Clinical Sr. Nurse Case Manager
Anthem BCBS
12.2019 - 06.2023
Disability Clinical Sr. Nurse Case Manager
GENEX services, LLC
01.2010 - 04.2020
Nurse Manger High Risk Pregnancy Unit
Gwinnett Medical Center
01.2008 - 12.2008
Telephonic/Triage Nurse, Nurse Case Management
United Healthcare group (Optum Health Care Solution)
01.2008 - 01.2010
Charge Nurse, Emergency Department
Piedmont Hospital
01.2007 - 01.2009
Registered Professional Nurse/ Charge Nurse (Emergency Room/ Surgical Intensive Care)
Dept Of Veterans Medical Center
01.2001 - 04.2007
Master of Science - Nursing Administration
Mercy College
Bachelor of Science - Nursing
Mercy College
Associate of Applied Science - Nursing
Borough of Manhattan Community College
Similar Profiles
Sandy MunozSandy Munoz
Sr Customer Care Representative at Alight Solutions LLCSr Customer Care Representative at Alight Solutions LLC
Tiffany StoneTiffany Stone
Training Specialist I at Alight Solutions LLCTraining Specialist I at Alight Solutions LLC
Jolene NixonJolene Nixon
Creative Project Manager II at Alight Solutions, LLCCreative Project Manager II at Alight Solutions, LLC
Francisco SegoviaFrancisco Segovia
Staff Accountant at Kaspar & White CPAStaff Accountant at Kaspar & White CPA
Tanner PattonTanner Patton
Youth Pastor at Ebenezer Baptist ChurchYouth Pastor at Ebenezer Baptist Church