Summary
Overview
Work History
Education
Skills
Timeline
Generic

SONYA RUSSELL

Nashville,US

Summary

Patient Care Coordinator with a strong focus on care planning and case management. Offering 8 years of Medicare and Medicaid experience as well as a thorough understanding of various insurance policies. Demonstrated ability to use management principles to advocate for the needs of patients and healthcare organizations. Compassionate Nurse Case Manager offering 10 years of experience working with patients and families to facilitate smooth transitions following discharge from medical facilities. Committed to working collaboratively with health plan, leadership and department coordinators to achieve highest quality of patient satisfaction. Well-versed in developing individualized care plans and advocating patient welfare.

Overview

11
11
years of professional experience

Work History

RN Case Manager

HCA Healthcare Inc.
12.2023 - Current
  • Provided emotional support to patients coping with chronic illness or end-of-life decisions, fostering resilience during difficult times.
  • Managed complex cases involving multiple comorbidities, requiring close monitoring and coordination of various healthcare services.
  • Collaborated closely with physicians to develop individualized treatment plans, supporting optimal patient outcomes.
  • Educated patients and families on available community resources, facilitating access to necessary support services.
  • Reduced hospital readmission rates through effective case management and patient education on self-care techniques.
  • Enhanced patient care by developing comprehensive care plans and coordinating with interdisciplinary healthcare teams.

RN Complex Transition Nurse

Amerigroup Medicaid
03.2023 - 11.2023
  • Collaborated with interdisciplinary teams for comprehensive patient care plans, resulting in better health outcomes.
  • Assisting individuals within the Choices Program with care and services in their homes or facilities within Davidson and surrounding counties.
  • Managed patient caseloads effectively, ensuring timely interventions and thorough follow-ups to mitigate potential complications.
  • Coordinated discharge planning efforts with social workers, case managers, and other multidisciplinary team members for smooth transitions post hospitalization.

LTSS Care Coordinator

Amerigroup Tennessee Inc
06.2015 - 02.2023
  • Responsible for overall management of member's case within the scope of licensure; provides supervision and direct participating in the member's case in accordance with applicable state law and contract; develops, monitors, evaluates, and revises the member's care plan to meet the member's needs, with the goal of optimizing member health care across the care continuum
  • Including telephonic or face-to-face clinical assessments for the identification, evaluation, coordination and management of member's needs, including physical health, behavioral health, social services and long-term services and supports within Medicare and Medicaid program.

Home Health Nurse

HighPoint Homecare
03.2013 - 05.2015
  • Provides services within the scope of practice as defined by the state laws governing the practice of nursing
  • Complete in-home patient visits and provides nursing care according to plan of care
  • Completes a progress note for each visit and submits progress notes to the agency daily
  • Continually observes and reports the patients' nursing needs
  • Instructs the patients family in the care of the patient and maintenance of a healthy environment for the patient
  • Adheres to and participates in the Care Management process.

Education

Bachelor of Science - Nursing

East Tennessee State University
Johnson City, TN
01.2023

Licensed Practical Nurse -

Tennessee Technical and Vocational School
Nashville, TN
01.2000

Skills

  • Care planning
  • Regulatory compliance
  • Case management
  • Conflict resolution
  • Insurance practices
  • Problem solving
  • Interdepartmental collaboration

Timeline

RN Case Manager

HCA Healthcare Inc.
12.2023 - Current

RN Complex Transition Nurse

Amerigroup Medicaid
03.2023 - 11.2023

LTSS Care Coordinator

Amerigroup Tennessee Inc
06.2015 - 02.2023

Home Health Nurse

HighPoint Homecare
03.2013 - 05.2015

Bachelor of Science - Nursing

East Tennessee State University

Licensed Practical Nurse -

Tennessee Technical and Vocational School
SONYA RUSSELL