STEPHANIE L HIGHT
West Chester,PA
Summary
I have been a Registered Nurse for many years, with managerial, instructional, and Clinical experience in Medical-Surgical, Pediatric and Adult populations, Chemotherapy, and Dermatology. I have much knowledge as a Nurse Case Manger along with Clinical Liaison experience. I believe I am a well-rounded RN who enjoys helping and working with others.
Overview
26
26
years of professional experience
1
1
Certification
Work History
Care Coordinator
Erickson Advantage
Glen Mills, PA
07.2019 - Current
- Provide authorizations for facilities and several vendors
- Created In-patient and Out-patient cases in Case Trakker
- Followed and performed Utilization Review for our Skilled facility
- Followed DME needs for all EA members
- Discussed care plans with the doctors and nurses re: the care needs for the EA members.
Nurse Case Manager
THE CHESTER COUNTY HOSPITAL
West Chester, PA
11.2010 - Current
- Discharge Planning for Medical-Surgical Patients
- All utilization review completed for all insurances
- Computer interaction to complete all case management tasks
- Daily interaction with the nurses and physicians to perform accurate and safe discharge.
PEMBROOKE HEALTH & REHABILITATION
West Chester, PA
12.2008 - 03.2012
- Clinical Liaison
- Performed all utilization review for the managed care population
- Provided the marketing for the facility
- Assessed all population in facilities for appropriate admission
- Worked closely with the Admissions Director and the management team
- Worked closely with all the social workers and case managers in the hospitals and long term acute care facilities
- Provided teaching to the facilities along with helping the families transition to our facility.
Case Manager
11.2005 - 01.2008
- Discharge Planning for Medical-Surgical Patients
- All utilization review completed for all insurances
- Computer interaction to complete all case management tasks
- Daily interaction with the nurses and physicians to perform accurate and safe discharge (I started as a Full-Time
Case Manager
01.2005 - 01.2008
- Continued to work per diem for Chester County hospital from 11/2010
- (While I was working full-time at Pembrooke as a Clinical Liaison, the Hospital created a part-time position for me, which is where I am currently working)., Continued to work per diem for Chester County hospital from 11/2010
- (While I was working full-time at Pembrooke as a Clinical Liaison, the Hospital created a part-time position for me, which is where I am currently working).
Appeals Coordinator
BRANDYWINE HOSPITAL
Coatesville, PA
04.2005 - 11.2005
- Denial and Appeal's
- Evaluate and read medical charts to review pertinent information for an appeal
- Discuss cases with other healthcare professionals, to gather facts regarding individual cases
- Write appeal letters daily to overturn any drop in level of care or denials
- Communicate with several insurance companies pertaining to a specific case
- Document a log of all denials and overturned appeals (Changes were being made, and the position was eliminated).
UR/Nurse Complex Case Manager
AETNA, King of Prussia, PA
05.2003 - 03.2005
- Converse with medical professionals and coordinate care pertinent to their current health needs by utilizing other facilities/vendors regarding HHC, Rehab., Hospice and DME equipment
- Correlate care with the medical directors regarding current health status
- Discuss cases with the Nursing Case Manager Supervisor relevant to the members' specific health needs.
Education
AAS -
DELAWARE COUNTY COMMUNITY COLLEGE
RN License in PA - undefined
1997
NURSING, Academics and Clinical Setting - undefined
1995
AAS - NURSING, Clinical
Crozer Chester Medical Center
1995
Skills
- Read and review Medical Charts
- Insurance
- Marketing
- Nursing
- Teaching
- Customer service
- Computer skills
- Organization
- Discharge Planning
- People skills
- Problem resolution
- Critical thinking
- Decision-making
Accomplishments
Chosen for Clinical Excellence in Nursing School.
Received Orthopedic Case Manager certificate.
Chemo Therapy Certified.
Certification
- Case Management - 2005-2008 at Chester County Hospital
Timeline
Care Coordinator
Erickson Advantage
07.2019 - Current
Nurse Case Manager
THE CHESTER COUNTY HOSPITAL
11.2010 - Current
PEMBROOKE HEALTH & REHABILITATION
12.2008 - 03.2012
Case Manager
11.2005 - 01.2008
Appeals Coordinator
BRANDYWINE HOSPITAL
04.2005 - 11.2005
Case Manager
01.2005 - 01.2008
UR/Nurse Complex Case Manager
AETNA, King of Prussia, PA
05.2003 - 03.2005
AAS -
DELAWARE COUNTY COMMUNITY COLLEGE
RN License in PA - undefined
NURSING, Academics and Clinical Setting - undefined
AAS - NURSING, Clinical
Crozer Chester Medical Center
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